Place of service 10 (telehealth provided in patient’s home) entered Medicare billing in 2022. Many practices treated it as a synonym for POS 02. It is not. The definitions differ, the payment rates differ, and documentation must support where the patient actually was. eBillRCM expects telehealth POS accuracy to stay a medical-review priority.
Definitions that matter
POS 02: telehealth provided other than in the patient’s home — for example a clinic, hospital, or other non-home originating site.
POS 10: telehealth provided in the patient’s home — residence, including settings such as assisted living when the patient is at that home location for the encounter.
The default-to-10 problem
Coding every virtual visit as POS 10 because reimbursement is higher fails when the patient was in a SNF, inpatient rehab, workplace, or other non-home site. The note must support home location.
One durable sentence is usually enough: patient confirmed the telehealth visit was conducted from their home in [city, state]. Audits often turn on whether that confirmation exists.
Modifier 95 vs modifier 93
Modifier 95 indicates synchronous audio and video. Modifier 93 indicates audio-only. They are not interchangeable. Some payers reduce or deny audio-only for selected CPT codes. If a video visit drops to audio for most of the encounter, code what actually dominated and document the technical reason.
Three checks for this month
- 1Split last quarter’s telehealth claims by POS. Near-100% POS 10 usually means a default template, not a real home mix.
- 2Sample 20 notes for an explicit patient-location statement. Under 80% is a documentation gap.
- 3Compare 95 vs 93 allowed amounts by payer so audio-only underpayment is visible, not surprising.
Telehealth billing rewards precision, not habit. Align POS, modality modifier, and the note — before an auditor does the alignment for you.