The rapid growth of telehealth has redefined how care is delivered, and how it’s billed. For providers across New York, navigating this new frontier is more than a convenience issue; it’s a compliance and revenue-critical challenge. That’s why many practices are turning to specialized medical billing services New York to streamline reimbursement and stay ahead of evolving payer policies.
In 2025, understanding telehealth billing helps you in many ways. It’s essential for maintaining cash flow, avoiding denials, and delivering patient-centered care in the Empire State.
1. The State of Telehealth in New York: Where Are We Now?
New York has embraced telehealth with open arms, spurred by pandemic-era necessity and sustained by state-backed expansion policies. Legislation like the New York State Telehealth Reimbursement Parity Law ensures providers are reimbursed at comparable rates for virtual visits.
However, this expansion has introduced new documentation requirements, coverage limitations, and billing complexities that vary by payer, procedure, and location.
2. Key CPT & HCPCS Codes for 2025
Correct coding is critical to getting paid for virtual services. As of 2025, the most frequently used telehealth billing codes in New York include:
- CPT 99421–99423 – Online digital E/M services
- CPT 99212–99215 – Office/outpatient visits, established patients (when delivered via video)
- HCPCS G2025 – FQHC telehealth services
- Modifier 95 – For synchronous telemedicine services
- Place of Service (POS) 10 or 02 – To indicate telehealth delivery location
Payers may require different combinations of codes, modifiers, and POS designations—so staying current is crucial.
3. Top Billing Pitfalls for NY Practices to Avoid
Even seasoned providers can face billing errors. Common telehealth-related issues include:
- Missing modifiers (especially Modifier 95)
- Incorrect place-of-service codes
- Improper use of time-based CPT codes
- Failing to meet documentation standards for virtual visits
Partnering with a professional billing company ensures these technicalities don’t derail revenue.
4. NY Medicaid & Commercial Payer Variations
Medicaid in New York offers relatively broad telehealth coverage, but commercial payers like Aetna, UnitedHealthcare, and Empire BlueCross BlueShield each have distinct policies and preauthorization requirements. Providers must also track:
- Allowed platforms (HIPAA-compliant only)
- Patient consent documentation
- State-specific telepsychiatry rules
5. Why Outsourcing Telehealth Billing Makes Sense
Given the complexity and rapid change in billing protocols, outsourcing is becoming standard for New York-based practices. Specialized firms offering medical billing services in New York provide:
- Real-time payer policy updates
- Claims scrubbing with telehealth-specific logic
- Denial management and appeals
- Revenue cycle analytics tailored to telehealth
With this level of expertise, denials can be reduced significantly which leads to more reimbursements.
Conclusion
Telehealth has already become the present of healthcare. But staying compliant with telehealth billing in New York demands precision, vigilance, and expert support. Whether you’re a solo practitioner or a growing multi-specialty clinic, aligning with experienced billing partners ensures you’re not just meeting patient needs, but getting paid properly for it.
Lynn Martelli is an editor at Readability. She received her MFA in Creative Writing from Antioch University and has worked as an editor for over 10 years. Lynn has edited a wide variety of books, including fiction, non-fiction, memoirs, and more. In her free time, Lynn enjoys reading, writing, and spending time with her family and friends.
