Telemedicine pays when the EHR, the clinical note, and the claim all match. So what does it take to run eClinicalWorks telemedicine that bills cleanly from the first visit?
eClinicalWorks telemedicine setup runs through five billing-aware steps: activate healow TeleVisits, create a telehealth visit type, load consent forms and questionnaires, turn on patient notifications, and check the claim setup before go-live. Visits then bill on CPT codes 99202–99215, the place of service that matches where the patient sits during the visit, and modifier 95 for audio-video or 93 for audio-only services.
Telehealth has settled into routine care rather than a pandemic workaround. KFF reports that more than one in ten eligible Medicare beneficiaries used a telehealth service in a single quarter of 2025. The practices that profit from it are the ones whose scheduling, documentation, and claim configuration agree with each other. This guide covers both sides: the eClinicalWorks setup and the 2026 billing rules around it.
What eClinicalWorks Telemedicine Includes
eClinicalWorks delivers telemedicine through healow Telehealth Solutions, which cover scheduled TeleVisits and healowNOW on-demand virtual care. Patients join from a secure link sent by text or email, the healow app, the Patient Portal, or a plain browser, with no separate download. Staff can start visits on behalf of providers, complete intake, and hand patients to the clinician. Providers can enable captions and invite additional participants into an active visit.
Every visit writes into the same progress note as an office visit, on a computer, smartphone, or iPad, and Sunoh.ai can record the visit to support note-taking. Patients can pay copayments before or after the visit through digital check-in. On-demand visits display real-time wait times and connect patients with providers licensed in the patient’s state.
For billing teams, the important part is what sits underneath. Charges move from the signed note into practice management, where claim edit rules and denial queues are already in place. eClinicalWorks also offers a managed RCM service alongside its self-service billing tools.
Telemedicine Setup Steps That Affect Your Claims
Each step below changes something the claim depends on, so the order matters.
Activate healow TeleVisits
Open Admin > Product Activation in eClinicalWorks and activate healow TeleVisits, then register each participating provider with an email, NPI, and ZIP code. eClinicalWorks also offers a five-step activation wizard, shown in the company’s training videos, that configures providers in one pass. Registration matters to billing because the provider record supplies the details that fill claim fields.
Create a Telehealth Visit Type
Go to Admin > User Admin > Visit Type Codes and add a visit type such as Telehealth or Virtual Visit, with the healow TeleVisit checkbox selected. That checkbox is what gives the appointment audio and video capability. The visit type also sets the scheduling duration, the codes that populate the encounter, and the reminder template the patient receives. Billing teams can build claim edits around visit types, so a telehealth visit triggers the POS and modifier checks automatically. Once the visit type exists, scheduling an eCW TeleVisit works from the same provider or resource schedule as an office visit.
Load Consent Forms and Questionnaires
Telehealth consent is a legal document between the practice and its patients, and state rules shape what it must say. Each practice configures a single telehealth consent form, activated through the customer portal with help from eCW support. Once it is live, patients accept it before joining a visit. Questionnaires link to the telehealth visit type through the Form (Ques & Imm) Settings under Patient Portal Settings, and one questionnaire can be linked per visit type.
Turn On Patient Notifications
Under Patient Portal Settings > Email Message Settings, enable the TeleVisit email reminder and email confirmation. Both notifications arrive with templates, and patients can join the visit directly from the notification. Reminders reduce no-shows, and the confirmation creates the message trail that supports the appointment record.
Check the Claim Setup Before the First Visit
Run a full test visit before the first patient day. Audit the codes linked to the telehealth visit type and clear deleted codes from templates and charge sheets. Build claim edit rules that flag place-of-service and modifier mismatches on telehealth claims. One workflow detail protects revenue: charges entered on telephone encounters and virtual check-ins do not create claims automatically in eCW, so the person closing those notes must create the claim by hand. A test pass finds that gap before it costs revenue. Practices that outsource their eCW billing can also have these claim edits configured as part of setup.
Telehealth Place of Service: POS 10 vs POS 02
The place of service on a telehealth claim follows where the patient sits during the visit, not where the provider sits. CMS defines POS 10 as telehealth provided in the patient’s home and POS 02 as telehealth provided other than in the patient’s home. The Medicare Physician Fee Schedule pays POS 10 at the higher non-facility rate and POS 02 at the facility rate, so the patient’s location changes the payment.
Most telehealth visits happen in the patient’s home, which makes POS 10 the usual correct code. Billing teams sometimes default to POS 02 out of habit. Payers flag that mismatch first. Documenting the patient’s location in the note backs the code choice on review.
| POS code | Where the patient is | Medicare rate | Common billing error |
| 10 | In their own home | Non-facility rate, higher | Using 02 for a home visit |
| 02 | Anywhere other than home | Facility rate, lower | Assuming POS follows the provider |
CMS publishes the current POS definitions in its telehealth booklet for providers.
