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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.

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.

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:

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.