Telehealth & Hybrid Care Billing: What Practices Must Know in 2025

Adapting to the New Era of Hybrid Care

Telehealth is no longer a temporary solution—it’s an essential part of the modern healthcare experience. As practices blend in-person and virtual visits, billing and reimbursement rules continue to evolve.

At One Source Medical Billing, we help healthcare providers stay compliant and profitable by keeping up with telehealth billing changes that matter most in 2025.

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1. Understanding 2025 Telehealth Codes & Rules

Both Medicare and private payers have refined their telehealth coverage lists for 2025. Practices must ensure their billing teams are using the right CPT and POS codes to avoid costly denials.

Key billing updates:

• POS 10: Telehealth provided to the patient in their home
• POS 02: Telehealth provided to a patient outside their home
• Modifiers: Use 95 (synchronous telemedicine) or GT when required by specific payers
• CPT Codes: Continue using 99212–99215 for virtual E/M visits and 99457–99458 for remote monitoring

🔍 Tip: One Source Medical Billing offers real-time payer policy tracking to help your team stay compliant across all telehealth services.

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2. Documentation: The Key to Denial Prevention

Payers now require detailed documentation for telehealth encounters. Missing even a single data point—such as consent or technology type—can lead to denied claims.

Documentation checklist:

• Start and end times for each session
• Provider and patient location
• Patient consent for telehealth
• Type of technology used (video or audio-only)

Our billing experts review your telehealth documentation for accuracy before claim submission, minimizing rejection rates.

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3. Billing for Hybrid Care Models

Hybrid care often combines in-person and virtual visits for the same patient. Without the right billing workflows, it’s easy to confuse codes or underbill services.

Our solution:
At One Source Medical Billing, we implement automated billing workflows that distinguish between telehealth and in-office encounters, ensuring accurate coding and faster reimbursements.

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4. Stay Ahead of Payer Policy Changes

Every payer updates their telehealth rules differently. Medicare, Medicaid, and commercial insurers may have unique policies—and keeping track of them manually is time-consuming.

We help practices maintain a centralized payer compliance dashboard that alerts you to:

• New telehealth coverage updates
• Modifier and POS changes
• Downcoding risk alerts

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5. Remote Monitoring & Asynchronous Care

In 2025, remote patient monitoring (RPM) and asynchronous messaging are becoming key revenue streams for providers.

Examples:

• RPM (99453–99458): Monitoring patients with connected health devices
• CCM (99490, 99491): Chronic care management for multiple conditions
• E-visits (99421–99423): Secure online communication between patient and provider

Our team helps you identify billable virtual care services you might be missing—and make sure you’re billing them correctly.

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6. Compliance & Audit Protection

Telehealth billing errors are among the top reasons for payer audits in 2025. To protect your revenue, One Source Medical Billing conducts proactive compliance reviews and internal audits of your virtual care claims.

We focus on:

• HIPAA-compliant documentation practices
• Retaining consent forms and tech verification logs
• Ongoing staff training for coding and modifier use

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7. Why Choose One Source Medical Billing?

We specialize in helping healthcare providers adapt to evolving billing regulations. Whether your practice offers telehealth, in-office visits, or both, our team ensures your claims are accurate, timely, and compliant.

Our services include:

• Full-service medical billing & coding
• Denial management and revenue recovery
• Payer policy monitoring
• Compliance and audit support

Partner with a billing company that understands today’s hybrid care landscape—and helps you get paid faster.

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Ready to Improve Your Telehealth Billing in 2025?

Contact One Source Medical Billing 888-624-5563 today to learn how our experts can simplify your telehealth and hybrid care billing processes.

📞 Schedule a Consultation