Telehealth has become an essential part of healthcare delivery in Maryland, giving providers more flexibility to treat patients while improving access to care. But delivering care virtually is only one part of the process. Billing telehealth services correctly and maintaining compliance with Maryland and payer requirements is equally important.

Incorrect place-of-service coding, missing modifiers, incomplete documentation, eligibility issues, authorization requirements, and payer-specific rules can result in claim denials, delayed payments, and lost revenue.

For Maryland healthcare providers, having a structured telehealth billing and compliance process can make the difference between getting paid accurately and constantly fighting rejected claims.

What Is Telehealth Billing Compliance?

Telehealth billing compliance means ensuring that every virtual healthcare service is:

    • Clinically appropriate for telehealth

    • Provided by an eligible and properly enrolled provider

    • Documented correctly

    • Coded accurately

    • Submitted with the appropriate modifiers and billing information

    • Supported by payer requirements

    • Consistent with Maryland regulations and the patient’s insurance plan

Maryland law defines telehealth broadly to include interactive audio, video, and other telecommunications technologies. Certain qualifying audio-only services can also fall under the state’s telehealth definition.

For Medicaid providers, Maryland requires providers to follow specific telehealth requirements under its Medicaid program and applicable COMAR provisions.

Why Telehealth Billing Errors Are Costly

Telehealth claims can look simple, but small billing mistakes can create significant revenue problems.

Common problems include:

    • Incorrect CPT or HCPCS codes

    • Incorrect or missing telehealth modifiers

    • Incorrect place-of-service coding

    • Missing patient consent documentation

    • Inadequate clinical documentation

    • Eligibility not verified before the appointment

    • Missing prior authorization

    • Billing services that are not covered through telehealth

    • Incorrect provider enrollment information

    • Payer-specific billing requirements being overlooked

A single billing error may lead to a rejected claim. Repeated errors can create a larger revenue cycle problem for the practice.

Maryland Telehealth Billing Compliance Checklist

Healthcare providers should review the following areas before submitting telehealth claims.

Verify Patient Eligibility

Eligibility verification should be completed before providing the service whenever possible.

For Maryland Medicaid patients, providers are expected to use the Electronic Verification System (EVS) to verify eligibility before rendering covered services.

A strong eligibility verification process should confirm:

    • Active insurance coverage

    • Patient eligibility

    • Covered benefits

    • Telehealth coverage

    • Copayment or coinsurance requirements

    • Prior authorization requirements

    • Provider participation status

Why it matters: Treating an ineligible patient or submitting a claim without confirming coverage can increase the risk of avoidable denials.

Confirm That the Service Is Telehealth-Eligible

Not every healthcare service is automatically appropriate for telehealth.

Maryland Medicaid states that covered services delivered through telehealth must be medically necessary and clinically appropriate for the telehealth delivery model.

Before billing, providers should confirm:

    • The service can appropriately be delivered virtually

    • The provider is authorized to perform the service

    • The payer covers the service through telehealth

    • Any specialty-specific restrictions are satisfied

Payer policies should always be checked because requirements may vary between Medicaid, Medicare, and commercial insurers.

Use Correct CPT and HCPCS Coding

Accurate coding is one of the most important parts of telehealth reimbursement.

Providers should select codes based on the actual service performed and the documentation supporting that service.

Your billing team should review:

    • CPT codes

    • HCPCS codes

    • Modifiers

    • Place of service

    • Diagnosis codes

    • Time requirements

    • Payer-specific rules

Incorrect coding can result in claim rejection or payment delays.

Understand Telehealth Modifiers

Modifiers communicate important information about how a service was delivered.

Maryland Medicaid guidance includes specific telehealth billing requirements, and its regulations have included use of the GT modifier for telehealth services. However, providers should verify the current payer-specific billing instructions before submitting claims.

Do not assume that one modifier or billing format works for every payer.

A professional medical billing team should maintain payer-specific billing rules and update them when requirements change.

Pay Attention to Place-of-Service Coding

Place-of-service coding can be particularly important for telehealth claims.

Maryland Medicaid’s provider manual states that Medicaid-only claims generally should continue using the place-of-service code appropriate to the service as if it were provided in person; POS 02 is not generally recognized for Maryland Medicaid-only claims, although it may be used in certain Medicare crossover situations.

This is an excellent example of why providers should never rely on generic telehealth billing advice without checking the specific payer’s current requirements.

Document Patient Consent

Proper documentation protects both the provider and the practice.

Maryland Medicaid’s provider manual states that providers should document the participant’s consent to receive telehealth services in the medical record, and consent may be given verbally.

Your documentation process should capture, when applicable:

    • Patient consent

    • Date and time of encounter

    • Provider information

    • Patient location

    • Provider location

    • Type of telehealth technology used

    • Clinical reason for the encounter

    • Assessment and treatment plan

    • Medical necessity

    • Follow-up instructions

Good documentation supports the claim if the payer requests additional information.

