Does Health Insurance Cover Teletherapy?

Amidst other uncertainties of switching to online therapy sessions, it's important to get clarity on the basics: Does health insurance cover teletherapy? Is teletherapy reimbursed at the same rate as in-person sessions?

Whether health insurance covers teletherapy or not depends on your state's policies and the health insurance company (here are the questions to ask when calling insurance companies).

That said, many states and insurance companies are updating policies during COVID-19; to make it easier for you to check, we compiled the latest data on the major health insurance companies and state policy changes, below! We hope this provides a helpful starting point.

Please remember it’s always best to verify directly with a client’s insurance, just as you would for an in-person therapy session.

Read our article on providing care across state lines during the coronavirus pandemic.

Does health insurance cover teletherapy?

Generally speaking, if a client meets all three of the below criteria, then teletherapy sessions should be covered:

1. The client’s state has a telehealth parity law
2. The client’s insurance plan covers mental health
3. The client’s insurance plan covers telehealth

While 42 of 50 states and Washington DC have some law surrounding telehealth coverage, some will only reference either coverage and service parity (ie. whether or not care is covered for telehealth as it would be for an in-person visit of the same kind), and/or payment and reimbursement parity (ie. whether a service is reimbursed at the same rate as an in-person visit of the same kind).

Although all states listed here do have some language in their laws regarding telehealth, you should always confirm with a client’s insurance provider whether and at what rate you’ll be reimbursed.

Teletherapy insurance coverage by state

Below are teletherapy insurance coverage details for each of the states in which Zencare is currently operating. We have also included whether you need informed consent from clients to provide teletherapy in these states, as well as whether they have cross-state telehealth compacts.

Please note we gathered this information based on two sources: Foley & Lardner LLP's 50-State Survey of Telehealth Commercial Payer Statuses and the Center for Connected Health Policy’s overview of Current State Laws & Reimbursement Policies.

New York

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions.
• COVID-19 exceptions: None as of 4/6/2020.
• Medicaid: Reimburses for video visits. In addition, during COVID-19, will also reimburse for telephone sessions.
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: None

Rhode Island

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions.
• COVID-19 exceptions: (1) Teletherapy must be reimbursed at the same rates: During COVID-19, Governor Raimondo signed an Executive Order mandating that virtual visits, including mental and behavioral healthcare, must be reimbursed at the same rate as an in-person visit. Telephone visits will also be covered. (2) Expedited 90-day license: Beginning March 18, 2020, out-of-state licensees can receive a 90-day license to practice in Rhode Island by completing this application form and a statement verifying the license status from their home state; these can be mailed to: Center for Professional Licensing Room 104 3 Capitol Hill Providence, RI 02908-5097. This temporary license can be renewed one time, and there is no cost to obtain the license or the one-time renewal. For questions regarding this license please email doh.elicense@health.ri.gov.
• Medicaid: Reimburses for video visits.
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: None

Massachusetts

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions.
• COVID-19 exceptions: The Commissioner of Public Health released an order stating that "health care providers who are licensed in another state who present to the corresponding Massachusetts licensing authority verification that such license is in good standing" will be issued a Massachusetts license for the duration of the emergency, and that providers licensed under this provision can provide services both in-person in Massachusetts and across state lines into Massachusetts using telemedicine where appropriate. It's important to note that not all professions are considered "health care providers," and you should check with your licensing board in Massachusetts as to whether or not you are included in this licensure provision.
• Medicaid: Reimburses for video visits. In addition, during COVID-19 MassHealth will reimburse for telephone calls.
• Requires client consent to teletherapy: No
• Cross-state licensure compacts: None
• Resources and contacts: MA Department of Public Health and the Division of Professional Licensure (phone number: 617-727-3080)

Illinois

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions.
• COVID-19 exceptions: Governor Priztker issued an Executive Order to expand telehealth options for both commercial and non-commercial insurance holders. All health insurers are now required to cover telehealth services and reimburse providers at the same rate as in-person visits and are prohibited from imposing any cost-sharing for in-network providers. Blue Cross Blue Shield of Illinois will also be offering telehealth coverage for behavioral health until at least April 30th, 2020. They will also be removing cost-sharing temporarily for medically necessary telehealth services. Please note that these changes only apply to “fully funded“ insurance plans and employer “self-funded” plans do not apply. Self-funded plans still have a choice to include telehealth coverage for mental health or not, so it is still important to check the estimate of benefits with this insurer.
• Medicaid: Reimburses for video visits.
• Requires client consent to teletherapy: No
• Cross-state licensure compacts: PSYPACT for psychologists (tentatively planned to take effect July 1st, 2020); IMLC for MDs and DOs

Washington D.C.

