As we move deeper into 2025, telehealth billing is undergoing another significant shift. The temporary flexibilities introduced during the COVID-19 public health emergency are winding down, and new CPT codes and modifiers have been introduced to reflect the evolving reality of telehealth reimbursement.

One of the most important upcoming changes: Medicare will soon roll back many of its current telehealth allowances, returning to pre-pandemic coverage rules. While telehealth remains active for now, providers should be preparing for a future in which Medicare coverage is more limited and narrowly defined—particularly for audio-only and non-rural services.

What’s Changed in 2025?

Several widely used telehealth codes—such as 99441–99443 for telephone E/M visits—have already been retired. In their place, practices must now use updated CPT codes and modifier 93 to accurately indicate audio-only services, when applicable.

At the same time, commercial payers are updating their own telehealth policies, resulting in inconsistencies across plans. What’s reimbursable varies from one payer to another, and the lack of standardization is creating confusion and coding risk for providers nationwide.

The Revenue Cycle Risks of Inaccurate Coding

Using outdated or incorrect codes can have real financial consequences. The impact of telehealth coding errors includes:

• Increased denials and rework
• Delayed reimbursements and growing A/R
• Underpayments or missed revenue due to resubmission timing
• Frustration among staff navigating unclear or shifting policies

With margins already tight for many practices, these preventable issues can quickly escalate and disrupt cash flow.

How IRCMS Helps You Stay Compliant—and Get Paid

At IRCMS, we take a proactive approach to telehealth billing. Our coding and billing experts monitor Medicare’s planned telehealth rollback, payer-specific policy changes, and CPT/HCPCS modifier requirements to ensure each claim is submitted correctly the first time.

We go beyond the codebook—educating your front office, providers, and billing staff on operational impacts and payer expectations. Whether it’s identifying where modifier 93 should be applied, or adjusting to pre-pandemic Medicare policies, our team helps you stay compliant and reduce costly errors.

Prepare for What’s Next in Telehealth

Telehealth isn’t going away—but how it’s reimbursed is changing. With Medicare shifting back toward pre-COVID rules and commercial payers redefining their policies, a forward-thinking coding strategy is more important than ever.

Let IRCMS help you navigate these changes with confidence. Contact us today to review your telehealth coding workflows and safeguard your revenue in 2025 and beyond.