Should I pay a facility fee for a telehealth visit?

No. Facility fees cover the overhead of a physical location. If your telehealth visit was conducted from your home, there should be no facility fee. If you see one, dispute it with the billing department.

Does insurance cover telehealth?

Most insurance plans cover telehealth visits as of 2026. The ACA requires marketplace plans to cover telehealth, and most employer plans do as well. Check your plan's Summary of Benefits for telehealth-specific copay or coinsurance amounts.

Telehealth Billing: What You Should (and Should Not) Be Charged

How Telehealth Billing Works

Telehealth visits are billed using the same CPT codes as in-person visits (like 99213 or 99214 for office visits), plus a modifier code indicating the visit was virtual. The modifier tells the insurance company the visit was conducted by video or phone. Since the COVID-19 pandemic, most insurers cover telehealth at the same rate as in-person visits, but some plans still have different cost-sharing rules for virtual care.

What a Telehealth Visit Should Cost

If your plan covers telehealth, you should pay the same copay or coinsurance as an in-person visit of the same type. A standard primary care telehealth visit typically costs $0-$75 with insurance. Some plans offer $0 telehealth through dedicated platforms. Without insurance, direct-to-consumer telehealth services charge $50-$300 per visit depending on the specialty.

Common Telehealth Billing Errors

Watch for: facility fees (telehealth visits should not include a facility fee since you are not at a medical facility), incorrect visit level coding (providers may upcode a brief telehealth check-in to a full office visit), charges for services not performed (physical exams cannot be fully conducted via telehealth), and billing for phone calls that were scheduling or administrative rather than clinical.

Phone vs. Video Visit Billing Differences

Audio-only (phone) visits are billed differently than video visits. Phone visits use CPT codes 99441-99443 and are typically reimbursed at a lower rate. If your bill shows a full office visit code (99213-99215) for a phone call, the provider may have coded it incorrectly. Some insurance plans only cover video telehealth, not phone visits — check your plan before scheduling.

How to Check Your Telehealth Bill

Review your bill for the CPT code and any modifier codes. Modifier 95 indicates a synchronous telehealth visit. Modifier GT indicates a telehealth visit via interactive audio/video. If you see no telehealth modifier, the provider may have billed it as in-person by mistake. Also check that the provider is in your insurance network for telehealth — network status can differ between in-person and virtual visits.