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions
• COVID-19 exceptions: Washington DC has temporarily waived licensure requirements for providers who are providing a continuation of care for an individual who has returned to DC and who was previously in their care.
• Medicaid: Reimburses for video visits
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: PSYPACT for psychologists (tentatively planned to take effect July 1st, 2020); IMLC for MDs and DOs pending

California

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions.
• COVID-19 Exceptions: An All Plan Letter was issued requiring that telehealth services (including telephone calls) must be reimbursed at the same rate as when those visits are provided in-person during COVID-19.
• Medicaid: Reimburses for video visits.
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: None

New Jersey

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; payments for telehealth visits are not to exceed in-person visit amounts.
• COVID-19 Exceptions: During this time, out-of-state practitioners may apply for an expedited NJ license by completing this one-page form and sending it via email to njtemplicense@dca.njoag.gov. The New Jersey Office of the Attorney General website indicates that your application will be reviewed and responded to within 24 hours.
• Medicaid: Reimburses for video visits.
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: NLC pending

Connecticut

• Teletherapy insurance coverage and reimbursement: Insurance companies must cover telehealth under the coverage parity law; however, there is no mandated payment parity, so reimbursement rates may be lower for teletherapy sessions vs. in-person therapy sessions.
• COVID-19 Exceptions: Governor Lamont signed an Executive Order indicating that he intended to provide patients with access to out-of-state telehealth providers by suspending licensure/certification requirements for being an approved telehealth provider in CT. The Department of Public Health issued an order stating that the requirements for licensure, certification, and registration are all suspended for 60 days in CT.
• Medicaid: Reimburses for video visits. During COVID-19, Medicaid will also reimburse for telephone sessions.
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: None

Washington

• Teletherapy insurance coverage and reimbursement: Coverage parity, no mandated payment parity
• COVID-19 Exceptions: Governor Inslee released Proclamation 20-29 which indicates that telehealth visits must be reimbursed at the same rate as in-person visits until midnight on April 24th, 2020.
• Medicaid: Reimburses for video visits
• Requires client consent to teletherapy: Yes
• Cross-state licensure compacts: PSYPACT for psychologists (tentatively planned to take effect July 1st, 2020); IMLC for MDs and DOs

COVID-19 Cost-sharing Waivers by Health Insurance

Some insurance carriers have also released guidelines specific to COVID-19 (please note that specifics may vary across plan types):

Aetna

• Cost sharing waived for teletherapy? Yes
• Applicable providers: For all Aetna plans offering Teladoc® coverage, cost sharing will be waived for all Teladoc® virtual visits. For all Commercial plans, cost sharing will also be waived for real-time virtual visits offered by in-network providers.
• Applicable plans: Applies to all Aetna plans; self-insured plan sponsors can opt out.
• Description: Until at least June 4th, 2020, Aetna will waive member cost sharing for any covered telemedicine visits — regardless of diagnosis. For all Aetna plans offering Teladoc® coverage, cost sharing will be waived for all Teladoc® virtual visits. Cost sharing will also be waived for real-time virtual visits offered by in-network providers (live video-conferencing and telephone-only telemedicine services) for all Commercial plan designs. Members may use telemedicine services for any reason, not just COVID-19 diagnosis. Self-insured plan sponsors will be able to opt-out of this program at their discretion.
• Notes: If clients have self-insured plans, it is important to check that the plan has not opted out of the program.
• Sources: Source one, Source two

