fbpx

Telehealth Certification Institute Logo

Medicare Reimbursement for TeleHealth

The Centers for Medicare & Medicaid Services (CMS), HHS published their final rule for 2018 stating the changes to the Medicare physician fee schedule(PFS) and other Medicare Part B payment policies. 

Click here to see the final rule.

Here is a summary of the important updates for behavioral health providers.  However, DO NOT consider this as guidance for your Medicare billing.  We advise that you consult directly with the Centers for Medicare & Medicaid Services (CMS) for guidance and to ensure the accuracy of your billing practices. 

Conditions for billing and payment for telehealth services:

To be reimbursed for telehealth services, the service must be on the approved list.

To view the approved list of telehealth services click here and select the most recent regulation number and then click on the following item “CY 2018 List of Medicare Telehealth Services”.

Also, all of the following requirements must be met (taken directly from the final rule):

● The service must be furnished via an interactive telecommunications system.

(audio and video equipment permitting two-way, real-time interactive

Communication)

● The service must be furnished by a physician or other authorized practitioner.

(At this time Counselors and Marriage and Family Therapists are working to be added as authorized practitioners)

● The service must be furnished to an eligible telehealth individual.

● The individual receiving the service must be located in a telehealth originating site.

(The originating site is the location of the client and the distant site is the location of the clinician.  Approved originating sites are those located in rural health professional shortage areas (HPSAs) or in a county that is not included in a metropolitan statistical area (MSA).)

 

Claims are to be submitted to the Medicare Administrative Contractors (MACs) that process claims for the service area where their distant site is located.

 

Payment Parity:

“Section 1834(m)(2)(A) of the Act requires that a practitioner who furnishes a telehealth service to an eligible telehealth individual be paid an amount equal to the amount that the practitioner would have been paid if the service had been furnished without the use of a telecommunications system.”

No more GT modifier.  Now that the place of service 02 is used to designate telehealth the GT modifier is not needed (with the exception CAH Method II billing).

TeleMental Health Codes include:

90785    Psytx complex interactive            

90791    Psych diagnostic evaluation        

90792    Psych diag eval w/med srvcs      

90832    Psytx pt&/family 30 minutes      

90833    Psytx pt&/fam w/e&m 30 min   

90834    Psytx pt&/family 45 minutes      

90836    Psytx pt&/fam w/e&m 45 min   

90837    Psytx pt&/family 60 minutes      

90838    Psytx pt&/fam w/e&m 60 min                   

90845    Psychoanalysis 

90846    Family psytx w/o patient              

90847    Family psytx w/patient 

Two new codes:

90839    Psytx crisis initial 60 min             

90840    Psytx crisis ea addl 30 min

2 comments

Leave a comment

Make sure you enter all the required information, indicated by an asterisk (*). HTML code is not allowed.

Latest Posts

  • Positive Results in VA’s Efforts to Bring Telehealth to Veterans

    JAMIA recently published their study on the US Department of Veteran Affairs (VA) initiative to bring telehealth to Veterans in serious need of healthcare and with barriers to accessible care. Eighty-six VA facilities provided tablets with telehealth capabilities to 6,745 patients.

    Read more...
  • Louisiana’s TeleTherapy Rule

    Louisiana's LPC Board of Examiners has enacted their Teletherapy Guidelines for Licensees, which requires telemental health training prior to licensees providing teletherapy.  The new regulation is clear, helpful, and resonable to comply with. 

    Read more...
  • TeleMental Health Training Grant Produces Results

    In June of 2018, I provided a two-part (two-day) training on TeleMental Health at the University of North Florida  as part of a grant project called CMHC CONNECT (Clinical Mental Health Counseling, Creating Opportunities Needed in North Florida for Educating Counselors through Technology). The project was funded by the Humana Foundation and held in partnership with UNF. According to the university’s follow-up summary, they “contracted with Telehealth Certification Institute, LLC to provide TeleMental Health Training for CMHC students and mental health providers with comprehensive information on the establishment and provision of TeleMental Health services to clients.

    Read more...
  • How to Market Counseling Services and Choose a Marketing Professional

    This week Raymond Barrett, CEO of Telehealth Certification Institute, had the opportunity to interview Lisa Wozniak, a professional marketing consultant and the founder/owner of Woz Marketing, which according to their website (wozmarketing.com) is “a social media marketing company dedicated to serving the needs of small business owners and medical professionals.” The full video of their conversation can be found below.

    Read more...
  • TeleSupervision: Finding the Right Fit and How it Works

    Ruby Blow, owner and operator of Atlanta-based Development Counts, provides clinical supervision, consultation, and training. Among her many licenses and certifications, Ruby is an Approved Clinical Supervisor (ACS). She has provided services since 2001 and increasingly, Ruby has seen a shift in the mode of services to electronic meetings (primarily via video conferencing) rather than in-person.

