Telehealth Coding Reference Guide: The Telemedicine CPT Codes Your Practice Should Know

The rise of telemedicine ranks among the more significant changes in healthcare following the COVID-19 pandemic. It is now an integral part of our healthcare system and can be an effective way to serve more patients and offer current patients flexibility. The administrative process for telehealth, however, can be complex and is a common area where practices can optimize their workflow, especially with telehealth coding. To help, this guide includes the most popular telemedicine codes and telemedicine coding mistakes to avoid.

What Is Telemedicine?

Telemedicine refers to any healthcare delivery method where someone meets with a clinician virtually – by phone or using video conference technology – instead of in person. It’s a great option when distance separates practitioners and patients, such as in rural settings or when life or work gets busy for patients. 

Let’s say a patient with arthritis needs regular check-ins with an orthopedic practice. In a traditional medicine model, the patient would commute to the practice’s physical location for each checkup. If the practice offers a telemedicine option, they may attend some checkups virtually, via a video conferencing software or an audio call. 

For clinicians, it’s also an opportunity to make your services more accessible and to grow your practice. During the pandemic, ImageLift had to close the doors to their physical office. The practice invested in administrative technology built to easily accommodate telehealth appointments, allowing them to offer patients the convenience of virtual appointments at a time when in-office meetings weren’t possible. These appointments brought in over $179,000 in revenue in six weeks. Fast forward to today, ImageLift still offers patients the flexibility of choosing telehealth services, which has provided an opportunity to grow their patient base with the appeal of convenient telemedicine offerings.

Should your practice decide to invest in telemedicine, know that you’re expanding access to your healthcare services, providing flexibility for patients and staff, and opening new opportunities to grow your business. It’s a smart way to enhance the patient experience and improve your financial performance over the long term. Make sure your team is prepared for the changes to come by implementing the right tools and processes to offer and properly document telehealth services. 

What CPT Codes Qualify for Telemedicine? 

Telemedicine is a rapidly growing field, but the CPT codes haven’t kept up with telehealth’s growth. To help, the Center for Medicare and Medicaid Services documented standard codes for telehealth services. 

At first, these codes were temporary and reserved for public health emergencies (PHE), such as the pandemic. In 2024, they rolled out new CPT coding guidelines for non-emergencies. These codes were based on the data collected from those initial PHE codes and some of the most common telehealth codes from this rollout are featured in this reference guide.

Note: The codes listed here are intended to be representative only and should not be considered a comprehensive list of all common CPT codes for telemedicine.

Codes for Virtual/Digital Visits

Digital appointments with both video and audio feed are the most common type of telehealth appointment. They have their own unique set of codes:

• 99202-99205: Office or outpatient visit with a new patient
• 99212-99215: Office or outpatient visit with an established patient 
• 99221-99223: Initial hospital care
• 99231-99233: Subsequent hospital care
• 99234-99236: Observational care at a hospital, same date 

Codes for Audio Only

The virtual/digital codes above cannot be used for audio only appointments or discussions. When an appointment is audio only, the following codes are used: 

• 99441: Telephone evaluation and/or management services
• 99441: 1-10 minutes of medical discussion via a phone call
• 99442: 10-20 minutes of medical discussion via a phone call
• 99443: 21-30 minutes of medical discussion via a phone call

Hybrid Codes

Since the pandemic, hybrid telehealth/in-person encounters – care that includes both virtual and in-person elements – have become more common. While hybrid codes don’t exist, it is important to keep track of what services were being delivered by telemedicine and which were delivered in person. 

Other Codes for Telehealth 

There are many industry-specific telehealth codes, which can be found on the Centers for Medicare and Medicaid’s website. For quick reference, other useful telehealth codes include:

• G0459: Telehealth inpatient pharmacy management
• G3003: Additional 15 minute appointment for pain management
• G0406: Inpatient telephone follow-up for 15 minutes
• G0407: Inpatient telephone follow-up for 25 minutes
• G0408: Inpatient telephone follow-up for 35 minutes
• G0425: Inpatient education teleconsult for 30 minutes
• G0426: Inpatient education teleconsult for 50 minutes
• G0427: Inpatient education teleconsult for 70 minutes

Teleconsult codes are generally used for telehealth appointments with video and audio feed, while telephone codes are used for audio only services.

Review Telehealth Regulatory Requirements and Security Concerns

Just because a practice offers telehealth services doesn’t mean regulatory requirements change. The regulatory requirements outlined by HIPAA may be even more pressing for telehealth providers, thanks to digital security concerns. An easy way to remain HIPAA-compliant is to invest in HIPAA-compliant telehealth technologies. An ophthalmology practice, for example, shouldn’t start hosting telehealth appointments through Instagram or WhatsApp, since these services are not HIPAA-compliant. Instead, they would need to invest in a HIPAA-compliant interface.

Billing and coding policies remain the same as well, though codes specific to telehealth are often used. These codes are still being built out by many insurance providers, but the Centers for Medicare and Medicaid Services offers a list of finalized codes. Referring to these codes (and checking for updates since telemedicine coding is changing quickly) is a great practice.

Common Mistakes When Coding Telehealth Visits

Medical coding is a standardized “language” that private practices, government payers like Medicare, and private insurance companies share. Uniform CPT coding supports efficient and accurate payments. 