Confirm Provider Enrollment and Credentialing

Telehealth billing compliance starts before the claim is ever created.

Providers should ensure that:

    • Their enrollment is active

    • Their NPI information is accurate

    • Their payer contracts are active

    • Required credentialing is complete

    • Their specialty information is correct

    • Any ordering/referring requirements are satisfied

Maryland Medicaid requires participating providers to meet applicable enrollment and billing requirements.

An enrollment problem can cause perfectly valid telehealth services to become unpaid claims.

Check Prior Authorization Requirements

Telehealth does not automatically eliminate utilization management requirements.

Maryland law permits insurers to conduct utilization review, including preauthorization, for covered healthcare services delivered through telehealth under applicable conditions.

Before the appointment, verify whether authorization is required for:

    • Behavioral health services

    • Specialty consultations

    • Certain procedures

    • High-cost services

    • Remote monitoring

    • Other payer-specific services

Failing to obtain authorization when required can result in avoidable denials.

Understand Audio-Only Billing

Audio-only telehealth can create additional billing considerations.

Maryland has continued Medicaid coverage for qualifying audio-only telehealth services. The state extended telehealth flexibilities, including audio-only coverage, on a permanent basis through the Preserve Telehealth Access Act of 2025.

However, providers should still verify:

    • Whether the payer covers the service

    • Whether the specific service qualifies

    • Required documentation

    • Applicable codes

    • Applicable modifiers

    • Any specialty-specific restrictions

Never assume that an audio-only visit should be billed exactly like an audio-video encounter.

Keep Up With Maryland Telehealth Changes

Telehealth regulations and payer policies can change.

For example, Maryland Medicaid issued updated guidance in 2026 affecting certain Applied Behavior Analysis telehealth services. Beginning April 1, 2026, certain listed ABA services could no longer be provided entirely through telehealth and required at least 25% of the service to be delivered in person.

This demonstrates why practices should regularly review:

    • Maryland Medicaid updates

    • COMAR requirements

    • CMS guidance

    • Commercial payer policies

    • Provider manuals

    • Payer bulletins and transmittals

Common Telehealth Billing Mistakes Maryland Practices Should Avoid

Mistake 1: Using the Same Billing Rules for Every Payer

Medicaid, Medicare, and commercial insurers may have different requirements.

Mistake 2: Skipping Eligibility Verification

A virtual appointment does not eliminate the need to confirm coverage.

Mistake 3: Using Incorrect POS Codes

Telehealth POS rules can differ by payer.

Mistake 4: Missing Required Modifiers

Missing or incorrect modifiers can prevent proper claim processing.

Mistake 5: Poor Documentation

If the medical record does not support the service billed, the claim may be challenged or denied.

Mistake 6: Ignoring Authorization Requirements

Telehealth does not automatically mean prior authorization is unnecessary.

Mistake 7: Failing to Monitor Payer Updates

Outdated billing rules can quickly turn into recurring denials.

How Professional Medical Billing Services Improve Telehealth Revenue

Managing telehealth billing internally can become challenging as patient volume increases.

A professional medical billing company can help your practice manage the complete revenue cycle, including:

Eligibility Verification → Authorization → Coding → Claim Submission → Payment Posting → Denial Management → A/R Follow-Up

This creates a more consistent billing process and reduces the chance that preventable errors will affect reimbursement.

At Medhasty Medical Billing Services, our team can help Maryland healthcare practices improve their telehealth revenue cycle by focusing on accurate billing, clean claims, denial prevention, and timely A/R follow-up.

Why Maryland Providers Choose Medhasty

Your practice should be focused on providing quality patient care—not spending hours correcting billing errors.

Medhasty can support healthcare providers with:

    • Medical billing

    • Telehealth billing support

    • Medical coding

    • Eligibility verification

    • Prior authorization support

    • Claims submission

    • Denial management

    • A/R follow-up

    • Payment posting

    • Revenue cycle management

Our goal is simple: help healthcare providers reduce billing problems and collect the revenue they have earned.

Ready to Improve Your Telehealth Billing?

Telehealth can expand access to care—but billing mistakes can reduce the financial benefits for your practice.

If your Maryland practice is experiencing telehealth claim denials, delayed payments, coding problems, or increasing accounts receivable, it may be time to review your billing workflow.

Let Medhasty help you build a more efficient and compliant telehealth revenue cycle.

Get a Telehealth Billing Review

Contact Medhasty Medical Billing Services today to discuss your practice’s billing challenges and discover how professional billing support can help improve collections, reduce avoidable denials, and streamline your revenue cycle.

Telehealth Billing Compliance Guide for Maryland Healthcare Providers