Documentation

Telehealth Coverage by Payer


Telehealth Coverage Overview

Every major payer covers telehealth services, but the rules differ on eligible services, modifiers, POS codes, originating site requirements, and audio-only coverage. Verifying each payer's telehealth policy before billing prevents an estimated 12-15% of telehealth claim denials. This page compares the five largest payers' current telehealth policies.

Payer Comparison

Payer Video E/M Audio-Only BH Telehealth Modifier Parity
Medicare Yes 99441-99443 Yes (90834, 90837) 95 Yes (POS 10)
UnitedHealthcare Yes Limited Yes 95 Yes
Anthem Yes State-dependent Yes 95 Yes (most states)
Aetna Yes 99441-99443 Yes 95 Yes
Cigna Yes Limited Yes 95 Yes

Medicare Telehealth Rules

Medicare covers 250+ telehealth-eligible services. Geographic restrictions were permanently waived for behavioral health services. For medical services, the patient must be at a qualifying originating site (rural area) unless the provider is using POS 10 under the extended COVID-era flexibility. Audio-only E/M (99441-99443) is covered for established patients when video is not feasible. See CMS telehealth billing rules for the full regulatory framework.

Commercial Payer Notes

UnitedHealthcare covers telehealth at parity with in-person visits but requires pre-registration of telehealth providers. Anthem's telehealth coverage varies by state — check the state-specific provider manual. Aetna covers telehealth through their partnership with Teladoc for on-demand visits and through standard provider networks for scheduled telehealth. Cigna covers video visits at parity but restricts audio-only to behavioral health in most plans. See telehealth modifiers for payer-specific modifier and POS requirements.

Common Questions About Telehealth Coverage

Will telehealth parity continue after the public health emergency extensions expire?

Most states have passed permanent telehealth parity laws. At the federal level, Medicare telehealth flexibilities have been extended through 2026. Commercial payers have largely adopted telehealth as a permanent benefit. Check your state's telehealth parity statute for ongoing requirements.

Can I provide telehealth to patients across state lines?

You must be licensed in the state where the patient is located at the time of the visit. Some states participate in interstate compacts (Psychology Interjurisdictional Compact, Interstate Medical Licensure Compact) that simplify multi-state practice. Check your professional licensing board.

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← Back to Telehealth Reference

This reference is for informational purposes. Always verify against current payer policies, CPT guidelines, and CMS documentation. Last updated: 2026-04-06.