Insurance Coverage for Behavioral TeleHealth Post-COVID-19

by | Aug 14, 2023 | Behavioral Health, Billing for Telehealth, Insurance Coverage, Outsource, Revenue

Billing Solutions Team
Billing Solutions provides medical billing services for behavioral healthcare practices.

Behavioral telehealth has been given a range of terminology; it may be referred to as telepsychiatry, telebehavioral health, telemental health, or telepsychology. It signifies the delivery of psychological services via telephone delivered therapy, videoconferencing, mental health apps, and/or internet delivered therapy programs. It is a platform promoting equitable access to health care that is patient centered and culturally responsive.

The majority of individuals who have participated in behavioral telehealth over the past year and a half, due to COVID-19 restrictions, have been satisfied with the accessibility of it, as well as the privacy. Clinicians noted the reduced number of missed visits with telehealth sessions, and the probability of an increase in adherence to treatment; while clients enjoy the ability to connect with quality clinicians. Therefore, the overall satisfaction amongst clinicians and clients has encouraged many clinicians and CEO’s to implement into their practice strategies to sustain treating clients virtually post-COVID-19.

The concern, however, is being adequately reimbursed in a timely manner for the services you have provided. During COVID-19, the federal government, state Medicaid programs, and private insurances lowered the barriers of reimbursement for telehealth coverage due to the public health emergency. Nevertheless, post-COVID-19 more billing laws, rules, regulations and policies have been put into place to govern telehealth reimbursement.

Medicare Behavioral TeleHealth Billing

According to the United States government best practice guide to telehealth for behavioral care, Medicare reimbursement for audio-only telehealth is only covered during COVID-19; as it is a government declared public health emergency. Post-COVID-19, however, Medicare will only reimburse clinicians for video telehealth. Therefore, if you have Medicare clients who are audio-only, consider helping them transition to video telehealth.

The updated (August 17, 2021) complete list of telehealth services for reimbursement under the Medicare Physicians Fee Schedule, provided by the Centers for Medicare & Medicaid (CMS.gov) is found here.

State Medicaid and Private Insurances Behavioral TeleHealth Billing

Every state has differing telehealth coverage for reimbursement. So it is important to check the insurance state’s laws regarding clients’ coverage prior to beginning virtual treatment.

For example, as of 2021 Medi-Cal Anthem Blue Cross of California states they do not provide telehealth coverage for audio-only telephone. While, Molina Healthcare’s Medicaid does provide audio-only for telehealth. Molina emphasizes the different telehealth billing codes for Audio-only/Phone as well as the telemedicine HIPAA Compliant Audio-Visual billing codes.

For more information regarding your state’s Medicaid and private insurance telehealth laws and reimbursement policies, and the temporary COVID-19 actions for Medicaid, click here or give us a call.

Outsourcing Your Telehealth Billing

If you are considering the continual implementation of telehealth in your behavioral health facility or addictions treatment practice post-COVID-19, outsourcing your billing will save you time and money. Transitioning your practice to sustain both a virtual bridge with your clients, as well as maintaining in-person visits, is challenging enough; outsourcing your billing will allow you to focus on your expertise in caring for your clients’ mental health needs in-person and the application of virtual interventions for your telehealth clients. Outsourcing your billing with us alleviates you of the burden of verification of benefits, and insurance authorizations for your telehealth services; we also minimize errors in billing claims, maximize your revenue, and manage any claims denials and appeals.

Our goal at Billing Solutions, is to help you move forward in the growth of your practice; so we stay up to date on the changes in telehealth billing, so that you do not have to spend the time researching the new codes, laws, and regulations. We pride ourselves on our customer service, so if you have any questions regarding telehealth billing, please feel free to call us and ask.