Insurance, Telehealth and You

  • Thursday, May 10, 2018
telehealth insurance, teletherapy insurance, telepractice insurance, converge for telepractice, insurance for teletherapy, telehealth and insurance, file claim teletherapy, teletherapy insurance submit, HIPAA compliant video conferencing, HIPAA compliant video conferencing platform.

After you’ve decided on your technology, chosen your HIPAA compliant video conferencing platform and delineated the process for adding telehealth services such as teletherapy to your practice, there’s one more question you need to ask:

“How will I get paid?”

The answer is both simple and complex. The fact is, you can have cutting-edge technology and be a rockstar therapist but if you’re not getting paid, you’re not getting anywhere but frustrated.

Of course, you may have some clients who are willing or able to private pay. In most places, those clients tend to be the exception. Most of your clients will probably be covered by some type of health insurance. They will surely want (expect) to be able to use those benefits for therapy. Before you say “OK”, you need to do your homework.

If you’re new to teletherapy and/or to the world of insurance coverage, it can feel overwhelming. It’s ok! You were new to therapy once too and look at you now…checking out the latest in service provision!

In this article, we’ll talk about insurance and Medicaid and telehealth and how it comes together.

All Plans Are Not Created Equally

Insurance plans, including Medicaid, and state policies are not created equally. Some insurance plans have coverage for telehealth. Some insurance plans may not have benefits for therapy. Still others may have mental health coverage but not for telehealth or may have specific criteria or designated providers for telehealth. It can be a mixed bag.

A common misconception is that there is federal policy or oversight for the types of services allowed. The fact is, states make their own policies regarding Medicaid services and what is required of commercial insurance companies doing business with people in their states. The exception is Medicare which has its own set of criteria and approved services.

The good news is, most states (48 and the District of Columbia at last count) have recognized the need for telehealth services especially in rural areas. They have added some type of telehealth services into their Medicaid programs.1  What is covered will vary by state.  

What about commercial (private) insurance? States have taken telehealth services a step further there too. At least 32 states and the District of Columbia have adopted some policy regarding telehealth and private insurance payors.1 Again, this will vary by state so you want to educate yourself about your state’s policy as well as the status of telehealth with any provider panels you may be on.

Knowledge is Key

Know the policies of the plans you are associated with. Whether you’re a Medicaid provider or a provider for commercial plans, take time to find out what the telehealth policy, criteria and standards are. Some plans require providers to be specially credentialed for their telehealth panel. Contact your state’s Medicaid administrator. Contact the insurance plans you’re a provider for. Ask lots of questions! Get copies of telehealth criteria or policies if that’s available. Knowing which of your plans will allow you to provide telehealth and what is covered/excluded will save you time when a client contacts you and will allow you to recommend the best available options for that client.

Don’t Assume Coverage

What about current clients that you might want to transition to telehealth? Do not assume that because you see a client face-to-face and receive payment via insurance that telehealth services will automatically be reimbursed. That particular plan may have restrictions or limitations on therapeutic services. Before initiating telehealth sessions, call the plan and verify their benefits. This step alone can save you countless hours of trying to get a denied claim paid or having to take a loss.

Trust But Verify – Every Time

A lot of plans don’t require pre-authorization for routine face-to-face outpatient services. However, they may for telehealth. Again, be proactive! Make it a policy that any new client you consider telehealth for has verified benefits and prior authorization if required. Trying to get a retroactive authorization is almost impossible.

Keep Abreast of Changes

At the end of the day, remember that telehealth is the rising star in the therapy world. With it will come a lot of policy and policy change as the insurance providers, therapists and clients all come together in this new world of service provision. Hundreds of telehealth bills have been introduced at the state and federal levels and this will no doubt continue as the field continues to be defined.

As a provider, stay informed and make sure you’re aligned with the best in technology and support. TheraPlatform remains on the cutting edge of the exciting world of telehealth and will provide you with the best and most accurate information that you need to know to be successful in the telehealth market.


1. Telehealth Medicaid & State Policy | Center for Connected Health Policy. (2018). Retrieved from

telehealth, technology teletherapy, teletherapy, behavioral telehealth, bhevioral teletherapy, online behavioral therapy, online therapy, speech therapy online, telepractice, telemedicine, social worker online therapy, health provider online therapy


Telehealth: Let’s Talk Technology

Hands down, telehealth is the next big thing in service delivery for behavioral and allied health providers. Clients love it. More and more insurance companies pay for it. Most of us were trained in the "brick-and-mortar" style of service delivery. So, one of the biggest questions providers have is, "How do I get started?"

online therapy, telepractice session, teletherapy, telepractice, teletherapy platform, telepractice platform, HIPAA compliant teletherapy platform, video conferencing, telemental health, telepsychology, telespeech,telemedicine


20 Tips for Smooth Online Therapy (Teletherapy) Session

The TheraPlatform Team has a few tips to help you make a teletherapy or telepractice session as smooth as possible

Teletherapy e-book

Get latest articles right to your Inbox

    Blog Categories
    Getting Started
    Behavioral Therapy
    Case Studies

    Latest Posts

    • When does a therapist have to break confidentiality

      Friday, April 30, 2021

      When does a therapist have to break confidentiality? Confidentiality is sacred in psychotherapy. Without it, there is no degree of trust between client and therapist. Think about it. Why would someone tell their deepest darkest secrets to a therapist if they thought that person could just tell whoever they wanted? The rules regarding the use of confidentiality are varied and do have exceptions. Before we explore those limits in more detail, let’s briefly discuss what confidentiality means in a counseling situation.

    • Occupational Therapy Assessments

      Friday, April 23, 2021

      This blog entry will cover adult occupational therapy assessments including: The COPM, Berg Balance Scale, MoCA, the Kettle Test, Nine-hole peg test, ACLS, FIM and AMPS.The practice setting and context of occupational therapy for adults varies widely. From geriatrics to physical disabilities, and acute rehabilitation to mental health, client needs, occupational profile, goals, and length of stay will vary greatly. As will the occupational therapy assessments you select. Some settings will call for a very complex evaluation with multiple assessments, while others may only allow for a 15 minute informal screen. Below are selected assessment tools that can be used with a diverse range of clients.

    • Intake forms counseling

      Tuesday, April 20, 2021

      Intake forms, consent forms for counseling and psychotherapy and other forms that every therapist needs such as release of information, social medial policy as well as tips will be covered in this post. When you think about conducting psychotherapy there are many things to consider: the client, your theoretical approach, and billing, to name a few. One critical—yet often overlooked—part of counseling is the forms that you give to the patient at the beginning of counseling. The proper forms can set the tone and boundaries for successful treatment. Here is what you need to know about the forms you will want to give to your clients.

    Download FREE Resources
    Anger Management Worksheets
    Anxiety Worksheets
    Couples Therapy Worksheets
    Self-esteem Worksheets
    DBT Worksheets