Reimbursement

Telepsychiatry reimbursement is not universal among all payer sources. It is recommended that any organization implementing a telepsychiatry program facilitate contact between their billing department and their primary payers to understand their individual reimbursement policies relative to telemedicine.

When applicable, there are typically two billable events within a standard telepsychiatry encounter: a professional fee and a facility fee to help offset infrastructure costs. Some states also allow for reimbursement of a transmission fee in addition to or instead of a facility fee. If beneficial to the program, telepsychiatry providers can choose to panel with commercial payers as well as opt in and enroll with Medicare and Medicaid, depending on state law.

For information on the most up-to-date reimbursement guidelines for private payers, Medicare and Medicaid visit the Center for Telehealth and e-Health Law (CTeL) or the American Telemedicine Association (ATA).

Medicare reimburses for telepsychiatry services when a community is considered rural. Use the Rural Assistance Center’s “Am I Rural?” tool to determine the status of your community.

For a more in-depth look on coverage by Medicare, please read Will Medicare Cover My Telehealth?