Telehealth Coverage and Billing in a Post-COVID Future
1.5 CE Credit Hours. Continuing Education Session Replay. [Approved for attendees whose licensing boards accept trainings on insurance billing for continuing education credit]
Presented By: Barbara Griswold, LMFT
As temporary COVID coverage rules relax, navigating the world of billing for these sessions has become more complex
Whether you work directly with insurance or not, this essential presentation will give you the latest updates on what you need to know about billing insurance for video and phone psychotherapy sessions — both now and post-COVID-19.
We will address your questions, including:
- How is coding different for telehealth sessions?
- Are insurance plans waiving copays? Will I get paid less if they do?
- Are out-of-network providers being covered, and will this continue?
- Will phone sessions continue to be covered, and if so, how are they coded?
- What’s the best way to get the latest coverage information?
- How is documentation for telehealth different?
- Are reimbursement rates different than in-person?
- Must I now use a HIPAA-compatible telehealth platform?
- Can I provide therapy to an out-of-state client? What if I travel out of state?
- How are insurance plans reacting to providers giving up their offices? What address do I put on my claim/superbill?
CE: 1.5 Hours [approved for attendees whose licensing boards accept trainings on insurance billing for continuing education credit]
Course Description
Educational Objectives
- Understand how to ethically code and bill for telehealth sessions, in order to avoid claim denials and treatment interruption
- Name two things clinicians may be required to document for each telehealth session
- Identify legal considerations before providing insurance-funded therapy across state lines
Syllabus
- The Mechanics of Billing Insurance for Telehealth
- What CPT code, Place of Service Codes and Modifier to use
- How to Verify Benefits, and What to Ask the Plan
- Insurance Coverage for Telehealth
- Trends in Insurance Coverage of Video Sessions
- Trends in Coverage of Phone Sessions
- Trends in Coverage of Out-of-Network Providers
- Payment/Coverage Parity for Telehealth vs. Office Visits
- Legal and Ethical
- Considerations When Seeing an Insurance Client in Another State
- Current Expectations About Using a HIPAA-Compatible Platform
- Insurance Billing for All-Telehealth Practitioners
- Will Insurance Plans Require an Office Address?
References
- 50-State Teletherapy Practice Rules Survey for Counselors, MFTs, Psychologists, and Clinical Social Workers, Person-Centered Tech, https://personcenteredtech.com/50-state-emergency-teletherapy-practice-rules-counselors-mfts-psychologists-social-workers/
- CCHP, How COVID has impacted telehealth laws (state by state): https://tinyurl.com/stateactions
- Renewal of Determination that A Public Health Emergency Exists, US Dept Health and Human Services, https://www.phe.gov/emergency/news/healthactions/phe/Pages/COVID-15April2021.aspx
Presented/Developed By
Barbara Griswold, LMFT is a private practice consultant and coach, and the author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance — And Whether You Should, now out in its 8th edition. In private practice in San Jose, CA, she has been interviewed on NPR’s “Morning Edition,” and her articles on insurance and documentation have appeared in Psychotherapy Networker and The Therapist magazines. She writes the e-newsletter “What EVERY Therapist Should Know About Insurance.” Her passion is helping therapists nationwide to feel as confident about their businesses as they do about their therapy. She invites PCT listeners to contact her at theinsurancemaze.com.
Program Notices
Accuracy, Utility, and Risks Statement: None.
Conflicts of Interest: None reported.
Commercial Support: Person Centered Tech Inc. is sponsoring this event and will give a brief commercial presentation during the break.
This course is subject to our cancellation/refund policy and complaint policy.