Does Health Insurance Cover Teletherapy?

Last updated: April 9th, 2020

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

Rhode Island

Massachusetts

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Illinois

Washington D.C.

California

New Jersey

Connecticut

Washington

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

Allways Health Partners

Anthem

Blue Cross Blue Shield Association

Blue Cross Blue Shield of Massachusetts

Blue Cross and Blue Shield of Illinois

Blue Cross and Blue Shield of Rhode Island

Blue Shield of California

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Cigna

ConnectiCare

EmblemHealth

First Choice Health

Harvard Pilgrim Health Care

Healthfirst

HealthPartners

Kaiser Permanente

Magellan Health

Neighborhood Health Plan of Rhode Island

Oscar

Premera Blue Cross

UnitedHealthcare

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:

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

Useful Resources

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