Billing for telebehavioral health
The federal government, state Medicaid programs, and private insurers have expanded coverage for telebehavioral and telemental health during the COVID-19 public health emergency.
Medicare and some Medicaid programs will continue to cover telebehavioral health through December 31, 2024. Information on Medicaid reimbursement for telehealth by state is available at the Center for Connected Health Policy with live policy trend maps.
Tip: If a patient has private insurance, verify coverage via the insurance provider policy or request the patient to confirm coverage before each appointment.
On this page:
Medicare billing guidance
The following Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are used to bill for telebehavioral and telemental health services and have been codified into the current Medicare Physician Fee Schedule (PFS). See the complete list of telehealth services covered by Medicare from the Centers for Medicare & Medicaid Services through to December 31, 2024.
Read more
Telebehavioral health requirements with safety-net providers (PDF) – from the Centers for Medicare & Medicaid Services
Telehealth codes for Medicare reimbursement for telebehavioral health
Although Medicare reimburses for audio and video telehealth services, reimbursement for audio-only telehealth services is currently only covered through December 31, 2024.
| Category | Telehealth CPT codes | Audio-only Reimbursed |
|---|---|---|
|
Aphasia and cognitive assessment |
96105, 96125 |
no |
|
Behavioral screening |
96127 |
yes |
|
Diagnostic evaluation |
90791, 90792 |
yes |
|
Psychotherapy |
90832, 90833, 90834, 90836, 90837, 90838 |
yes |
|
Psychoanalysis |
90845 |
yes |
|
Group psychotherapy |
90853 |
yes |
|
Family psychotherapy |
90846, 90847 |
yes |
|
Psychological and neurobehavioral testing or status exam |
96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139 |
no |
|
Crisis intervention and interactive complexity |
90839, 90840, 90785 |
yes |
|
Speech-language behavioral analysis |
92524 |
no |
|
Psychological evaluation |
96130, 96131 |
yes |
|
Neuropsychological evaluation |
96132, 96133 |
yes |
|
Health behavior assessment |
96156, 96160, 96161 |
yes |
|
Health behavior intervention, individual |
96158, 96159 |
yes |
|
Health behavior intervention, group |
96164, 96165 |
yes |
|
Health behavior intervention, family with patient |
96167, 96168 |
yes |
|
Developmental screening and testing |
96112, 96113 |
no |
|
Adaptive behavior assessment |
97151, 97152, 0362T |
no |
|
Adaptive behavior treatment |
97153, 97154, 97155, 97156, 97157, 97158, 0373T |
no |
|
Therapeutic interventions |
97129, 97130 |
no |
|
Therapeutic interventions (group) |
97150 |
no |
|
Smoking and tobacco use counseling |
99406, 99407 |
yes |
|
Obesity counseling |
G0447 |
yes |
|
Category |
Telehealth HCPCS codes |
|
|
Screening, brief intervention, and referral to treatment |
G0396, G0397, G0442, G0443, G0444, G0445, G0446 |
yes |
|
Opioid use disorder treatment |
G2086, G2087, G2088 |
yes |
Non-covered services
These telebehavioral health services are not Medicare reimbursable.
| Category | Telehealth CPT codes |
|---|---|
|
Developmental screening and testing |
96110 |
|
Health behavior intervention, family without patient |
96170, 96171 |
|
Psychophysiological therapy |
90875 |
Private insurance
Health care billing code changes initiated during the COVID-19 public health emergency cover telehealth and include specific information for audio-only or video-only visits. It is important to note that most states distinguish between reimbursement standards for permanent telehealth policies and temporary COVID-19 reimbursement policies. For tips on coding private insurance claims, see:
- Current State Laws & Reimbursement Policies (Private Payer Laws) — from the National Policy Center - Center for Connected Health Policy
- Coding Scenarios for telehealth visits (by payer policy) — from the American Academy of Family Physicians
Have a question?
Contact the staff at the regional telehealth resource center closest to you for help setting up billing and reimbursement for a new telehealth service.
For more details about billing and reimbursement, including telehealth coding, watch Behavioral Health Billing & Coding 101: How to Get Paid (video) — from the American Medical Association (AMA)
Medicaid
While each state is different, many have expanded coverage for telebehavioral and telemental health during the COVID-19 public health emergency. Many states currently match Medicare’s telebehavioral and telemental health coverage.
To see which telebehavioral and telemental health services Medicaid covers, check your state’s current laws and reimbursement policies.