Telehealth has opened hundreds of doors for mental health providers and their clients. This digital visit tool has broken down barriers to mental health care and allowed thousands and thousands of individuals to get the care and attention they need. In recent years, the use of telehealth has skyrocketed as individuals embrace digital advancements, but even more so due to the constraints of the 2020 pandemic. The limits on in-person interactions dictated by COVID-19 had the nation turn to telehealth to continue delivering and receiving health, mental health, and behavioral health care.
On the provider side, the introduction of telehealth and its increased use means an equal increase in the use of telehealth billing codes for therapists. Insurance billing is complicated, and billing codes are a common cause of denied reimbursements. Providers who deliver telehealth services need to be familiar with these top telehealth billing codes.
Telehealth Billing Codes for Therapists:
The following codes are approved for mental health CPT billing by the Centers for Medicare and Medicaid Services (CMS):
99202-99205 E/M New Patient Office Visits –
99202-15-29 Minutes – Straightforward decision making, minor problem, minimal data, and minimal risk.
99203 – 30-44 Minutes – Low decision making, 2 or more self-limited or minor problems, limited data, low risk.
99204 – 45-59 Minutes – Moderate decision making, moderate data, moderate risk.
99205 – 60-74 Minutes – High level of decision making, high data, high risk.
+99417* Modifier – 75 Minutes and beyond for every 15 Minutes Additional
99211-99215 E/M Established Patient Visits
99211 – No Time Reference
99212 – 10-19 Minutes – Straightforward decision making, minor problem, minimal data, and minimal risk.
99213 20-29 Minutes – Low decision making, 2 or more self-limited or minor problems, limited data, low risk.
99214 – 30-39 Minutes- Moderate decision making, moderate data, moderate risk.
99215 – 40-54 Minutes – High level of decision making, high data, high risk.
+99417* Modifier- 55 Minutes and beyond for every 15 Minutes Additional
90791 – 90792 Diagnostic Interview
90791 – Integrated biopsychosocial assessment including history, mental status, and recommendations. Non-medical providers.
90792- Integrated biopsychosocial assessment including history, mental status, and recommendations. Medical services provided.
90832 – Psychotherapy for 30 Minutes
90834 – Psychotherapy for 45 Minutes
90837 – Psychotherapy for 55 Minutes or More
+ 90836 Add On – Individual Psychotherapy
+ 90838 Add On – Individual Psychotherapy when performed with evaluation and management services
90845 – Psychoanalysis
90846 – Family Psychotherapy w/o the patient present
90847 – Family Psychotherapy w/ the patient present.
Telehealth CPT Code Modifiers:
95/GT – Synchronous telemedicine services rendered via real-time interactive audio and Video Telecommunications Systems (Source).
How to Perfect Telehealth Billing Codes:
To perfect telehealth billing codes in practice, providers will need a system in place that simplifies the coding process overall or outsource your billing process to a highly qualified team of billing experts.
Benefits of a Quality Telehealth System:
Most importantly, making sure you have a telehealth system that is approved for use and offers you everything you need to optimize the patient experience and streamline your workflow should be at the top of the list. Did we mention ShareNote has a HIPAA-compliant telehealth portal?
Not all telehealth systems are created at the same level of quality as they should be. In fact, some systems will leave providers and their clients/patients frustrated with their lack of usefulness and abilities.
Providers need to find a quality telehealth system that has the following features:
Ultimately, the ability to see and communicate with your client during an online session is a huge priority with telehealth. No provider should deal with lagging systems or poor video quality, and providers should look for a high-functioning system.
Custom Waiting Room
Your system should create a pleasant client experience in every way, including the waiting room. While your client shouldn’t have to wait long, your virtual waiting room should be customizable to you and your practice, fit with marvelous imagery, music, and more.
Telehealth should be built for individual therapy and group therapy sessions as well. A great system will enable everyone in a group session to see and communicate with one another just as they were in office.
Your telehealth solution should support the overall workflow of you or your practice, helping you see more clients and improve their overall experience.