Allways Health Partners

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists.
• Applicable plans: Not explicitly indicated.
• Description: AllWays Health Partners is removing cost-sharing (copayments, deductibles, or coinsurance) for testing and copayments for treatment at in-network facilities; ensuring access to out-of-network providers for the initial COVID-19 test or treatment when no in-network providers are available; and removing all cost-sharing for telemedicine services, including virtual visits with primary care providers and specialists, and through Partners HealthCare On Demand, to enable members to seek COVID-19-related care without the need to go to medical offices... There will be no cost to you for telemedicine (including telephone) visits for standard/routine outpatient behavioral health.
• Sources: Source

Anthem

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: Applies to all Anthem affiliated plans; self-insured plan sponsors can opt out.
• Description: For 90 days effective March 17, 2020, Anthem’s affiliated health plans will waive member cost shares for telehealth visits, including visits for mental health or substance use disorders, for our fully-insured employer plans, individual plans, Medicare plans and Medicaid plans, where permissible. Cost sharing will be waived for members using Anthem’s authorized telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. Self-insured plan sponsors may opt out of this program.
• Sources: Source

Blue Cross Blue Shield Association

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: All "fully-insured" members
• Description: "All 36 independently-operated BCBS companies and the Blue Cross and Blue Shield Federal Employee Program® (FEP®) are expanding coverage for telehealth services for the next 90 days. The expanded coverage includes waiving cost-sharing for telehealth services for fully-insured members and applies to in network telehealth providers who are providing appropriate medical services. We are also advocating for physician and health system adoption of social distancing-encouraged capabilities such as video, chat and/or e-visits. This builds on the commitment we previously announced to ensure swift and smooth access to care during the COVID-19 outbreak."
• Sources: Source

Blue Cross Blue Shield of Massachusetts

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: All members
• Description: "Blue Cross has waived member cost share (co-pays, co-insurance and deductibles) for all medically necessary medical and behavioral health covered services, via phone or video (telehealth) with in-network providers if such services are offered."
• Sources: Source

Blue Cross and Blue Shield of Illinois

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: All BCBSIL members with telemedicine/telehealth benefits in their plan (excluding Part D plans for Medicare members)
• Description: "Currently, if you are insured by BCBSIL, including Medicare (excluding Part D plans) and Medicare Supplement members, you can: Access provider visits for covered services through telemedicine or telehealth as outlined in your benefit plan. You won’t pay copays, deductibles, or coinsurance on in-network covered telemedicine or telehealth services."
• Sources: Source

Blue Cross and Blue Shield of Rhode Island

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: All members
• Description: Expanded coverage for clinically appropriate telehealth services that are provided by any in-network provider through permitted means, including telephone and audiovisual technologies. Permitted audiovisual capabilities include nonpublic video conferencing such as Skype, Google Hangouts and FaceTime. Waived all member cost sharing (copays and deductibles) for telehealth whether provided by an in-network provider or through the Doctors Online telehealth platform.
• Sources: Source

Blue Shield of California

• Cost sharing waived for teletherapy? Yes, but only for Teladoc Services
• Applicable providers: Only waiving costs for Teladoc Health virtual care service.
• Applicable plans: Applies to Blue Shield’s Individual and Family Plans, Medicare Supplemental plans, Medicare Advantage plans, as well as employer- and union insured plans.
• Description: "Blue Shield previously announced it is waiving prior approval and copayments for Teladoc Health virtual care service through May 31, 2020 for most of its members. Not all plans have access to these services."
• Sources: Source

Cigna

• Cost sharing waived for teletherapy? No (only for categories of "screening, diagnosis, or testing" for COVID-19)
• Applicable providers: N/A
• Applicable plans: N/A
• Description: "Effective today, Cigna is waiving customer cost-sharing for all COVID-19 treatment through May 31, 2020. The treatments that Cigna will cover for COVID-19 are those covered under Medicare or other applicable state regulations. The company will reimburse health care providers at Cigna's in-network rates or Medicare rates, as applicable. Will Cigna cover Coronavirus virtual care visits? Yes. If your visit is related to screening, diagnosis, or testing for the Coronavirus, your out-of-pocket costs will be waived."
• Sources: Source