    Read more...
This course was short yet informative.
Annette Cornish
Therapist / Dust 2 Destiny Counseling & Wellness
Great training!
Jacqueline Hayes, M.Ed., LPC, LMHP
Professional Counselor 4 / State of LA
Ray was a wonderful, interactive instructor who really captured the heart of counseling in the world of Telehealth. The course was thorough and beneficial. Two thumbs up!
Rachel Morales
Licensed Professional Counselor
Ray does a spectacular job presenting the ethics in technology! Thank you!
Elaine Marie Barclay
Licensed Professional Counselor/ Assistant Professor / Shorter University/ Capella University
Very beneficial and useful to the direction i am moving of providing therapy
Linda Marie Margosian, MS, NCC, LMHC
I thought the video was very informative and gave me a good back ground on Telehealth , hippa laws and things I needed to know to run an ethical and hippa complent practice .
Meg Maginn
Director /private practitioner / Eating Disorder Associates

I believe this is a good course to take because this is the new wave of society. As a therapist I would like to be able to offer clients the best tools available.

Wihletta Michelle Davis MA, LPC
Therapist / Find the Miracle Within...
This course was very informative for me as a clinician and for my profession
Roseline Ngoeh
Community Clinician / NPS

Thank you for the introduction to telemental health.

Michele Frances Purvin
Psychotherapist / Michele Frances Purvin, LCSW, LCDC

Very good.

Franklin Castillo

Really excellent training full of valuable information and resources - surpassed my expectations!

Dori Ryherd
Therapist / The Cognitive Refinery

Great information with step by step instructions

Donna Tucker
Addiction Counselor / Spectrum Health

What a superb introduction to telemental health, well organized and packed with useful tips. I so appreciate this. Thank you.

Ann P Cahouet
Owner - Clinician / Equine Assisted Solutions LLC

Awesome job! This is a very insightful presentation.

ZUNILDA CHAUDRY
Licensed Therapist, LPC / Seasons of Change Behavioral Health Services, Inc
Ray is down-to-earth, warm, pragmatic and exceptionally well-informed.
G. Reid Doster, LPC, LMFT
Director of Behavioral Health, EXCELth Inc.Primary Health Network & Private Practice Psychotherapist / www.excelth.com

An excellent course, but needs more legal information regarding where the patient needs to reside.

Barry Barmann
Clinical Psychologist / Behavior Therapy & Family Counseling Clinic
This legal course was phenomenal saturated with much detail and clarity!
Elaine Marie Barclay
Licensed Professional Counselor, Assistant Professor / Capella University and Shorter University
Great and very informative! Will help me take my skills to a new level. Gave me a great idea of how the session should go.
Jessica Latin
LPC / JL Counseling

Course provided several case scenarios regarding Interstate counseling and resource websites for further research.

Cowenda Jefferson
Clinical Director / Wise Life Choices LLC
Course provided additional information regarding the legal aspects of TeleMental Health.
Cowenda Jefferson
Clinical Director / Wise LIfe Choices LLC
I have completed prior training by Raymond and greatly appreciate his detailed and thorough trainings.
Dr Lynn Duffy, PsyD, LCPC, NCC, CCMHC, BCPCC, BC-TMH, Diplomate/CMH in Trauma
Director/Counselor/Mediator / Lighthouse Counseling & Consulting Services
This course was most helpful in helping me make my practice more compliant for me and my clients.
Marlene Small
Private Psychotherapist
This is the 4th TMH course I have taken with Ray and it is BY FAR the best TMH training out there. I've learned so much that I can use every day in my practice.
Dawn Ferrara
LPC-S, LMFT

Very Informative

Naomie Pierre
community clinician / nps
I loved this course. It was very informative and provide a great deal of information about ethics.
Tracey Marshall
Easy to learn and easy to follow. User friendly on-line course.
Kelly Johnson
Licensed Mental Health Therapist

Awesome

Melissa J Davis
LAPC- counselor
This was a phenomenal training and necessary for the continued growth of all helping professionals. This will certainly improve the manner in which I conduct counseling.
Elaine Marie Barclay
This training was extremely informative and supportive for professionals looking to gain further knowledge in Telemental health.
Marcy Abramsky
LCSW / Marcy Abramsky LCSW, InspireAmind TM Counseling and Consulting
I found this video to be very informative and helpful.
Michelle Parker
Contract Therapist

Great course, very informative!

Ashley Simmons
BCBA / Northstar Psychological Services

Love the course, worth every penny!!! Definitely helped jump start my Tele-mental health services!

Nakia Clark
Owner/ Therapist / Insightfullly You, LLC

This gave me and my staff some important insights and information regarding telehealth..

Larry Cowan
Executive Director / Samaritan Counseling and Growth

This course was easy and user friendly

Vanessa Reiser
Social Worker / JBFCS

I learned a great deal from this program and look forward to implementing telemental health in my therapy practice.

Michelle Hitchcock
Therapist

It was fantastic! Just the forms he provides are worth the cost of the course!

Mark Wagemaker, LPC, NCC, DCC, CPCS
Counselor, Clinical Supervisor / Transitions Counseling

This was an excellent class and worth my time.  Ray provided great information and is clearly an expert in TMH!

Jennifer Stuckert
Director / Restoration Counselor of Atlanta, LLC

I found these courses informative and helpful. They make establishing best practices policies and procedures for telemental health services and supervising those who provide them. so much easier. I highly recommend his courses.

Nena Rybarczyk, MA, EMBA, LPC, NCC, CPCS
Counselor / Strategies for Life Counseling, LLC

Ray's workshop was one of the most informative I have taken in years. He brought clarity to took a topic which has been intimidating and I left feeling empowered!

TRUDY POST SPRUNK, LMFT-S LPC CPCS RPT-S CPT-S EMD
Clinical Supervisor and Play Therapist / Georgia Association for Play Therapy