Bill POS 10 when the client is in their home and POS 02 when they're anywhere else, and append modifier 95 for live video sessions. POS 10 generally pays the full non-facility (office) rate at the major payers in 2026, while POS 02 can price at the lower facility rate, so defaulting to POS 02 for at-home clients is a quiet, recurring pay cut.
Telehealth billing errors rarely deny; they underpay. A wrong place-of-service code doesn't bounce the claim. It prices the claim at a different rate, and unless you reconcile EOBs against your contracted rate the difference never surfaces.
When do I bill POS 02 versus POS 10?
The client's location during the session decides it, and only two answers exist. POS 10, "Telehealth Provided in Patient's Home," covers a client in any residence: their apartment, a parent's house, a dorm room. POS 02, "Telehealth Provided Other than in Patient's Home," covers everything else: the client at their office, in a parked car outside work, at school, or in a facility. Your location never enters into it.
CMS split the old single POS 02 into this pair in 2022 precisely because payers wanted to price home-based telehealth like an office visit. Since most private-practice therapy clients take telehealth sessions from home, POS 10 should dominate your claims. If your billing software still defaults every telehealth session to POS 02, that default is costing you money. A claim priced at the facility rate can run meaningfully below your contracted non-facility rate for CPT 90837.
Ask where the client is at the start of each telehealth session and put it in the note. That one sentence is both your POS justification and your audit trail.
Do I need modifier 95 or GT, and does it differ by payer?
Modifier 95 is the answer for nearly every claim you'll file in 2026. It certifies the session used synchronous, real-time audio and video. Modifier GT means the same thing but is a legacy code: Medicare retired it in 2018, and the national commercial payers have followed. A few regional plans and Medicaid programs still ask for GT, which is why the payer's own telehealth policy, not a forum thread, should settle it once per payer.
| Payer | Video modifier | POS for client at home | Audio-only |
|---|---|---|---|
| Aetna | 95 | POS 10 | Covered for behavioral health; restricted code list |
| Anthem BCBS | 95 | POS 10 | Varies by state Blue; verify the local plan's policy |
| Cigna | 95 | POS 10 | Behavioral health only; restricted code list |
| UnitedHealthcare | 95 | POS 10 | Covered per its telehealth policy's eligible-code list |
Audio-only sessions carry their own modifier, 93. Medicare and most commercial plans cover audio-only for behavioral health specifically, one of the few service categories where phone sessions survived the pandemic rules, but several payers pay it below the video rate or limit which CPT codes qualify. Document why video wasn't used ("client had no broadband access") every time.
The state Blues are the wildcard row. "Anthem" is the Blue in only part of the country: BCBS is 33 independent companies, and telehealth policy is set per licensee. Pull the telehealth reimbursement policy from the provider portal of your actual local Blue.
Who pays the office rate for telehealth in 2026?
For live-video behavioral health billed POS 10 + 95, all four national payers generally reimburse at parity with in-person rates in 2026. Behavioral health kept telehealth parity even as payers tightened rules for medical E/M visits. The gap opens in two places: POS 02 claims, which some payers price at facility rates, and audio-only claims, which are the most restricted and most frequently down-paid category.
Parity means parity with your contracted rate, not with anyone else's. What that contracted rate actually is varies more by payer than by modality: the spread across the majors for a 90837 is wider than any telehealth adjustment. Here's the real CMS-derived picture for UnitedHealthcare, the payer whose telehealth policy PDF is linked below:
| CPT code | Session type | Rate range |
|---|---|---|
| 90837 | 60-min therapymost common | $110–$154 |
| 90834 | 45-min therapy | $75–$105 |
| 90791 | Initial evaluation | $131–$179 |
| 90847 | Family therapy | $92–$122 |
| 90785 | Interactive add-on | $11–$15 |
Ranges are P20–P80 from CMS Transparency in Coverage data. Rates vary by state, locality, and contract negotiation. Look up rates by state, payer, and CPT code
Two habits protect you: verify telehealth benefits per client (copay, POS 10 coverage, audio-only coverage) using a benefits-verification script, and reconcile a sample of telehealth EOBs each month against your contracted rates. An EHR that defaults every telehealth session to POS 02 can run that way for months unnoticed, and a reconciliation after eight months of all-POS-02 billing can surface roughly a $9-per-session underpayment across 200 or more at-home sessions. The payers process every such claim correctly for the code submitted. Correcting the POS going forward is one settings change; refiling the look-back takes weeks.