ConnectiCare

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network
• Applicable plans: All members
• Description: "Today, ConnectiCare, one of the region’s leading health plans, announced that members can temporarily use telehealth for covered medical and mental health services at no cost. To make it easier for our members to get the care they need, ConnectiCare is eliminating the financial burden associated with office visits by covering telehealth appointments for any reason."" The company is allowing no-cost member real time visits with medical and mental health professionals by phone, computer, and mobile app."
• Sources: Source

EmblemHealth

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network
• Applicable plans: All except potentially not ASO plans
• Description: "EmblemHealth members across all our product lines will have no cost sharing (including copayments, coinsurance, or deductibles) for in-network telehealth visits. These visits have no cost-sharing for COVID-19 and non-COVID-19 related services. Members with a benefit plan that includes the Teladoc™ program will also have no cost-sharing for Teladoc visits. The telehealth cost-sharing waiver may not apply to ASO plans."
• Sources: Source

First Choice Health

• Cost sharing waived for teletherapy? No (only for virtual primary care service, not teletherapy)
• Applicable providers: N/A
• Applicable plans: N/A
• Description: "To help ensure people will have access to a doctor during the current COVID-19 crisis, First Choice Health (FCH), a leading provider-owned healthcare administrator in the Northwest, has announced that it is covering the cost of telehealth services for its self-funded employer customers via on-demand primary care service 98point6."
• Sources: Source

Harvard Pilgrim Health Care

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network
• Applicable plans: Members on individual and group fully insured plans
• Description: All telemedicine services: Covered in full (no copays, deductibles or coinsurance)
• Sources: Source

Healthfirst

• Cost sharing waived for teletherapy? No (only COVID-19 related testing and evaluation)
• Applicable providers: N/A
• Applicable plans: N/A
• Description: "Healthfirst is waiving co-pays for all diagnostic testing and evaluations related to coronavirus."
• Sources: Source

HealthPartners

• Cost sharing waived for teletherapy? No (only COVID-19 related testing and diagnosis)
• Applicable providers: N/A
• Applicable plans: N/A
• Description: "If you’re a HealthPartners member, you have coverage with no member cost sharing for COVID-19 testing and diagnosis. This includes the cost of the care visit associated with testing."
• Sources: Source

Kaiser Permanente

• Cost sharing waived for teletherapy? No (only COVID-19 related screening and testing fully covered)
• Applicable providers: N/A
• Applicable plans: N/A
• Description: "We’re proactively extending the use of telehealth appointments via video and phone where appropriate. As a Kaiser Permanente member, you won’t have to pay for costs related to COVID-19 screening or testing if referred by a Kaiser Permanente doctor. If you’re diagnosed with COVID-19, additional services, including hospital admission (if applicable), will be covered according to your plan details."
• Sources: Source

Magellan Health

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: All members
• Description: "As the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) guidance came out on Tuesday, Magellan was revising its operations to permit all credentialed and contracted behavioral health providers to conduct telehealth video sessions for all routine services and certain psychological testing, applied behavior analysis (ABA), intensive outpatient programs (IOP) and partial hospitalization program (PHP) services. Providers are able to use a number of HHS OCR-approved platforms to conduct their telehealth video sessions. Magellan is also allowing telephone-only sessions when a member has no access to a video platform. These alternative approaches will be covered to ensure members get the care they need, when they need it. Our experienced behavioral health network providers are available to serve the needs of our clients’ members through a variety of avenues. We are proud of our network providers and look forward to working with them to support those who may need mental health services as a result of the COVID-19 outbreak."
• Sources: Source

