In 2025, the virtual telehealth demand will have increased. The pandemic shifted most of the healthcare to virtual care. This shift became the permanent system. Healthcare organisations are more focused on delivering care online, engaging patients, and managing everything virtually. 

But with these changes and shifts, there come many challenges that a healthcare organisation just needs to cope with in order to be competitive in this world. Many organisations struggle, which leads to revenue loss and costly claim denials. 

In this blog, we will explore the telehealth challenges and their solutions, and how Ascend RCM helps healthcare organisations streamline their tasks and improve their revenue 

1. Why Telehealth Is Booming in 2025

In 2025, virtual care services by healthcare organisations will be a necessity. People prefer to consult online rather than visit a hospital or clinic. Some patients feel it is convenient to get care from their home. The organisations compete for immediate care, better communication, and satisfaction through telehealth.

But this expansion comes with complexity. It becomes difficult to manage the monitoring of all patients, and this comes with more coding, more modifiers, more payer rules, and hence more chances of mistakes. It takes extra documentation standards for virtual care. 

The organisation must make more effort to make sure its telehealth billing systems evolve with the evolving advantages. 

2. Top Telehealth Billing Challenges Every Provider Must Tackle

In 2025, with evolving telehealth services. More obstacles come in the way of all the opportunities. The following are the telehealth billing challenges that an organisation experiences during its journey. 

Challenge #1: The Never-Ending Changes in Payer Policies

Each insurance payer, whether it is Medicaid, Medicare, or any other insurance, including private. These insurance companies have their own set of rules, definitions, and requirements for documents and claim processes. 

These rules and policies change frequently and at their own pace. With these changes, it takes a heavy administrative burden to keep up with their pace. 

For example, a video-based visit is paid for by all companies, but only a few cover audio-based consultation. These types of differences must be kept in mind while making claims, and failing to understand such differences in rules may lead to denials and revenue loss. This affects the telehealth billing reputation and forces the organisation to keep up with the changed rules. 

Challenge #2: Costly Coding Mistakes and Missing Documentation

Online consultation and treatment may increase coding and modifier complexities. The coding requires precision to reduce mistakes and documentation errors. Organisations must follow and identify the following things correctly: 

• Visit type (synchronous, asynchronous, remote monitoring)
• Place of service (POS)
• Correct relevant modifier 
• Time-based demands
• Medical requirement

Even small errors, like missing modifiers, can lead to claim rejections and delayed payments.

The documentation standards for telehealth are equally strict. Many payers require proof that:

• The visit occurred on a secure platform
• The interaction met their criteria for a reimbursable consultation
• The service type justified the code used

These documentation gaps are one of the most common issues Ascend encounters during telehealth billing reviews. 

Challenge #3: Telehealth Coverage That Changes State by State

State-level policies continue to shift, especially for Medicaid. What qualifies as reimbursable in one state may not qualify in another. Providers offering multi-state telehealth services experience even greater complexity.

This state-level fragmentation increases the burden on billing teams and affects reimbursement speed and accuracy, especially during cross-state telehealth billing submissions. 

Challenge #4: The Complexity of Billing for Remote Patient Monitoring

RPM codes have seen massive growth, but they are still widely misunderstood. RPM generates significant revenue potential if done correctly. Without clear internal workflows, practices miss out on thousands of dollars each month. Providers struggle to understand:

• Minimum data collection requirements
• 16-day rule compliance
• Device eligibility
• Supervision requirements
• Billing frequency limitations

Challenge #5: Navigating Telehealth Platform Requirements

Payers may require HIPAA-secure platforms for reimbursement. If a clinic uses non-compliant communication tools or fails to document platform security, claims may be denied.

Additionally, unstable connectivity, low-quality video, or patient tech barriers can lead to incomplete encounters that complicate the billing process.

This adds yet another layer of unpredictability to telehealth billing administration. 

