An alternative to face-to-face psychotherapy is telehealth, also known as teletherapy or telemedicine.
HIPAA standards require telehealth sessions to be conducted over a secure, encrypted channel. TherapyAppointment's integrated telehealth exceeds these standards.
Protecting Your Practice
Here are several key areas to be aware of when incorporating telehealth into your growing practice.
Legal and Ethical Issues
- We urge you to check with your state licensing organization to fully understand your state's requirements regarding practicing telehealth.
- Research the Interstate Medical Licensing Compact for information on conducting telehealth across a state line.
- Ethics - this link by a for-profit insurance carrier suggests the best ways to conduct telehealth ethically.
- Click here for direct access to a map and search options that cover current laws and regulations for all fifty states and the District of Columbia. If there are other questions, contact your insurance carriers to ensure that they cover telehealth services.
Billing & Insurance
- The billing codes used for telehealth differ from the codes used for face-to-face encounters. Different insurance companies may require different methods for coding these encounters. For example, some carriers want you to use the modifier code "GT" while others want the modifier "95". Still others may want you to specify a Place of Service code of "02" to indicate telehealth. TherapyAppointment memorizes these requirements for each insurance carrier, but you must first contact them to discover their requirements.
- Before billing for a service you may want to consult with a billing professional, the CPT code manual, and/or the insurance providers you are billing. Insurance providers may have special requirements or proof of training; this is especially true for Medicare and Medicaid.
Telehealth Best Practices
We have produced a video discussing all aspects of telehealth, available HERE.
Your clients may need some reassurance if they're new to telehealth:
- Inform clients of what can be expected when using teletherapy and how to access the session. Be able to explain how the technology and process is going to work. (See additional resources on using telehealth below). *
- Client intake forms for telehealth should include the same information that non-telehealth client forms contain. In addition, you will also want your client to sign an additional consent form specific to telehealth.
- Distractions can increase when the environment shifts to an in-home setting. Remind clients of the importance of confidentiality during the session (no one within earshot), as well as being in a safe and quiet environment (not driving, not in a cafe, etc).
- Adjust your seating so that your facial expressions and body language are easily seen. Suggest that your client do the same. Make sure that your camera is roughly at eye level. Don't have a strong light (like a window) in the background, since this can make your face seem dark and threatening.
- Though it is a difficult habit to establish, try to look at the camera rather than directly at the screen. Looking at the screen may appear to your client like you are looking down or avoiding eye contact, which can unconsciously dilute your client’s sense that you are “present” in the session.
- Though telehealth works with a computer or a cell phone, some clients dislike using a phone. It is tiring to hold it for an hour, the video image is small, and battery life may be limited. Others prefer a phone for its portability and familiarity. If possible, you will probably want to use a computer.
Legacy CPT Modifier Codes
2.0 CPT Modifier Codes
Three New Covered Telehealth/Teletherapy Services
American Psychological Association: Medicare Telethealth Psychotherapy Coverage
American Psychological Association: Psychotherapy Coding Clarifications
American Psychological Association: Legal and Ethical Guidelines for Telehealth
COVID-19 Related State Actions
CDC Cases & Latest Updates for COVID-19
Symptoms of COVID-19 (pdf)