While simple in theory, coding can get complicated quickly due to confusion around what codes to use. The right codes vary based on industry and service type; the codes for dermatology, for example, differ from the codes for ophthalmology. Learning the five most common coding mistakes (and how to avoid them) can help your practice build a more efficient coding process and revenue cycle management. 

1. Using Outdated Codes

Telehealth codes for Medicare and Medicaid were updated in June of 2024. As a busy practice owner or administrator, there’s a chance you missed this most recent update. To ensure your practice uses the most recent CPT codes, set aside time each quarter for you or a staff member to check any changes to codes in your industry or related to telemedicine.

2. Inadequate Training and Education on Codes

A common staff onboarding pitfall is assuming new staff members already have training in CPT coding. Even if they are experienced with the codes related to your industry, they won’t be familiar with your practice’s coding process and administrative technologies. To close that knowledge gap, offer training on CPT coding and your practice’s process as part of the onboarding process.

If you recently implemented telehealth services or are interested in doing so, extra training for all administrative staff can be part of the telehealth implementation.  

3. Delay in Coding

Often, CPT coding errors come from bulk coding at the end of the week. Bulk coding may save time in the short run, but it’s easy to forget supporting details when coding in retrospect. 

Instead, implement a process where staff complete coding and appointment documentation on the same day as an appointment. This could look like staff entering the billing code and supporting details right after an appointment and then reserving 30 minutes at the end of the day for administrative staff members to review the documentation of that day’s appointments.

4. Inefficient Coding Processes

Coding errors often stem from an inefficient coding process. Without clear guidelines, staff can be confused on what supporting details to document and where to document CPT codes and other details. 

To clarify any confusion, a practice administrator can spend a short amount of time organizing all the necessary details to document and creating a step-by-step list of how to code an appointment as a formal process for everyone to follow. This clear process can then be given to current employees and any future hires so everyone is on the same page.

5. Outdated or Inefficient Technology

Not long ago, coding was primarily done via a paper filing system, and some practices may have even had some rudimentary internal computerized process. Today, newer technologies can reduce coding errors and the time your team spends on coding.

To get the most out of your software, it’s important to choose administrative technologies that are built for your industry and directly integrate telehealth capabilities. Modern EHR and practice management software that is purpose-built for specific specialties can accommodate the clinical and administrative needs of practices looking to elevate their telemedicine efforts. A dermatology EHR is more likely to be equipped to handle codes related to that specific field, while that same EHR may not be the right choice for a cardiology practice. 

The Future of Telemedicine & Coding 

Codes for telehealth services are relatively new and continuing to evolve. As telehealth becomes more integrated into our healthcare system, coding guidelines will become clearer. Plus, newer technologies, like artificial intelligence, may make it easier to detect any coding errors or figure out the right code for specific services and scenarios. 

It’s too early to determine the immediate future telemedicine usage. Many factors such as the proliferation of healthcare consumerism and changing federal regulations will impact how telemedicine grows. In 2021, 37% of adults had a telemedicine appointment. A year later, that number fell to 30.1%. A main reason for decreased use is that many federal insurance providers covered more telehealth services during and in the immediate aftermath of the pandemic than they do today. 

In Medicare’s 2025 guidelines, the federal agency has removed coverage for most telemedicine services, except for individuals living in rural areas or who meet certain requirements. Keep this trend in mind when deciding how to incorporate telemedicine into your business plans. For example, you may decide that telemedicine is a better fit for elective procedures or for patients with private healthcare coverage.

Common Challenges and Solutions

When switching to telehealth, there are some common challenges practices face, such as ensuring their practice follows regulatory requirements, and that telehealth CPT codes align with industry and insurer standards.

A significant hurdle is protecting digital data. According to a survey conducted by the United Nations, one-third of responding health institutions experienced at least one ransomware or cyberattack in 2021. When you move healthcare service online, there are additional touchpoints where cybercriminals could steal healthcare data. Investing in telehealth and administrative technology with robust data protection policies may reduce your practice’s exposure to cybersecurity threats. 

Alongside regulatory and coding challenges, many practices struggle to determine the right telehealth services to offer. To decide what telehealth offerings are right for you, reflect on which appointments can be delivered virtually. A dermatology practice may find they can deliver most of their consultations virtually, while a plastic surgery practice may want to do an initial consultation in-person, with the option for virtual check-ins after a procedure. 

Resources for Staying Up to Date on Telehealth Coding 

Telehealth coding is still a work in progress, meaning it’s important to stay up to date on new regulations for telehealth more broadly and for delivering virtual care services within your field of medicine. 

While this reference guide is a great resource to bookmark, it’s not the only one. Other useful resources on telehealth coding include:

• The U.S. Department of Health and Human Services’ guide to telehealth
• The complete reference guide for ophthalmology, updated annually 
• Telemedicine coding resources for orthopedic practices
• Telemedicine coding guidelines when working with Medicare 
• Telehealth guidelines for plastic surgery practices
• Teledermatology coding and administrative guidelines

One of the most important resources for any specialty practice looking to enhance its telemedicine offerings is an EHR and PM platform designed for your industry that can seamlessly support both in-person and telehealth appointments. Nextech offers comprehensive, telemedicine-friendly software tailored to ophthalmology, plastic surgery, dermatology, and orthopedics. To learn if Nextech is the right partner for your practice, schedule a free demo.