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

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.

Tip: If a patient has private insurance, verify coverage via the insurance provider policy or request the patient to confirm coverage before each appointment.

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.

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.

Non-covered services

These telebehavioral health services are not Medicare reimbursable.

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  .

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)