Telehealth Modifiers: 95, 93, FQ, and GT
| Modifier | Meaning | Who uses it |
| 95 | Synchronous audio-video telemedicine | Most payers for video visits |
| 93 | Synchronous audio-only telemedicine | Payers that cover audio-only services |
| FQ | Audio-only service on RHC and FQHC claims | Rural health clinics and FQHCs, added with 93 |
| GT | Legacy telehealth modifier | Critical Access Hospital Method II claims only |
Modifier 95 identifies synchronous audio-video visits and remains the modifier most commercial plans require. Medicare fee-for-service identifies telehealth through the place of service, so 95 is optional there but harmless. Modifier 93 marks synchronous audio-only visits, and payers that cover audio-only services expect it. Rural health clinics and FQHCs append FQ alongside 93 for audio-only telehealth under 42 CFR 410.78. Modifier GT belongs to history: Medicare eliminated it for professional claims effective January 2, 2018, and it survives only on Critical Access Hospital Method II institutional claims.
<!– developer: INFOGRAPHIC SLOT 1. Anatomy of a telehealth claim: a single CMS-1500-style claim screen with callouts showing where the CPT code and modifier (box 24D) and place of service (box 24B) land, with a patient-location icon deciding POS 10 vs POS 02. Clean labels, brand colors, no patient data. →
Telehealth CPT Codes for 2026
Three code families cover most telehealth billing in 2026, and Medicare treats each differently.
E/M Codes 99202 to 99215
Office and outpatient E/M codes remain the backbone of telehealth billing. New-patient codes run from 99202, covering 15 to 29 minutes, through 99205 at 60 to 74 minutes. Established-patient codes run from 99211 through 99215, and 99215 covers 40 to 54 minutes. Code selection follows time or medical decision making, the same standard as in-person visits. CMS lists these codes as covered telehealth services, and federal billing guidance confirms them for virtual encounters.
The 98000 Series and What Medicare Pays
The AMA created a telemedicine E/M family effective 2025. Codes 98000 through 98007 cover audio-video visits, split between new and established patients. Codes 98008 through 98015 cover audio-only visits on the same split. Code 98016 is a patient-initiated brief check-in of five to ten minutes that succeeds G2012. Medicare treats the family differently. The CY 2026 Physician Fee Schedule assigns 98000 through 98015 a status of not valid for Medicare purposes. Medicare claims continue on 99202–99215, with modifier 93 for audio-only services. Commercial adoption of the 98000 series varies payer by payer, so each payer contract determines which family applies.
Codes Deleted From Telehealth Billing
Telephone E/M codes 99441 through 99443 were deleted from CPT effective January 1, 2025, and claims for them do not pay. The deletion affects practices that copied old charge sheets into their EHR. Templates, favorite lists, and charge entries linked to telehealth visit types warrant a full audit for the deleted codes. The audio-only path for Medicare is 99202–99215 with modifier 93.
Documentation Every Telehealth Claim Needs
Payers read telehealth documentation against the same standard as in-person care, with a few added elements. The note should show the technology used, the patient’s physical location, patient consent, the clinical content of an equivalent in-person visit, and the rendering provider’s identity. Time-based coding needs start and stop times. Audio-only visits need the reason video was unavailable.
eCW-certified implementation specialists recommend a telehealth template built on structured fields. It captures consent with its date, the platform used, everyone present on the call, the patient’s location, the provider’s location, and start and end times. Structured fields also let the practice query its own telehealth data later, which supports internal audits and payer reviews.
Medicare Telehealth Rules in Force for 2026
The Consolidated Appropriations Act, 2026 extends Medicare telehealth flexibilities through December 31, 2027. Patients can receive telehealth in any location, including their homes, with no rural or facility-based originating-site requirement. Audio-only telehealth remains available for behavioral health services and for other services when clinically appropriate and on the Medicare telehealth list.
The behavioral-health in-person requirement returns after December 31, 2027. From then, an in-person visit within the six months before a first telehealth mental health service is required, with an annual in-person visit after. Patients established before the deadline are exempt from the initial requirement. Two supervision and coverage changes also matter. Frequency limits on subsequent inpatient, nursing facility, and critical care consults are permanently removed. Virtual direct supervision through real-time audio-video is permanent. The visit-complexity add-on G2211 can attach to telehealth E/M visits.
On the privacy side, HHS ended its telehealth enforcement discretion in 2023, so telehealth runs on platforms covered by a Business Associate Agreement. A plain phone call where the vendor only connects the call and never touches protected health information sits outside the BAA rule under HHS guidance.
Telehealth Denials and How to Prevent Them
Telehealth denials come from a short list of preventable causes:
- A place of service that does not match the patient’s documented location
- Modifier 95 appended by default, without checking payer rules for the service
- Deleted codes such as 99441–99443 still sitting in templates
- Eligibility not checked before the visit, so the claim travels to the wrong payer
- The provider not licensed in the state where the patient sits
- Missing consent, location, or time documentation on post-payment review
The prevention tools sit inside eClinicalWorks. Claim edit rules can block POS and modifier mismatches before submission. The denial queue in practice management groups rejections by reason, so the team works patterns rather than single claims. A monthly report on telehealth denial reasons by payer keeps the claim edits current as payer policies shift.
Conclusion
eClinicalWorks telemedicine works when the setup and the billing rules move together. The visit type is configured once, the consent form is in place, the claim edits check place of service and modifiers, and the templates carry the documentation payers read. The eClinicalWorks telehealth setup steps above cover that sequence in order. Practices that want support with telehealth setup and billing can find both at ORCM.
