Telepsychiatry Reimbursement

Reimbursement and state regulations with telepsychiatry are constantly changing and it can be difficult to keep up. Our experienced team can provide guidance about the regulatory and reimbursement environment in your state.

Mental Health Parity

33 states now have some type of parity law that mandates the coverage and reimbursement of telepsychiatry to a certain extent. However, unfortunately no two states are the same.

Parity laws in your state will affect commercial and Medicaid plans, however, Medicare has separate requirements. In order for telepsychiatry services to be reimbursed by Medicare, the location of your facility needs to:

1. Be located in a rural area as indicated by CMS 

2. The patient must be located in an approved site for telepsychiatry.

Click here to see if your location qualifies for Medicare reimbursement. There are a number of proposed regulatory updates that if approved will remove some of the hurdles to Medicare reimbursement for telepsychiatry.

Telepsychiatry Recommendations

If you are considered launching telepsychiatry, here are two recommendations to start with when researching the reimbursement landscape in your state.

  1. Research the parity law in your state.

    Not every parity law is created equal. Some parity laws mandate the coverage of telepsychiatry, however not necessarily equivalent reimbursement. It’s very important to look up the status of your state’s parity law.

  2. Talk to your payers.

    It’s also recommended to talk to your payers about your telepsychiatry strategy. There have been successful telepsychiatry programs in states that did not have the strongest parity laws because payers were on board with the value of telepsychiatry. 

Here are two great resources to check out where you can find out specifics about your state.

Take a look at some additional resources.