Neighborhood Health Plan of Rhode Island

• Cost sharing waived for teletherapy? Yes, but only for Optum-based virtual visits
• Applicable providers: Optum virtual visits only for behavioral health
• Applicable plans: All members
• Description: "Neighborhood’s behavioral health partner Optum, offers virtual visits so you can receive confidential care without leaving your home. For more information on accessing virtual visits, go to live and work well to locate providers and schedule an appointment with them online. Neighborhood has expanded telemedicine coverage for all members to include clinically appropriate and medically necessary services to support you not having to go into your doctor’s office, urgent cares or emergency rooms during the time of the Governor’s executive order. If your plan usually has co pays, deductibles or other cost-sharing, you will not need to pay for the services outlined below. Primary care physicians All Medical Specialists – defined as any MD, DO, NP and PA Optometrists Doctors of Podiatric Medicine (DPM’s) Lactation Consultants Physical, Occupational, and Speech Therapists Diabetes Educators Nutritionists Midwifes Urgent Care Centers Emergency Departments Retail Based Clinics"
• Sources: Source

Oscar

• Cost sharing waived for teletherapy? No; standard cost sharing rules apply for teletherapy
• Applicable providers: Offering Oscar's Doctor on Call for "most members" free of charge
• Applicable plans: Varies depending on details of individual plans
• Description: "In addition to offering Oscar's Doctor on Call services to most members for $0, Oscar will cover all COVID-19 care delivered via telemedicine at $0 for our members through May 10. We will re-evaluate this date as needed. Oscar will also cover telemedicine care, consistent with our plan terms, for our members when they see an in-network provider through May 10. Standard cost-sharing rules will apply in all states except New York and New Jersey. In these states, members will pay $0 for any medically-necessary telemedicine visit with an in-network provider."
• Sources: Source

Premera Blue Cross

• Cost sharing waived for teletherapy? No; only through certain platforms
• Applicable providers: Specific services only (Talkspace for therapy)
• Applicable plans: Varies depending on "participating groups"
• Description: "To ease the burden for our members, we will waive copays, deductibles, and coinsurance for COVID-19 related treatment (both inpatient and outpatient). This waiver will continue through October 1, 2020 for participating groups. We've expanded options for you: Call your in-network primary care doctor's office. 24-Hour NurseLine is available at no charge. Just call the number on the back of your member ID card to reach medical professionals. Doctor On Demand is a video chat with a doctor. 98point6 is a text-based primary care app. Talkspace offers virtual access to licensed therapists."
• Sources: Source

UnitedHealthcare

• Cost sharing waived for teletherapy? Yes
• Applicable providers: All in-network therapists
• Applicable plans: Medicare Advantage, Medicaid, Individual and Group Market fully insured health plans
• Description: "Starting March 31, 2020 until June 18, 2020, UnitedHealthcare will now also waive cost-sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Medicaid, Individual and Group Market fully insured health plans. Again, we will work with self-funded customers who want us to implement a similar approach. The company previously announced we would waive cost-sharing for telehealth visits related to COVID-19 testing, in addition to waiving cost-sharing for 24/7 Virtual Visits with preferred telehealth partners."
• Sources: Source

Medicare coverage

For the duration of the Public Health Emergency (PHE) declared by the Secretary of Health and Human Services, CMS will be making these changes. The main note is that there will no longer be a limit on the originating site -- the place where a client or patient is receiving care. Clients can now temporarily receive telehealth visits in their home, regardless of whether they are located in a rural area.

What questions should I ask my client’s health insurance company about telehealth?

When calling your client’s health insurance company to confirm coverage, ask questions that allow you to confirm that:

1. Teletherapy is a covered benefit
2. You will be reimbursed for providing care
3. You will be reimbursed at the same rate as in-person sessions

Important questions are:

• Can you please confirm my network status?
• Is telehealth a covered benefit?
• What specific payer ID should claims be routed to?
• Are there any restrictions or requirements around the location of the patient or provider?
• I am a {psychologist / social worker / counselor / creative arts therapist}. Am I eligible to provide teletherapy services?
• Are there any documentation requirements associated with billing for teletherapy?
• Is the reimbursement rate the same as the rate for in-person services?

For more questions and a comprehensive guide, watch SimplePractice’s video and download the associated presentation!

Useful Resources

• Foley & Lardner LLP's 50-State Survey of Telehealth Commercial Payer Statuses
• Center for Connected Health Policy’s overview of Current State Laws & Reimbursement Policies
• Center for Connected Health Policy: State Telehealth Laws and Medicaid Program Policies