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Telehealth for behavioral health care

Getting started: Is telebehavioral health right for your practice?

Telebehavioral health can break down barriers and offers more privacy protections than face-to-face mental health care. Other benefits include:

  • Connecting patients and providers to a broader network regardless of location.
  • Easier, more convenient access to specialists and unique opportunities for patients and providers to connect with others who speak the same language or come from a similar cultural background.
  • More confidence in patients who are unwilling to seek out in-person behavioral health treatment, but feel comfortable with telehealth.

Providing behavioral health care via telehealth takes planning. It requires new ways of delivering care. Understanding the pros and cons for you and your patients will help you decide if providing telebehavioral or telemental health services is right for your practice.

Adding new telebehavioral/telemental health services

  • Decide which telebehavioral and/or telemental services you will provide. Identify any gaps in your services and the problems you want to solve. Remember that certain behavioral or mental health approaches may not be ideal for telehealth, such as exposure therapy or intensive treatment that requires inpatient monitoring.

    Common telebehavioral and telemental health services include:

    • Psychiatric assessments
    • Individual online counseling for anxiety and depression
    • Online group therapy
    • Treatment for substance use disorder
    • Telepsychiatry for prescription monitoring and refills
  • Understand the community you serve. Think about what services your patients need and what the common behavioral health challenges are in your area. Decide which telehealth approach best matches your skills and will be the most effective in your community.

    Research the common behavioral and mental health models that work well with telehealth, including individual therapy, group therapy, and substance use disorder treatment.

    Some factors to consider include:

    • Increased need for mental health services for health care providers and front line workers who work longer hours in stressful circumstances
    • Challenges unique to your area that impact the community’s need for behavioral or mental health services
    • How your telebehavioral or telemental health services can be easily accessed by a diverse group of patients with different needs.
  • Determine your budget for technology and customer support. Review your budget to understand if you have the financial resources to invest in ongoing maintenance and tech support. Also, consider whether you want to use existing telehealth software or hire someone to create a new behavioral health platform just for your practice.

    Other expenses could include:

  • Take time for staff training. Spend time to make sure your staff have the skills to do their job well. Help your staff better understand and support your patients with training on the basics of telehealth as well as behavioral, addiction and mental health disorders. Include cultural sensitivity and accessibility requirements as part of your regular skills training.

Exploring telehealth technology

  • Get connected. Making sure your patients can get online for telehealth is essential. Do your research and ensure broadband internet is available, affordable, and easily accessible in your community. Some cities also offer “tele-hubs” — rooms with a computer and free internet access, often located in community centers or libraries.

Understanding telehealth and behavioral health laws

  • Get familiar with state and local laws. Using telehealth for your behavioral and mental health practice requires following a new set of regulations specific to telehealth. It also means spending more time and cost to stay compliant (video). Review the different laws for telehealth services, including specific state licensure requirements for psychologists and other behavioral and mental health professionals. If you plan to practice telepsychiatry or offer services prescribing controlled substances via telehealth, research the state and federal rules and regulations.

  • Research telehealth insurance reimbursement. Private insurance companies and even Medicare and Medicaid limit telehealth reimbursement to certain types of services and care. It is important to understand if the services you plan to offer can be reimbursed and if the reimbursement rates are enough to cover your costs.

    Insurance reimbursements can take a long time to process. You will need to have enough money set aside to cover your costs until you receive payment for your services.

  • Audio-only or video telehealth. Audio-only telehealth may be a good option for patients who do not have access to a smartphone, tablet or a computer with a webcam. But it may not be easily billable. Although Medicare reimburses for audio and video telehealth, audio-only reimbursement is currently covered only during the COVID-19 public health emergency.

Many policies have changed to allow for broader telehealth reimbursement during the COVID-19 public health emergency, but these policies may change again, and coverage may end for certain telebehavioral or telemental health services.

Read more about incorporating telebehavioral and telemental health into your practice: