How To Bill Mental Health Telehealth?

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How To Bill Mental Health
Telehealth?
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How To Bill Mental Health Telehealth?
Introduction Billing for mental health telehealth
services can be challenging due to various
factors. Mental health providers must navigate
different payer coverage and reimbursement
policies, choose the correct CPT codes and
modifiers, document telehealth services properly,
comply with regulations related to telehealth,
and educate patients about insurance coverage.
Technical issues such as connectivity problems,
audio or video quality issues, and software or
hardware malfunctions can also disrupt the
telehealth session and make it difficult to
document and bill for the service. In this
article, we will try to answer basic question how
to bill mental health telehealth and all relevant
questions about mental health telehealth
billing. How to Bill Mental Health
Telehealth? Billing for mental health telehealth
services can be done using the same codes as for
in-person mental health services. However, there
are some specific requirements and guidelines
that mental health providers need to follow when
billing for telehealth services. Lets see how to
bill mental health telehealth? 1. Benefits
Verification To ensure reimbursement for
providing mental health telehealth services, it
is important to confirm that each patients
insurance plan covers telehealth services and has
approved the use of telehealth for the specific
type of service being provided
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How To Bill Mental Health Telehealth?
While many insurance plans have expanded their
coverage of telehealth services after COVID-19
pandemic, coverage and approval policies can vary
widely between plans and may also depend on the
patients specific diagnosis or treatment
needs. To verify coverage and approval,
providers should contact each patients insurance
plan and ask specifically about coverage for
mental health telehealth services. Providers
should also ask about any specific billing codes
or modifiers required to bill for telehealth
services and what documentation is needed to
support the claim. It is also important to note
that insurance plans may change their policies
regarding telehealth coverage and approval at any
time. Therefore, providers should stay up-to-date
on any changes in policy and be prepared to adapt
their billing practices accordingly to ensure
that they continue to receive proper
reimbursement for the telehealth services they
provide. To ensure you get reimbursed for
providing telehealth psychotherapy, always call
each patients insurance plan and ask about
approval for telehealth therapy. 2. Common
Telehealth CPT Codes The accurate CPT codes for
mental health telehealth services can vary
depending on the type of service being provided,
the payer, and the location of the patient and
provider. However, here are some commonly used
CPT codes for mental health telehealth services
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How To Bill Mental Health Telehealth?

• Psychotherapy services
• 90832 Psychotherapy, 30 minutes with patient
  (individual or group)
• 90834 Psychotherapy, 45 minutes with patient
  (individual or group)
• 90837 Psychotherapy, 60 minutes with patient
  (individual or group)
• Psychiatric diagnostic evaluations
• 90791 Psychiatric diagnostic evaluation
• 90792 Psychiatric diagnostic evaluation with
  medical services
• Medication management
• 90863 Pharmacologic management, including
  prescription and review of medication, when
  performed with psychotherapy services
• It is important to note that CPT is a registered
  trademark of the American Medical Association
  (AMA). So we cant complete list of applicable
  CPT codes along with their description. Codes
  listed above are shared for provider reference
  purpose only. Mental health providers should
  check with their payers to ensure that they are
  using the correct CPT codes and modifiers to bill
  for telehealth services. Additionally, some
  payers may have specific requirements for
  telehealth services, so providers should ensure
  that they are familiar with the payers policies
  and requirements before submitting claims.

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How To Bill Mental Health Telehealth?

• 3. Modifiers for Mental Health Telehealth
• Telehealth modifiers indicate that a service was
  provided remotely, rather than in-person, and
  help payers to identify and process telehealth
  claims appropriately. Using the correct
  telehealth modifier is important for several
  reasons, including ensuring proper reimbursement,
  compliance with payer policies, data collection,
  and effective communication between providers.
  Mental health providers should ensure that they
  are familiar with the specific telehealth
  modifiers required by their payers and use them
  appropriately when billing for telehealth
  services. Key modifiers used for mental health
  telehealth are as follows
• Modifier 95 Modifier 95 is used to indicate that
  a service was provided via telehealth. It can be
  used with many CPT codes to indicate that the
  service was provided remotely instead of
  in-person. Modifier 95 is recognized by Medicare
  and some other payers, but not all payers
  recognize this modifier.
• Modifier GT Modifier GT is used to indicate that
  a service was provided via interactive audio and
  video telecommunication systems. This modifier
  was used prior to the creation of Modifier 95 and
  is no longer required by Medicare, but some other
  payers may still require it.
• Modifier GQ Modifier GQ is used to indicate that
  a service was provided via asynchronous
  telecommunication system. This modifier is used
  for services that are not provided in real-time,
  such as the transmission of radiological images
  or ECG tracings.
• Modifier G0 Modifier G0 is used to indicate that
  a service was provided via telehealth and that
  the originating site was a patients home or
  other non-medical location. This modifier is used
  when the patient is not located in a healthcare
  facility or clinic when the telehealth service is
  provided.

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How To Bill Mental Health Telehealth?

• Mental health providers should check with their
  payers to ensure that they are using the correct
  modifiers for telehealth services to avoid claim
  denials or delays. Additionally, providers should
  ensure that they are familiar with any additional
  requirements or documentation needed by the payer
  to bill for telehealth services.
• 4. Telehealth Place of Service Codes 02 and 10
• Telehealth Place of Service (POS) codes are used
  to indicate the physical location where a
  healthcare service was provided. Two common POS
  codes for telehealth services are 02 and 10.
• POS code 02 This code refers to the use of
  telecommunication technology to provide health
  services and related services at a location other
  than the patients home. This means that the
  patient is not physically present in their own
  residence when receiving the services.
• POS code 10 POS 10, on the other hand, refers to
  the use of telecommunication technology to
  provide health services and related services in
  the patients home. This means that the patient
  is physically present in their own residence when
  receiving the services, as opposed to being in a
  hospital or other healthcare facility.
• Its important to note that the use of POS codes
  may vary depending on the payer and the specific
  service being provided.

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How To Bill Mental Health Telehealth?
We hope this article has answered the question
how to bill mental health telehealth services.
Detailed knowledge of benefits verification, CPT
codes, modifiers, and place of service codes will
ensure accurate claim payment of mental health
telehealth claims. Medisys Data Solutions is a
leading medical billing company providing
complete billing and coding services. Our billing
and coding experts are well aware of mental
health telehealth billing guidelines to receive
accurate insurance reimbursement for delivered
services. To know more about our mental health
telehealth billing services, contact us at
info_at_medisysdata.com / 888-720-8884
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