Medical Billing Forum

Billing => Billing => Topic started by: tdiet0928 on August 08, 2017, 08:53:16 AM

Title: telepsychiatry
Post by: tdiet0928 on August 08, 2017, 08:53:16 AM
My office is looking at doing telepsychiatry. I cannot find much information on it and the boss wants to know if it will be profitable before we dive into it. Does anyone have any experience with this and knows what codes can be billed and if there is anything different that I need to do when billing for the services.

Thank you!
Title: Re: telepsychiatry
Post by: PMRNC on August 08, 2017, 09:20:39 AM
You will want to take a look at your state law regarding insurance reimbursement of telehealth services. This is a good link state by state with the law for each: http://securetelehealth.com/private-insurance.html
Keep in mind that coverage may not be available on grandfathered ERISA plans. You'll also want to analyze your payor mix especially those with group health coverage that are ERISA based plans.

Next you'll want to make sure all of your equipment/connections are HIPAA compliant of course. Appropriate patient disclosures should also be in place.

Most of the offices in my area (NY) that offer it, have patients pay cash and give them a bill they can use to submit to their insurance carrier. This lessens the burden of filing appeals, etc. For example, there is one mental health clinic in my area that does these but only for established patients. Patient's pay through their secure system on the day of their session.
If you do choose to bill insurance, you would use the same CPT codes as you would for face-to-face but you would add the GT modifier to indicate it was telehealth services and you can also bill Q3014 for the site originating fee (check each plan to see if that is a covered benefit). If billing insurance I would also make sure to get appropriate authorizations from the carriers as you would for face-to-face if required.

Also check any payor contracts for specific payor requirements.
Title: Re: telepsychiatry
Post by: tdiet0928 on August 31, 2017, 02:12:13 PM
Thanks so much! That is a big help!  Do you know off hand if the rates are lower for telepsychiatry than if it is a face to face code?
Title: Re: telepsychiatry
Post by: Michele on September 02, 2017, 06:03:55 PM
I do believe the reimbursement rate for telemedicine is lower than office visits but I do not know by how much.  Sorry!