The New Era of Post-Pandemic Care
When the COVID-19 pandemic began, telehealth became a lifeline for healthcare providers and patients. However, as of October 1, 2025, the temporary flexibilities that made virtual care widely accessible have officially ended. For many small and mid-sized practices, this shift has created confusion, extra administrative work, and frustration for patients.
At Elevare Management Solutions, we’re helping healthcare practices across the country adapt to these changes with clarity, compliance, and confidence.
1. What Changed in 2025 Telehealth Policy
During the Public Health Emergency (PHE), Medicare and many commercial payers expanded telehealth coverage to include services provided from home and allowed audio-only visits. Those rules have now reverted to pre-pandemic standards.
Here’s what that means:
- Medicare: Non-behavioral telehealth visits from a patient’s home are no longer reimbursed. Behavioral health telehealth remains covered, but patients must be seen in person periodically.
- Audio-only visits: Now limited to specific behavioral or crisis-related services.
- Commercial payers: Some may still cover telehealth, but most are expected to align with Medicare soon.
The bottom line — telehealth remains available in certain situations, but it is no longer a one-size-fits-all option.
2. How These Changes Affect Your Practice
The biggest challenge practices are facing right now isn’t compliance — it’s patient management.
Patients have grown comfortable with the convenience of virtual visits, and being asked to return to in-person appointments can feel like a step backward. Practices are seeing:
- More rescheduling and cancellations
- Confusion about which visits can remain virtual
- Denied claims due to payer inconsistencies
- Increased workload for front office teams
This transition can be handled smoothly with a clear plan and consistent communication.
3. A Step-by-Step Plan to Navigate the Change
Step 1: Verify Coverage by Payer Type
Start by reviewing telehealth coverage with each payer your practice works with.
- Medicare: Move all non-behavioral visits back to in-person. Keep behavioral telehealth if documentation requirements are met.
- Commercial Plans: Check with your payer representatives or provider portals for current coverage details.
- Self-Pay Telehealth: Offer virtual visits for patients who prefer them, with signed consent confirming they’ll pay out of pocket.
Keep a shared document or internal chart showing which payers cover which types of visits, and update it weekly.
Step 2: Simplify Scheduling Workflows
To reduce confusion, create a quick reference chart for your staff.
| Payer | Telehealth Allowed? | Visit Type | Notes |
|---|---|---|---|
| Medicare | ❌ No (except behavioral) | In-Person Only | Follow pre-2020 rules |
| BCBS | ✅ Confirmed | Telehealth or In-Person | Review monthly |
| UHC | 🔄 Pending | In-Person Recommended | Check weekly |
Train schedulers to verify the payer first and document visit type before confirming appointments.
Step 3: Communicate Clearly with Patients
Proactive communication prevents frustration and no-shows.
Here’s an example message your team can adapt:
“Starting October 1, insurance rules for telehealth have changed. Some virtual visits now require in-person appointments, depending on your coverage. We’ll reach out if your visit needs to be updated and will continue working to make this transition as smooth as possible.”
Update your website, voicemail, and patient portal with this notice. Consistency helps patients feel informed and confident in your care.
Step 4: Lighten the Administrative Load
A few workflow adjustments can make a big difference:
- Assign one team member to track payer telehealth updates.
- Use group messages or patient portal announcements instead of individual calls.
- Temporarily disable self-scheduling for telehealth visits until your policies are firm.
These steps keep your staff focused and reduce repeat work.
Step 5: Review Billing and Coding
Billing errors are one of the fastest ways to lose revenue. Make sure your team:
- Uses the correct POS codes (POS 02 for telehealth, POS 11 for in-person).
- Removes modifiers from visits that no longer qualify as telehealth.
- Reviews denials weekly to spot payer trends early.
Step 6: Create a 30-Day Transition Plan
| Week | Focus |
| Week 1 | Verify payer coverage, update telehealth matrix, notify Medicare patients. |
| Week 2 | Transition Medicare patients to in-person. Keep verified commercial telehealth. |
| Week 3 | Audit upcoming visits and reschedule as needed. |
| Week 4 | Review denials, patient feedback, and update workflows. |
A gradual approach helps your practice adapt without overwhelming your team or patients during this transition.
4. Partnering with Elevare for Support
At Elevare Management Solutions, we work alongside practices to:
- Develop payer-specific telehealth matrices
- Build efficient front-office workflows
- Draft patient communication templates
- Monitor payer policy updates
Our focus is to help you stay compliant and keep operations running smoothly through every transition in care.
Moving Forward
While the end of telehealth flexibilities creates short-term challenges, it also offers a chance to refine systems and strengthen patient engagement. With clear communication, well-structured processes, and the right guidance, your practice can turn this change into an opportunity for long-term growth.
Frequently Asked Questions (FAQ)
1. How does telehealth billing work?
Telehealth billing involves using specific CPT and POS codes to identify services delivered virtually. Practices must confirm that the payer still covers telehealth services and apply the correct modifiers when applicable.
2. What CPT codes can be billed for telehealth?
Many of the same evaluation and management (E/M) codes used for in-person visits can apply to telehealth when allowed by the payer. Common codes include 99201–99215 for outpatient visits and 99441–99443 for telephone visits. Always verify with each payer before billing.
3. Is Medicare shutting down telehealth?
Not entirely. Medicare has ended many temporary flexibilities, but behavioral health telehealth remains available with certain requirements. Non-behavioral telehealth visits generally must now be performed from an approved originating site rather than the patient’s home.
4. How to bill for a telehealth visit in 2025?
In 2025, ensure compliance with updated payer policies. Use the correct CPT code, include POS 02 for telehealth visits, and confirm that your payer allows virtual services. Keep documentation detailed to support reimbursement and avoid claim denials.
Need help adjusting your telehealth workflows?
We’re here to make the process simpler.
📞 (984) 326-5665
📧 DDaniels@Elevaremgmts.com
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