Growing Reimbursement Opportunities for Behavioral Telehealth Services

The new Centers for Medicare and Medicaid Services Congressional Report highlights the growing opportunities for behavioral health providers to offer telehealth services. This annual report helps highlight growing trends in services, payment, and reimbursement, guiding third party payors and health facilities.

According to the most recent report, 85.4% of all telehealth users in 2016 had a mental health diagnosis, including:

• Major depressive disorder

• Bipolar disorder

• Schizoaffective disorders

• Substance abuse disorders

Telehealth users received treatment for these conditions far more often than they received treatment for chronic physical conditions such as diabetes. With the current prevalence of behavioral telehealth services, treatment facilities can seek out new ways to reach patients in their service areas and find new opportunities to maximize revenue.

Expanding Telehealth Reimbursement Opportunities

Currently, 49 states and Washington, DC have legislation that allows for Medicaid reimbursement for some form of live video and 39 states have parity laws requiring that telemedicine services be reimbursed at the same rate as in-person care. Private payors tend to follow these guidelines as well, drastically increasing the number of patients who are covered for telehealth services. However, rules vary greatly from state-to-state so you must always check your state’s telehealth coverage requirements.

Medicare continues to advance reimbursement for virtual care, especially for behavioral services and rural populations. A huge portion of the United States, 75 percent of all counties, qualifies as rural or mental health shortage areas. These are the areas that Medicare is most likely to cover telehealth services.

Telehealth provides benefits to providers and patients. Improved technology increases efficiency and allows providers to take on a larger patient panel. Telehealth not only provides more opportunities for reimbursement, but helps meet the shortage in mental health services across the U.S. by removing barriers to care such as lack of transportation and time constraints. By adopting telehealth services now, you’ll be in the forefront of a huge change in behavioral health care delivery.

At Datapro billing, we have years of experience helping behavioral health facilities implement new services for billing. Contact us to discuss new opportunities for improved patient care and additional revenue.