Coronavirus and Teletherapy: 9 Steps To Transition To Remote Sessions

With the rapidly changing circumstances around the coronavirus, you may be considering moving your therapy practice online.

As you already know, protecting your health and the health of your clients is paramount. If you live in a region where there are community outbreaks and you have the option to work remotely, it might be a safe choice to move some or all of your client appointments to online sessions. For many therapists, this has also become much less of a choice and much more of a question around how to best provide care, given recommendations from school systems, their own potential exposure, and client requests. Providing virtual support during an event like COVID-19 can be a great way to help clients during times of heightened anxiety and stress, as well as allow you to continue to work.

Here are nine easy ways to make the transition feel positive, supportive, caring and individualized for clients, and reflective of the great work you already do in your office:

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1. Set up your space

Just as your office set-up is a key part of your in-person practice, the way you arrange your remote office can make a big difference in your online sessions. For example, you might consider the following steps before your first online session:

2. Double-check logistics

Especially if this is your first time offering remote therapy, you’ll want to be certain that you’re following all the applicable rules and regulations.

After HIPAA compliance, the other major factors to consider are:

Insurance logistics to consider

Not all health insurance plans cover Behavioral Health Televideo Services. It's important to check benefits for clients individually, both for those who are using in-network and out-of-network benefits, as coverage depends on the patient's insurance plan.

Codes for telehealth services

Billing for teletherapy for the most part looks similar to billing for in-person sessions, with the biggest difference being the added modifiers of "GT" and "95," and the Place of Service changing to "02."

When to use GT vs 95? Codes vary by health insurance preference, so it's best to ask your health insurance company. That said, anecdotally, we have been told that in Washington DC, Blue Cross Blue Shield and Aetna accept both "95" and "GT" modifiers, while Cigna uses the "95" modifier.  

3. Get your tech in place

HIPAA-compliant video therapy platforms

No matter how you approach remote therapy, the one tool that you absolutely must have in order to set up online sessions is a HIPAA-compliant portal.

Most EHR systems, think SimplePractice, TheraNest, TherapyNotes, include secure video session options.

In addition, below are some popular video conferencing options that Zencare therapists have used. All are, or have a HIPAA-compliant option.

Make sure that your computer will work smoothly with online sessions. That means a updated operating system, a strong wifi connection, and ideally a hardwired ethernet cable as a backup in case your wifi turns out not to be strong enough to support back-to-back sessions without interruption.

HIPAA-compliant payment platforms

If you typically do cash payments for sessions, you'll need to set up an online payment method. Here are a few options you can consider that offer HIPAA-compliant options with a BAA.

Note that Venmo and PayPal are not HIPAA-compliant options at this time.

4. Make the tech comfortable

Once you get your HIPAA-compliant portal and payment methods set, it's time to make the system comfortable for you! Here are some tips on making that happen:

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5. Engage mindfully with clients

If you do decide to move some or all of your sessions online, it’s important to broach the subject mindfully with your clients. Chances are that this change won’t come as a complete surprise to them (some may already have been asking you for this option!), but it could still be a jarring break in their routines.

Here are a few tips to keep in mind as you open this conversation with clients:

6. Continue building the therapeutic alliance

This is a wonderful opportunity for people to remain connected and continue with the work during a time that might otherwise feel quite stressful and alienating.

A beautiful way to frame this is by expressing your continued dedication to your client by offering comfortable, safe, ongoing, individualized care through the transition to a virtual session. You can do this in session or in an email, making room for any type of response the client may have.

It can also be valuable to create a written safety plan you can share with clients that includes any changes necessary if the session is not happening in your office. For example, if a client is in need of hospitalization and you would normally do this from your office, outline a different way to support this circumstance from their home.

7. Make the most of your "home visit"

Given that clients will generally be taking your session somewhere in their home, this is a great opportunity for you to experience some of what you talk about in session in real time with your client.

Be open to anything your client may want to share about their home environment. This is a great way to learn more about who you've been working with!

In addition, expanding the ways you are able to connect with clients also opens the door for innovative ways to engage in our work.

Here are some creative ideas you can incorporate into sessions:

8. Practice self-care

Taking good care of your clients means taking good care of yourself too! Working from home can have its own unique challenges, especially if you’re not used to it. Consider some of the following strategies to make the transition easier on yourself:

9. Refer to additional resources

Transitioning to virtual support has been made easy by those who have come before in the remote therapy world, and being able to provide safe continuity of care during such a challenging time can help enhance what you are able to do with each of your clients.

For more questions, you can reach out to Laura Federico at laurafedericotherapy@gmail.com. Laura offers consultation services for clinicians looking to create a thoughtful, individualized, seamless transition to virtual care.

Here are additional resources for clients and your practice that may be helpful in the current environment:

For clients

For therapists


Continue growing your practice!

Don't let COVID-19 stop you from building your practice, online or in-person! At Zencare.co, we are encouraging and supporting clients to continue therapy as we work through this difficult situation.

Grow Your Practice With Zencare!

We're looking for clinically excellent and compassionate therapists and psychiatrists to refer clients to. We'd love to learn about your practice!