Place of Service (POS) Codes 

Telehealth or telemedicine professional claims submitted on a CMS 1500 form must be submitted with POS Code ‘02’or ‘10’. Providers should submit the most appropriate place of service code that accurately describes where the services were rendered. POS 02 does not apply to originating site facilities when billing a facility fee.

• Place of Service (POS) Code 02 (Telehealth Provided Other than in Patient’s Home)
• Place of Service (POS) Code 10 (Telehealth Provided in Patient’s Home): 

HCPCS Q3014 “Telehealth originating site facility fee”:

• The provider who is supplying the room and telecommunication equipment with the member physically present, may submit Q3014.
• The member visits their PCP’s office, and the PCP helps to initiate a telehealth appointment with a specialist located in another office location.
•  PCP’s office can submit Q3014 for physically hosting the patient (member). The specialist located in another office location may not bill code Q3014 since they are not the originating site.

 Inappropriate billing of Q3014 (Not to be used for virtual type visits or use of equipment for those purposes): 

• The member is in their home and initiates telehealth visit with their PCP.
•  Since the PCP is not physically hosting the patient (member), they cannot bill Q3014 as the patient (member) is not present at their facility. 
• The PCP is acting as a distant site provider to the member who is at home.

Telehealth Origination Site Fee, Effective date: February 1, 2026 
The revisions amend the Medicaid State Plan to add a reimbursable originating site (facility) fee for telehealth services. This change allows certain facilities hosting a member during a telehealth visit to receive separate reimbursement when the appropriate facility-fee code is billed. Eligible originating sites include hospitals, outpatient departments, physician and practitioner offices, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Indian Health/Tribal/Urban (I/T/U) clinics, and public health clinics. This fee is reimbursed separately from the professional service billed by the distant-site provider and does not apply when the member’s home is the originating site or when no staff or facility resources are used. Equipment and transmission costs remain non-reimbursable.

Removal of Physician Visit Limits, Effective date: February 1, 2026.
The proposed revisions remove existing caps on adult physician visits, including the four-visit monthly limit and the two-visit limit for members residing in nursing facilities. Removing these limits allows members to receive all medically necessary outpatient services and supports timely access to primary and preventive care.

Reimbursement

• Health care services delivered by telehealth such as Remote Patient Monitoring, Store and Forward, or any other telehealth technology, must meet OHCA standards in order to be reimbursed. See Oklahoma Care Authority- Telehealth.
• Services provided by telehealth must be billed with the appropriate modifier. 
• If the technical component of an X-ray, ultrasound or electrocardiogram is performed during a telehealth transmission, the technical component can be billed by the provider that provided that service. The professional component of the procedure and the appropriate visit code should be billed by the provider that rendered that service. 
• The cost of telehealth equipment and transmission is not reimbursable by SoonerCare. 
• For reimbursement of audio-only health service delivery, see OAC 317:30-3-27.1.

Private Payers — Telehealth Coverage & Payment Parity

Oklahoma law requires private health plans to cover telehealth services on at least the same basis as in-person care — insurers may not exclude a service solely because it’s provided via telemedicine if it’s otherwise covered when delivered in person. Cost-sharing (copays/coinsurance/deductibles) for telehealth generally cannot exceed what applies to in-person services.

Additional Requirements for School Settings

Please note that in order for school-based telehealth to be reimbursed by SoonerCare, the services must meet a special set of requirements, in addition to the initial requirements set by OHCA.

Consent-  Advance parent or legal guardian consent for telehealth services must be obtained for minors

Notification-  For telehealth medical services provided in a primary or secondary school setting, the telehealth practitioner must provide a summary of the service, including, but not limited to, information regarding the exam findings, prescribed or administered medications, and patient instructions, to

(A) The SoonerCare member, if he or she is an adult, or the member’s parent or legal guardian, if the member is a minor; or 

(B) The SoonerCare member’s primary care provider, if requested by the member or the member’s parent or legal guardian. 

Quick Billing Summary (Oklahoma)

Scenario: Telehealth office visit for a SoonerCare member
✔ Bill standard CPT/HCPCS code for the service.
✔ Include appropriate telehealth modifier (e.g., GT or 95).
✔ Use proper Place of Service (POS).
✔ Add originating site fee (Q3014) if valid and applicable.
✔ Submit via SoonerCare or managed provider billing portal and follow OHCA provider manual instructions.

Notes & Best Practices

• Always verify with the specific SoonerCare provider manual and managed care plan instructions as policies and reimbursable telehealth code lists are updated regularly. General Telehealth Guidance
• Check for audio-only service lists and updated telehealth CPT guidance each year. Audio-only guidance
• Private payer contracts may have additional billing requirements that differ from state-mandated parity language, so review contracts and insurer policies.