Telehealth Coding in 2026: The Skills That Make You Indispensable to Any Team

In 2025, nearly one in four Medicare fee-for-service beneficiaries who received telehealth-eligible services used telehealth. For medical coders, this shows that telehealth is no longer a temporary accommodation. The coding rules, however, keep changing, which means coders are expected to learn and adapt right along with them.  

Know what kind of virtual service you’re coding 

The first step in coding a telehealth encounter is figuring out what type of service was provided. From there, everything else falls into place, including billing and documentation requirements. Types of service include: 

• Audio-video visits: real-time encounters using both video and audio 

• Audio-only visits: phone-based encounters without a video component 

• E-visits: patient-initiated communication through a portal 

• Virtual check-ins: brief patient-initiated contact to decide if a visit is needed 

• Remote physiologic monitoring (RPM): ongoing tracking of physiologic data like blood pressure or glucose 

• Remote therapeutic monitoring (RTM): tracking of therapy-related data such as pain levels or medication adherence 

In 2026, remote monitoring coding expanded further, adding more granularity to how monitoring time and data collection get reported. This means more room for error if the service type is misidentified from the start.  

A coder who can look at a note and correctly name the service, before moving into a code set, is already ahead of most denial patterns — because getting it wrong sends the rest of the claim down the wrong path, no matter how well the following codes are chosen. In short, they’ve got the skill that everything else builds on.  

Become fluent in payer rules 

Just because CPT recognizes a code doesn’t mean a payer will reimburse for it. Knowing the difference can prevent a lot of rework. Medicare, Medicaid, and commercial payers each set their own rules for telehealth, and those rules do not move in sync. Place of services matters here. POS 02 applies when the patient is somewhere other than home, POS 10 applies when the patient is at home, and mixing the two up is one of the more common reasons a solid-looking claim gets rejected.  

Then there’s audio-only care. Some visits can be billed, some can’t. And in many cases, the answer depends as much on the payer’s policy as it does on CPT. Medicare’s own telehealth landscape reflects the split. Several flexibilities from the pandemic era, including audio-only coverage for non-behavioral services and expanded originating sites, are now extended through December 31, 2027, under recent legislation. A smaller set of policies, mostly tied to behavioral health, have been made permanent. Knowing which rules fall into which category makes it easier to catch potential issues before a claim is submitted.  

Catch documentation and denial risks early 

Telehealth-related denials rose 84% in 2025, which reflects just how much scrutiny payers now apply to virtual visits. The patterns behind those denials are fairly consistent, and most trace back to a handful of usual suspects, including: 

• Modality mismatches between what was billed and what occurred 

• Missing or unclear documentation of patient location 

• Missing time or medical decision-making documentation when the code requires it 

• Unclear ties between the telehealth visit and any related service 

• Modifier of place-of-service errors 

• Documentation that meets general standards but not a specific payer’s requirements  

A coder is not responsible for missing documentation. The coder’s job is to identify when the documentation does not support the claim and ask the provider to address the gap before the claim is submitted. Finding the problem early takes mere minutes, whereas finding it after a denial can mean resubmitting the claim, filing an appeal, and waiting longer for payment. Reviewing documentation with these common risk points in mind can help reduce claims denials. 

Building the skills your team (and recruiters) will notice 

Telehealth expertise is a win-win for coders, whether you’re looking for a new position or growing within your organization.  

In either case, focus on four capabilities: 

• Payer-policy fluency, which means knowing how to find, interpret, and apply current guidance instead of relying on what worked in the last similar claim. 

• Documentation judgment, which helps you recognize whether the record supports the service and when a question needs to be raised. 

• Denial analysis, which enables you to see patterns across claims and find problems that may be affecting an entire workflow.  

• Provider communication, which helps turn coding knowledge into better documentation and cleaner claims by giving clinical teams clear guidance.  

If you’re on the job hunt, show employers how you have used those skills. “Telehealth coding experience” says much less than explaining that you maintained payer-specific guidance, investigated recurring denials, audited modifier and POS usage, or helped providers improve virtual-care documentation.  

If you’re staying put, the same abilities apply and can make you the person colleagues consult when the telehealth environment changes or a certain claim raises a new question.  

Judge works with healthcare organizations across the country hiring medical coders with exactly these skills. Browse our open positions to see where your expertise fits.