OB/GYN Telehealth Billing Services

Telehealth in OB/GYN is here to stay

Telehealth fits women's health naturally. Many prenatal check-ins, postpartum mood follow-ups, contraception visits, lab and imaging result reviews, and menopause management visits don't require a physical exam. Patients appreciate not having to take time off work or arrange childcare, and practices can fit more access into the schedule.

Billing for those visits is another matter. Telehealth rules vary by payer, change frequently, and interact with OB/GYN-specific rules like the global maternity package. A virtual visit that's coded correctly for a commercial plan can be wrong for Medicare, and a code that pays this year may be deleted next year. With more than eight years in OB/GYN billing, we've tracked these changes as they happened and built payer-specific rules into our workflow.

The building blocks of a telehealth claim

Place of service (POS)

Some commercial payers instead want the POS where the visit would have occurred in person (usually 11, office) plus modifier 95. We follow each payer's instruction.

Modifiers

• 95 — synchronous audio-video telemedicine. Widely required by commercial and Medicaid plans.
• 93 — synchronous audio-only telemedicine.
• GT — older audio-video modifier; still used in limited situations, such as Medicare critical access hospital method II billing and some state Medicaid programs.
• FQ — audio-only services furnished by rural health clinics and federally qualified health centers under Medicare.

Read our detailed comparison: modifier 95 vs 93 vs GT.

Visit codes

• Office/outpatient E/M codes 99202–99215 remain the codes Medicare uses for most telehealth visits, with the telehealth POS and any required modifier.
• Telemedicine E/M codes 98000–98015, introduced in CPT 2025, describe audio-video (98000–98007) and audio-only (98008–98015) visits. Coverage varies widely — Medicare generally doesn't pay most of them, while some commercial plans have adopted them.
• Brief virtual check-in 98016 replaced HCPCS G2012 in 2025.
• Online digital E/M 99421–99423 for patient-initiated portal communication over a seven-day period.
• Interprofessional consultations 99446–99452 for physician-to-physician consults, where covered.
• Remote physiologic monitoring (for example 99453, 99454, 99457, 99458), which some practices use for postpartum blood pressure monitoring.

Code selection follows each payer's adoption of the newer codes, which is exactly the kind of moving target that causes telehealth denials.

Medicare telehealth status

The Consolidated Appropriations Act, 2026 extended the core Medicare telehealth flexibilities through December 31, 2027: patients can receive telehealth at home, geographic restrictions are lifted, and audio-only services are allowed where clinically appropriate. We watch CMS guidance closely and update billing rules as policy changes.

Telehealth and the global maternity package

This is where OB/GYN telehealth billing gets specialty-specific:

• Routine prenatal visits delivered virtually are generally part of the global package through 2026, just as they would be in person. They count toward the antepartum visit total but aren't billed separately.
• Problem-oriented visits during pregnancy — for example, managing hyperemesis or gestational diabetes beyond routine care — may be separately billable with the appropriate O-codes, whether in person or virtual.
• Postpartum follow-up within the global package isn't billed separately; postpartum depression screening and other services may be.
• Starting January 1, 2027, prenatal and postpartum visits will be reported per encounter using E/M codes, including telehealth visits. See our 2027 maternity transition guide.

Post-operative telehealth visits inside a surgical global period follow the same logic — they're included unless the visit addresses something unrelated.

Documentation for telehealth visits

Payers that audit telehealth claims look for:

• The patient's consent to telehealth (where required by state law or payer policy)
• The modality used — audio-video or audio-only — and, for audio-only, why video wasn't used
• The patient's location and the provider's location
• The same clinical documentation required for an in-person visit, supporting the E/M level by MDM or total time
• Start and end times when time is used to select the level

State Medicaid and commercial payer differences

Every state Medicaid program sets its own telehealth policy, and Medicaid managed care plans can add their own rules. Commercial plans vary in which modifiers, POS codes and visit codes they accept, whether audio-only visits are covered, and whether telehealth is paid at parity with in-person visits. We maintain a payer-by-payer rules table for each client's payer mix and update it when policies change.

Common telehealth billing errors we fix

• Billing POS 11 without modifier 95 to a payer that requires the modifier
• Using modifier 95 on an audio-only call
• Billing telemedicine codes 98000–98015 to payers that don't recognize them
• Separately billing routine virtual prenatal visits that are part of the global package
• Missing documentation of patient location or consent
• Billing the old audio-only codes 99441–99443, which were deleted in 2025

Part of complete OB/GYN billing

Telehealth billing is included in our revenue cycle management service, and our coding audits can review your telehealth claims specifically if you'd like an independent check.

Which OB/GYN visits work well as telehealth

From a billing perspective, these visit types are commonly delivered and billed as telehealth in women's health — subject to clinical judgment and payer coverage:

• Results reviews for labs, imaging and pathology
• Contraception counseling and follow-up (excluding device procedures)
• Postpartum check-ins, including mood screening follow-up
• Menopause and hormone therapy management
• Management of gestational diabetes or hypertension between in-person visits
• Pre-operative counseling and some post-operative follow-ups (noting surgical global periods)
• Fertility consultations and treatment planning

Visits that require a pelvic exam, ultrasound or procedure need to be in person — and when a telehealth visit leads to a same-day in-person visit, payers may expect only one E/M for the day.

Get a free telehealth billing review

Send us a WhatsApp message. We'll review a sample of your recent virtual visits — codes, modifiers, POS and documentation — and show you what each of your payers expects. No forms and no cost.