How do I get listed as a telehealth provider in payer directories?
Attest to it during credentialing, because directories don't infer telehealth from your claims. CAQH ProView asks per practice location whether you offer telehealth services; payer applications and recredentialing packets ask again. Answer yes everywhere it appears, keep your CAQH attestation current, and your directory profile shows the telehealth flag that plan members filter by when searching for a therapist.
If you're already paneled but the directory doesn't show you as telehealth, update the CAQH question, re-attest, and submit a directory-change request through the payer portal (Availity for Aetna and most Blues, the UHC provider portal for Optum). This matters for referrals and for practicing into other states, where telehealth is the whole practice. Tracking those per-payer attestations is part of what paneled.ai handles during credentialing.
EVERY TELEHEALTH CLAIM: THE THREE DECISIONS
-
WHERE WAS THE CLIENT? Home (any residence, dorm, parent's house) -> POS 10 Anywhere else (work, car, school, facility) -> POS 02 Record the client's location in the session note.
-
VIDEO OR AUDIO-ONLY? Live audio + video -> modifier 95 Audio-only -> modifier 93 + note why video wasn't used Modifier GT: only if a specific plan's policy demands it.
-
SAME CPT CODE AS IN PERSON 90791 / 90834 / 90837 / 90847: telehealth does not change the code. Example claim line: 90837, POS 10, modifier 95.
PER-PAYER NOTES AETNA: 95 + POS 10. Audio-only limited to behavioral health code list. ANTHEM/BCBS: 95 + POS 10, but policy is set by YOUR state's Blue; pull its telehealth reimbursement policy from Availity. CIGNA: 95 + POS 10. Audio-only behavioral health only; check code list. UHC/OPTUM: 95 + POS 10. Audio-only per the eligible-code list in the UHC Telehealth and Telemedicine policy.
BEFORE THE FIRST SESSION (each new client)
- Verify telehealth benefit: POS 10 covered? audio-only covered? copay?
- Confirm the client is in a state where you can practice and are paneled
MONTHLY
- Pull 5 telehealth EOBs, compare paid amount to contracted rate
- Any POS 02 claims for clients who were home? Correct and refile.
- CAQH telehealth attestation still current (re-attest every 120 days)
Common questions
- What is the difference between POS 02 and POS 10 in therapy billing?
- Both are telehealth place-of-service codes, split by where the client is. POS 10 means the client was in their home during the session; POS 02 means the client was somewhere other than home: an office, school, or facility. Many payers price POS 02 at the lower facility rate, so using it for at-home clients quietly underpays you.
- Do I use modifier 95 or GT for telehealth therapy sessions?
- Modifier 95 for almost everyone in 2026. It tells the payer the session was live, synchronous audio and video. Modifier GT is largely obsolete: Medicare dropped it years ago, and among the majors only scattered legacy plans still want it. Check each payer's telehealth policy once, note the answer, and stop guessing per claim.
- Do insurance companies pay the same rate for telehealth as in-person therapy?
- For live video behavioral health, the four national payers generally reimburse telehealth at parity with in-person rates in 2026 when you bill POS 10 with modifier 95. The common exception is POS 02, which some payers price at a lower facility rate, and audio-only sessions, which several payers restrict or pay less for.
- Can I bill a therapy session that was audio-only, with no video?
- Sometimes. Medicare covers audio-only behavioral health with the right modifier, and most commercial payers cover it for behavioral health specifically, but several restrict which codes qualify or pay them below the video rate. Append modifier 93 for audio-only, document why video wasn't used, and verify the payer's audio-only policy before relying on it.
The paneled.ai team · Credentialing specialists. We file and track insurance credentialing applications for behavioral health providers every day — these guides come from what we see go wrong (and right) in real applications.