Insurance Reimbursement: New
List of All Telemental Health/Online Therapy Procedures (CPT/HCPCS) & Codes Added for 2013
Squyres, PhD & Marlene M. Maheu, PhD
Historically, insurance reimbursement for telehealth has been
difficult. Payers typically have only reimbursed for telehealth when a
patient presented at a physician's office, medical clinic, hospital,
community health center or skilled nursing facility.
While dismay about declining reimbursement rates is
widespread, some professionals are
also beginning to understand the benefits
of telepractice involving Medicare and Medicaid, especially when they can work from home, reduce monthly office expenses, reach more clients/patients, and often continue seeing clients/patients after relocation.
To date, these procedures are reimbursable for telemental health:
Individual & group health & behavior assessment & intervention
In final rulemaking for the 2013 Medicare Part B physician fee
schedule, the Centers for Medicare and Medicaid Services (CMS) have
approved adding telehealth coverage for the following Healthcare Common
Procedure Coding System (HCPCS) codes:
G0396 and G0397 -- Alcohol and/or substance (other than tobacco)
abuse structured assessment (for example, AUDIT, DAST) and brief
intervention, 15 to 30 minutes and intervention greater than 30
G0445 -- High-intensity behavioral counseling to prevent
sexually transmitted infections, face-to-face, individual, includes:
education, skills training, and guidance on how to change sexual
behavior, performed semiannually, 30 minutes
G0447 -- Face-to-face behavioral counseling for obesity, 15
The full 1362-page notice of proposed rulemaking is available here.
An excerpt of the core 16 pages for telehealth is available here.
The final rulemaking will be published in the Federal
Register on November 16.
Much progress has also been made with private payers as well. As we
have reported in our blog, States
Requiring Private Insurance Payers Reimbursement for Telehealth,
fifteen states mandate that insurers cover telehealth at the same rate
as services delivered in person. Many private insurers are
becoming increasingly willing to reimburse for telehealth services to
Read more about how these changes will impact mental health here....
Get your professional training now, while prices are still low.
Telehealth Summit 2012
Speaking of reimbursement and profits, are you tired of paying for an expensive office lease
Have you ever calculated how much overhead you can save (after-tax dollars) if you could avoid paying for:
your brick-and-mortar office lease
wear and tear on your automobile
gas you burn driving to work or sitting in traffic
lost productivity due to travel time to work every day
Learn how to stay at home and work from your den, a spare bedroom, or home office, retain valued clients /patients and enjoy a 30-second commute from your kitchen.
Professional training has never been easier.
Attend our Telehealth
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recordings delivered to your desktop or any portable device, combined
with 10 CEs or 8 CMEs.
years Marlene has been the leader
in thought, training and advocacy
regarding the impact of technology
on mental health professions."
Donna Ford MA, Former
President, American Counseling
a true innovator in bringing
technology to the mental health
field. Her books are a must and I
recommend them to my students."
Dale Masi, Ph.D.
President/CEO, Masi Research
worked at the forefront if
Telehealth for many years and
has substantial expertise in the
area. I strongly recommend her
as a speaker and consultant in
Associate Provost at Simmons
provides all of the essential
training needed to start
practicing telemental health or
telepsychiatry. The courses are
unsurpassed, unique and contain
everything one needs to know in
order to start practicing. Upon
completing this training, a
provider is "ready to go."
Lacy, MD. Former Chief of
Telehealth for the US Air Force
Surgeon General, CEO of
trainees are saying about their
"I have to tell you that I'm
really enjoying the materials and the whole process you are using to do
the event, from promotion to delivering the
So, a big thank you for the Summit 2012 and what must be a truly gargantuan effort behind it."
Donald Coggan, PE
"I found the
style, format, and length were
excellent." Brent Lindquist,
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All rights reserved.