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Best practice guide

Telehealth for behavioral health care
For providers Best practice guides Telehealth for behavioral health care

Billing for telebehavioral health

If you decide to provide telebehavioral health services, you will have to learn about rules and regulations for billing and reimbursement.

The federal government, state Medicaid programs, and private insurers have all expanded coverage for telehealth during the COVID-19 public health emergency. Most insurance companies cover telehealth services — often including behavioral telemedicine. To confirm coverage, make a habit of verifying each insurance provider policy. Ask patients to confirm their own coverage before each appointment.

Medicare billing guidance

Below are common codes used to bill for services, including some that were updated for the 2021 Physician Fee Schedule (PFS). Note: Although some services will be permanently reimbursable, this list also includes those that are temporarily covered, due to the COVID-19 public health emergency, and thus subject to change. See the complete list of telehealth services covered by Medicare during the public health emergency from the Centers for Medicare & Medicaid Services.

Audio-only or video telehealth

Although Medicare reimburses for audio and video telehealth, audio-only reimbursement is currently covered only during the COVID-19 public health emergency.

Category Billing codes

Diagnostic evaluation

90791, 90792

Psychotherapy

90832, 90833, 90834, 90836, 90837, 90838

Psychoanalysis

90845

Group psychotherapy

90853

Family psychotherapy

90846, 90847

Crisis intervention and interactive complexity

90839, 90840, 90785

Speech-language behavioral analysis

92524

Psychological and neurobehavioral testing or status exam

96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139

Psychological evaluation

96130, 96131

Neuropsychological evaluation

96132, 96133

Psychological & neuropsychological test administration & scoring

96136, 96137, 96138, 96139

Health behavior assessment

96156, 96160, 96161

Health behavior intervention, individual

96158, 96159

Health behavior intervention, group

96164, 96165

Health behavior intervention, family with patient

96167, 96168

Behavioral screening

96127

Smoking and tobacco use counseling

99406, 99407

Screening, brief intervention, and referral to treatment

G0396, G0397 G0442, G0443, G0444, G0445, G0446, G0447

Opioid use disorder treatment

G2086, G2087, G2088

Video telehealth only

Category Billing codes

Developmental screening and testing

96110, 96112, 96113

Adaptive behavior assessment

97151, 97152, 0362T

Adaptive behavior treatment

97153, 97154, 97155, 97156, 97157, 97158, 0373T

Non-covered services

It is important to note that these behavioral health services are not Medicare reimbursable.

Category Billing codes

Health behavior intervention, family without patient

96170, 96171

Psychophysiological therapy

90875

Medicaid

While each state is different, most have expanded coverage for telehealth due to COVID-19. Many are now matching Medicare’s telehealth coverage. Check your state’s current laws and reimbursement policies exit disclaimer icon  to see what is covered. For updates on COVID-19 reimbursement and related Medicaid codes and procedures for your state, see:

Private insurance

Many code changes for COVID-19 care cover telehealth and include specific information for visits that are video- or audio-only. 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:

Tip: For help setting up billing and reimbursement for a new service, contact the National Telehealth Policy Resource Center exit disclaimer icon .

More details about billing and reimbursement:

Last updated: March 9, 2021