CPT Codes for Teletherapy: What You Need to Know for Billing and Reimbursement

The COVID-19 pandemic has led to a significant shift in the way mental health services are delivered. Teletherapy, or the delivery of therapy services via phone or videoconferencing, has become increasingly popular as a way to provide mental health services to clients who may not be able to attend in-person sessions.

As a mental health provider, it's important to understand the CPT codes for teletherapy, so you can bill insurance companies and receive reimbursement for your services. In this blog post, we will explore what you need to know about CPT codes for teletherapy and how to ensure that you are billing correctly.

What are CPT codes for teletherapy?

CPT codes, or Current Procedural Terminology codes, are used to identify specific services and procedures provided by healthcare providers. CPT codes are used by insurance companies to determine the reimbursement amount for a particular service or procedure.

For teletherapy services, there are specific CPT codes that mental health providers need to use when billing insurance companies. The CPT codes for teletherapy include:

90832: Psychotherapy, 30 minutes with patient

90834: Psychotherapy, 45 minutes with patient

90837: Psychotherapy, 60 minutes with patient

90791: Psychiatric diagnostic evaluation

90833: Psychotherapy, 30 minutes with patient when performed with an evaluation and management service

90836: Psychotherapy, 45 minutes with patient when performed with an evaluation and management service

90838: Psychotherapy, 60 minutes with patient when performed with an evaluation and management service

It's important to note that not all insurance companies cover teletherapy services. Be sure to check with the insurance company before providing teletherapy services to ensure that they will cover the services.

How to bill for teletherapy services?

When billing for teletherapy services, you will need to use the appropriate CPT code for the service provided. You will also need to include a modifier to indicate that the service was provided via teletherapy. The appropriate modifier to use for teletherapy services is "95."

For example, if you provide a 45-minute psychotherapy session via videoconferencing, you would use the CPT code 90834 and the modifier 95. The billing code would be 90834-95.

It's important to ensure that you document the teletherapy session properly in the client's medical record. The documentation should include the date and time of the session, the type of service provided, and the length of the session.

What are the reimbursement rates for teletherapy services?

The reimbursement rates for teletherapy services vary depending on the insurance company and the specific plan. Some insurance companies may reimburse at the same rate as in-person sessions, while others may reimburse at a lower rate.

It's important to check with the insurance company to determine the reimbursement rate for teletherapy services. If the insurance company does not cover teletherapy services or reimburses at a lower rate, you may need to consider charging the client a self-pay rate for the service.

In conclusion, understanding the CPT codes for teletherapy is essential for mental health providers who provide teletherapy services. Using the appropriate CPT codes and modifiers, documenting the teletherapy session properly, and checking with the insurance company for reimbursement rates can help ensure that you are billing correctly and receiving appropriate reimbursement for your services. By following these guidelines, you can continue to provide quality mental health services to clients, even during the pandemic.

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