3. Proven Solutions to Fix Telehealth Billing Challenges in 2025

To keep virtual care profitable and compliant, practices must implement streamlined workflows, automated systems, and professional billing support. Below are proven solutions that Ascend Revenue Cycle Management provides to its clients.

Solution #1: Tailor Telehealth Protocols for Each Payer

Every hurdle comes with a solution. Creating tailored protocols helps organisations keep up their pace. Creating detailed payer matrices allows billing teams to:

• Know exactly which services each payer covers
• Apply correct modifiers for each encounter
• Track reimbursement rates
• Understand payer-specific documentation rules

Solution #2: Streamline Billing With Standardised Documentation

Ascend develops templates tailored to speciality, visit type, and payer requirements to ensure every telehealth encounter meets billing criteria. Effective templates capture:

• Patient identity and consent
• Technology used
• Duration of visit
• Clinical assessment
• Medical decision-making
• Provider credentials
• Time spent in synchronous communication

Solution #3: Master Coding and Modifiers for Flawless Billing

Most mistakes occur due to coding errors and wrong modifiers. A single error can delay payments and double the cost, which includes financial and administrative. The best solution for this is to partner with a trusted medical coding company like Ascend RCM and stay consistent with your growth. Telehealth requires the correct use of the following:

• POS 02, POS 10
• Modifiers 95, GT, GQ, FQ, FR
• Time-based E/M codes
• Asynchronous and synchronous CPT codes
• RPM, RTM, and virtual check-in codes

Solution #4: Automate Eligibility Checks to Speed Up Billing

Real-time verification prevents billing surprises and ensures the clinic only performs reimbursable virtual services. Automation helps practices:

• Verify if a patient’s plan covers telehealth before the visit
• Flag coding inconsistencies
• Reduce manual data entry
• Track claims in real time

Solution #5: Build Audit-Ready Telehealth Billing Workflows

With telehealth audits increasing in 2025, practices must:

• Maintain secure technology
• Store video visit logs
• Capture consent
• Follow payer-approved guidelines

Ascend’s compliance team regularly monitors regulatory updates and ensures practices maintain audit-ready documentation for all telehealth billing submissions.

Solution #6: How Outsourcing Streamlines Telehealth Billing

Outsourcing telehealth billing offers clinics several advantages:

• Reduced administrative burden
• Lower operational costs
• Fewer denials
• Faster payments
• Better coding accuracy
• Stronger compliance
• Access to certified specialists

4. The Advantage of Partnering With Ascend for Telehealth Billing

Telehealth is here to stay. But without proper billing support, clinics risk losing revenue, increasing compliance risks, and overwhelming their staff with administrative tasks.

Ascend Revenue Cycle Management offers:

• Certified telehealth and RPM coders
• Deep expertise in payer-specific rules
• End-to-end RCM services
• Customised workflows for virtual care
• Continuous updates on 2025 billing regulations
• Transparent reporting and analytics

Our goal is simple: help providers get paid faster, stay compliant, and operate efficiently, no matter how complex payer rules become.

Ascend ensures that your telehealth billing process works smoothly, efficiently, and profitably in a fast-changing environment.

5. What’s Next for Telehealth After 2025

Virtual healthcare will continue evolving. Clinics should expect:

• More RPM and RTM adoption
• Bundled payment models
• Expanded mental health telehealth coverage
• Better payer clarity (but stricter documentation)
• AI-assisted virtual diagnostics
• Integration of wearable health data
• Increasing hybrid care models

Those who prepare today will thrive tomorrow.

Conclusion

Telehealth has transformed modern healthcare, but it brings challenges that clinics cannot afford to ignore. From shifting payer rules to complex modifiers, inconsistent documentation to multi-state variations, the billing landscape is more dynamic than ever.

2025 demands precision, compliance, and expert-driven processes. With the right partner, clinics can not only navigate these challenges but also unlock major revenue opportunities.

Ascend Revenue Cycle Management is committed to helping healthcare providers simplify their workflows, reduce claim denials, and maximise reimbursement for every virtual service delivered.