Does Health Insurance Cover Teletherapy? Your Questions, Answered

Due to the coronavirus pandemic, many therapists who otherwise did not offer teletherapy are providing this mode of therapy for the very first time. Amidst other uncertainties, 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?

Below are answers we have found to these questions. We'll update this post as states evolve their telehealth policies.

Last updated: April 2, 2020

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

Does health insurance cover teletherapy?

Unfortunately, there is no easy answer to this: whether health insurance covers teletherapy or not depends on the health insurance company. It’s always best to verify directly with a client’s insurance — just as you would for an in-person therapy session.

That said, 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: All states on Zencare.co (New York, Massachusetts, Rhode Island, California, New Jersey, Connecticut, Illinois, Washington, Washington DC) have a telehealth coverage parity law in place.
  2. The client’s insurance plan covers mental health: This would be true for existing clients who have been able to see you in-network for in-person therapy services.
  3. The client’s insurance plan covers telehealth: If the insurance company covers telemedicine and the state has a parity law, then teletherapy should be covered similarly to any other telemedicine service.

While 42 of 50 states and Washington DC have some law surrounding telehealth coverage, the scope of each is different. The two key elements to this are:

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

Do health insurance companies reimburse teletherapy at the same rate?

Payment parity laws vary by state, and will determine whether health insurance companies reimburse at the same rate as an in-person session (see below for a list of states).

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!

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

Illinois

Washington D.C.

California

New Jersey

Connecticut

Washington

Health insurance adjustments to COVID-19

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

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.

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