In recent years, telehealth has become a popular method for mental health treatment. Telehealth allows patients to receive mental health services from the comfort of their own homes, and it has become increasingly important during the COVID-19 pandemic. However, many mental health providers are unsure of how to bill for telehealth services. To answer the billing question how to bill mental health telehealth, we discussed the best practices for billing mental health telehealth services along with applicable CPT codes, modifiers, and place of service codes.
How to Bill Mental Health Telehealth
When billing for mental health telehealth services, it’s crucial to understand the requirements of your payer and use proper billing codes. Verify patient eligibility, document services, submit claims timely, and be prepared for denials. Let’s quickly review these best practices for billing mental health telehealth:
1. Understand Your Payer Requirements
Before you begin billing for mental health telehealth services, it is important to understand the specific requirements of your payer. Different insurance companies have different rules and regulations regarding telehealth services. Some insurance companies may require pre-authorization for telehealth services, while others may not cover certain types of telehealth services. To ensure that you are properly billing for your telehealth services, it is important to review the specific requirements of your payer.
2. Use Proper Billing Codes
When billing for mental health telehealth services, it is important to use the proper billing codes. The American Medical Association (AMA) has created specific codes for telehealth services. The codes for telehealth services are similar to the codes for in-person services, but with a “GT” modifier to indicate that the service was provided via telehealth. It is important to use the proper billing codes to ensure that your claims are processed correctly. We also discussed applicable CPT codes, modifiers, and place of services codes, at the end of this article.
3. Verify Patient Eligibility
Before providing mental health telehealth services, it is important to verify that the patient is eligible for telehealth services. Most insurance companies have specific requirements for telehealth services, such as the patient’s location or the type of service provided. It is important to verify that the patient meets all eligibility requirements before providing telehealth services to avoid denied claims.
4. Document Your Services
Just like with in-person services, it is important to document your mental health telehealth services. Documentation should include the date of service, the type of service provided, and the length of the session. It is also important to include any specific details about the telehealth session, such as the type of technology used. Proper documentation is important to ensure that your claims are processed correctly.
5. Submit Claims Timely
It is important to submit claims for mental health telehealth services in a timely manner. Most insurance companies have specific deadlines for submitting claims. Failure to submit claims on time can result in denied claims or delayed payments. To ensure that you are paid for your services in a timely manner, it is important to submit your claims as soon as possible.
6. Be Prepared for Denials
Despite your best efforts, you may experience denials when billing for mental health telehealth services. If you receive a denied claim, it is important to review the reason for the denial and take appropriate action. In some cases, the denial may be due to a simple error that can be corrected. In other cases, the denial may be due to a specific requirement that was not met. By understanding the reason for the denial, you can take appropriate action to correct the issue and resubmit the claim.
CPT Codes for Mental Health Telehealth
Following CPT codes are approved for mental health telehealth billing by both the current procedural terminology (CPT) and the Centers for Medicare Services (CMS):
- 99202 – 99215 – Evaluation and Management Service Codes
- 90791 & 90792 – Diagnostic Interview
- 90832 – Psychotherapy for 30 Minutes
- 90834 – Psychotherapy for 45 Minutes
- 90837 – Psychotherapy for 55+ Minutes
- +90836 – Add On CPT Code for Individual Psychotherapy
- +90838 – Add On CPT Code for Individual Psychotherapy when Preformed with Evaluation and Management Services
- 90845 – Psychoanalysis
- 90846 – Family Psychotherapy without the patient present
- 90847 – Family Psychotherapy with the patient present
Modifiers for Mental Health Telehealth
Modifiers play a crucial role in properly billing for mental health telehealth services. Four common modifiers used for mental health telehealth services include 95, GT, GQ, and G0. The 95 modifier is used to indicate that the service was provided via telehealth. The GT modifier is also used to indicate that the service was provided via telehealth, but it is specifically used for Medicare billing. The GQ modifier is used for asynchronous telehealth services, such as store-and-forward technologies. The G0 modifier is used to indicate that the service was provided through real-time interactive audio and video telecommunications systems. By using the appropriate modifier, mental health providers can ensure that their claims are processed correctly and they are paid for their telehealth services.
Place of Service Codes (POS) for Mental Health Telehealth
When billing for mental health telehealth services, it is important to use the appropriate place of service (POS) code. For telehealth services, there are two main POS codes that can be used: 02 and 10. The POS code 02 is used to indicate that the service was provided through a telehealth platform, while the POS code 10 is used to indicate that the service was provided through a secure electronic messaging platform. The use of the correct POS code is important for billing purposes, as it indicates to the payer that the service was provided remotely. It is important to note that some insurance companies may have specific requirements for the use of each POS code, so it is important to review the specific requirements of your payer.
In conclusion, billing for mental health telehealth services can be a complex process, but it is an important part of providing telehealth services. To ensure that you are properly billing for your services, it is important to understand your payer requirements, use proper billing codes, verify patient eligibility, document your services, submit claims timely, and be prepared for denials. By following these best practices, you can ensure that your mental health telehealth services are billed correctly and that you are paid for your services in a timely manner.
About Medisys Data Solutions (MDS)
We hope that you might have got satisfactory answer to the question, how to bill mental health telehealth? In this article, we shared most common CPT codes and their short description. Sharing complete CPT code description and guidelines is not possible due to copyright issues. Medisys Data Solutions (MDS) is a medical billing company that specializes in billing for various healthcare services, including mental health telehealth services. We have a team of experienced billing professionals who are knowledgeable about the specific requirements for billing mental health telehealth services and can ensure that claims are submitted correctly and in a timely manner. By utilizing our services, mental health providers can focus on providing quality care to their patients while having the peace of mind that their billing is being handled by experts. To know more about our mental health telehealth billing services, contact at info@medisysdata.com / 888-720-8884
CPT is registered copyright of American Medical Association
