How to Dispute a Telehealth Bill

Telehealth billing mistakes are new and common

Telehealth billing uses its own rules, and providers are still learning them — which means errors. The place-of-service code, the type of visit (video vs. audio-only), and facility fees all follow different rules for virtual care, and each is a place where the billing can go wrong.

The same visit can be priced three different ways depending on how it's coded: as an in-person office visit, a video telehealth visit, or an audio-only visit. That flexibility is exactly why telehealth errors happen — one keystroke in the place-of-service field changes the entire price, and patients rarely see the code until the bill arrives.

Telehealth coverage has also become a moving target: many plans broadened virtual-care benefits during the public health emergency and later narrowed them again, changing copays and coverage limits with little notice. That means a service that was covered last year may be billed to you this year — which is why checking your plan's current telehealth policy matters as much as checking the codes.

The place-of-service code is the first check

Telehealth claims must use place-of-service code 02. If your virtual visit was billed with an in-person place-of-service code, it may have been priced at an in-person rate or processed incorrectly by your insurer. Request the claim and verify the code.

Audio-only vs. video visits

Medicare and many plans now cover audio-only visits for many services, but billing rules differ. An audio-only visit billed at a video-visit rate, or billed as in-person, is an error you can dispute. If you received a phone-only visit, confirm the claim reflects audio-only.

Keep your own record of the visit: the date, the provider, and whether it was video or phone. Providers' systems occasionally default to the higher video or in-person coding, and your note of "this was a 10-minute phone call" is the evidence that turns a confusing bill into a one-line correction.

• A facility fee added to a virtual visit.
• An in-person place-of-service code on a telehealth claim.
• An audio-only visit billed at the higher video-visit rate.
• A telehealth visit denied when your plan covers telehealth.
• Charges for a visit that was rescheduled or cancelled.

Facility fees on telehealth — a growing dispute

Some hospital systems now add facility fees to virtual visits, arguing they cover the infrastructure of the telehealth program. Patients and state regulators have pushed back, and several states restrict or ban facility fees on telehealth. If your telehealth bill includes a facility fee that wasn't disclosed, dispute it in writing and cite your state's rules if it has them.

The dispute argument for telehealth facility fees is clean: the fee is supposed to pay for the physical facility — the room, the equipment, the staff on site — and a virtual visit uses none of it. State insurance departments have started to notice, and an undisclosed fee on a virtual visit is exactly the kind of charge a written complaint gets corrected.

Denied telehealth claims

If your insurer denied a telehealth claim, the reason is often an outdated plan policy or incorrect coding. Appeal with the claim showing the correct place-of-service code, and confirm telehealth coverage in your plan documents — many plans cover it now, but at different levels than in-person care.

1. 1Request the claim with the place-of-service code.
2. 2Confirm video vs. audio-only billing matches the visit.
3. 3Flag any facility fee on a virtual visit.
4. 4Appeal denials with correct telehealth coding.
5. 5Dispute charges that don't match your EOB.

Preventing telehealth surprises

Before a virtual visit, confirm with the provider whether a facility fee applies, whether the service is covered by your plan, and what your cost-sharing will be. Written confirmation beforehand prevents most telehealth disputes.