Current telehealth billing rules for OB/GYN visits, including which visit types qualify and which modifiers apply.
Telehealth billing rules have stabilized somewhat since the rapid changes of the pandemic years, but OB/GYN-specific nuances still trip up practices — particularly around which visit types are appropriate for telehealth at all, and how to bill them correctly when they are.
Which OB/GYN Visits Are Appropriate for Telehealth
Certain antepartum visits — particularly ones focused on counseling, medication review, or lab result discussion rather than physical assessment — are well suited to telehealth. Visits requiring physical exam, fetal heart tones, or in-person testing are not, regardless of payer telehealth policy, simply because the clinical need doesn't disappear.
Modifier and Place of Service Requirements
Correctly identifying a telehealth visit to a payer requires the right combination of modifier and place-of-service code, and the specific requirement varies by payer. Our companion piece on [telehealth modifiers 95 and GT](/blog/telehealth-modifiers-explained) covers this distinction in detail.
Billing Within a Global Maternity Package
One nuance specific to OB/GYN: if a telehealth visit is part of the routine antepartum care already covered under [global maternity billing](/global-maternity-billing), it isn't billed separately regardless of whether it happened via telehealth or in person — the delivery method doesn't change the bundling rules.
Key Takeaways
- ›Telehealth appropriateness should be a clinical decision first, billing decision second
- ›Modifier and place-of-service requirements vary by payer — verify before relying on assumption
- ›Telehealth visits inside the global maternity window are still bundled, not separately billable
Telehealth billing errors tend to be quiet — claims process without an obvious denial, but at a reduced or incorrect rate. A periodic review as part of your broader [coding audit](/coding-audits) process is the most reliable way to catch this.