Are eVisits the Next Frontier in Mental Health Care Delivery?

by | Last updated Dec 4, 2023 | Published on Aug 16, 2017 | Medical Billing

Mental Health Care
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Telemedicine has come a long way since it was introduced in the 1950s. Now, experts say that eVisits have the potential to transform the delivery of mental health care. The telemedicine model allows physicians to better connect with their patients and increase patient flow. They can utilize medical billing and coding services to ensure compliance with reporting requirements and maximize reimbursement.

According to the National Institute of Mental Health (NIMH), approximately 43.8 million adults in the US, or 1 in 5 people, experiences mental health illness in a given year. Many of these individuals may be affected by several chronic conditions, phobias, substance use disorders, and suicidal tendencies, and need proper treatment from multiple healthcare providers. Moreover, there is a national shortage of mental health providers, which is leading to increased appointment wait times and missed consults. It is estimated that nearly 60 percent of those living with these conditions go untreated. Lack of access to timely treatment will lead to deterioration in mental health with grave consequences.

A recent report published by HIT Consultant says that the solution lies in eVisits for mental healthcare delivery. Utilizing digital technology could help alleviate the backlog in appointment schedules and provide mental health patients with the services they need. In fact, Forbes reported last year that telemedicne companies see a huge opportunity in telebehavioral services to bridge the gaps in access to quality behavioral health services.

In addition to alleviating the shortage of mental healthcare professionals, virtual face-to-face visits offer many advantages for both patients and behavioral health specialists:

  • The physician can establish an emotional bond and rapport with the patient in a private setting
  • eVisits make mental health services more accessible, convenient and affordable for patients
  • Patients can easily schedule and attend appointments from home, avoiding the perceived social stigma associated with seeking behavioral health support.
  • Online consultations eliminate travel delay, no shows, and in-office distractions.
  • The virtual visit model improves operational efficiencies through shorter appointment times
  • Practitioners can see more patients, and provide more follow up appointments for those who need it most
  • Clinicians can serve patients living beyond their geographic area

Telemental healthcare includes telepsychiatry, telepsychology, distance counseling, online therapy, and behavioral telehealth and mhealth. For the virtual visit model to work effectively, telemedicine companies need to ensure that the systems they provide allow appropriate reporting and scheduling options in a secure, HIPAA-compliant environment.

Telepractice through video conferencing is reimbursable through Medicare, Medicaid in many states, as well as several private health insurance companies. Insurance providers, especially Medicare and Medicaid, may vary in terms of their requirements for billing telemental health services.

The CPT codes that can be billed for psychotherapy conducted via video conferencing in 2017 are:

  • 90832 Psychotherapy, 30 minutes with patient
  • 90834 Psychotherapy, 45 minutes with patient
  • 90837 Psychotherapy, 60 minutes with patient
  • 90845 Psychoanalysis
  • 90846 Family psychotherapy (without the patient present), 50 minutes
  • 90847 Family psychotherapy (with the patient present), 50 minutes 90863

Important considerations for billing video conferencing sessions in 2017 are:

  • The “95” modifier has replaced the “GT” modifier.
  • The place of service POS should be 02 when billing for telemental health.
  • There are changes to the code descriptors: the words “and/or family” have been dropped for several codes and changed to “with patient”.
  • Practitioners should document total time and percent spent in counseling and/or coordination of care in the patient record.
  • Only the physician’s face-to-face time with the patient/caregiver is counted toward the level of service provided.

Maximizing reimbursement is easier with help from experts. Behavioral health specialists can bill for conventional services rendered as well as take advantage of innovative strategies to bill for telehealth services with the help of an experienced medical billing and coding company. Their expert teams would be knowledgeable about the right CPT codes to uses as well as the requirements of private and government payers in different states. Partnering with a reliable medical billing outsourcing company is crucial to meet payer requirements, prevent claim denial, and optimize revenue.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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