Telehealth Billing Checker
Which place-of-service code and modifier belong on this telehealth claim? Tell us the payer, the service, the technology, and where the patient sat — and get the standard combination plus the policy checks that matter.
Most telehealth denials are coding mismatches, not coverage decisions. A claim with POS 11 for a patient who was at home, or a missing audio-only modifier, gets rejected even when the visit itself is fully covered. The standard building blocks are simple: POS 10 when the patient is at home, POS 02 when the patient is somewhere else, modifier 95 for audio-video, and modifier 93 for audio-only. Which combination a given payer wants — and whether the service is covered by telehealth at all — depends on the plan. Answer four questions for the recommended starting point.
Check a telehealth claim
Step 1 of 4
The standard telehealth codes, in one table
| Element | Code | Meaning |
|---|---|---|
| Place of service | 10 | Telehealth provided in the patient's home |
| Place of service | 02 | Telehealth provided other than in the patient's home |
| Modifier | 95 | Service furnished via real-time audio and video telecommunications |
| Modifier | 93 | Service furnished via audio-only (telephone) technology |
| Modifier (behavioral health settings) | FQ / FR | FQ: mental health service furnished using audio-only technology. FR: supervising practitioner present through a virtual presence. Used mainly in Medicare RHC/FQHC behavioral-health contexts. |
The rule that decides most telehealth claims is also the simplest: the POS describes where the patient was, not where the provider was. A provider sitting in the office with a patient at home is POS 10, not POS 11. Get the location from the visit note — if the note does not say where the patient was and how the visit was conducted, the claim is a guess. Our mental health billing team sees telehealth POS/modifier mismatches among the most common — and most fixable — behavioral health denials.
Disclaimer: This checker is educational only. It is not medical, legal, or billing advice for a specific case, and it does not guarantee coverage or payment. Telehealth rules change frequently and differ by payer, plan, state, and date of service; confirm the current payer policy with CMS or the payer before billing.
Frequently asked questions
What is the difference between POS 10 and POS 02?
POS 10 means the patient was at home during the telehealth visit. POS 02 means the patient was somewhere other than home — a clinic, hospital, school, or other location. The code follows the patient's location, not the provider's.
When do I use modifier 95 versus modifier 93?
Modifier 95 is for services furnished through real-time audio-video technology. Modifier 93 is for audio-only (telephone) services. Audio-only coverage is usually narrower — many payers limit it largely to behavioral health — so check the plan's policy before the visit, not after the denial.
Does Medicare require modifier 95 on telehealth claims?
Medicare fee-for-service generally identifies telehealth services through the place-of-service code (10 or 02) rather than modifier 95, though instructions can vary by service and over time — follow your MAC's current guidance. Most commercial payers and many Medicaid programs do require modifier 95 (video) or 93 (audio-only).
What should the visit note document for a telehealth claim?
At minimum: that the visit was conducted by telehealth, the modality (audio-video or audio-only, and why if audio-only), the patient's location, the provider's location, patient consent, who participated, and the total time or the medical decision-making supporting the code billed. Missing modality or location documentation is a leading cause of telehealth audit findings.