Legal Corner: Highlights from the Practice Leadership Conference’s “Ask the Attorneys Town Hall”
Every year, the APA Practice Organization hosts a Practice Leadership Conference (PLC) in Washington, D.C., bringing psychologists from Canada, the United States and its territories together to hone their advocacy and leadership skills. During this year’s PLC, the attorneys in Legal & Regulatory Affairs convened a town hall meeting to address some of the legal challenges faced by psychologists*. Audience members were invited to submit questions in advance, as well as ask them on the spot. The next several issues of “Legal Corner” will feature a psychologist’s question from PLC that has broad impact.
Q: Can you bill for web therapy services?
A: It depends. The Centers for Medicare & Medicaid Services covers telepsychological services so long as the Medicare beneficiary receiving the services is in a rural or health professional shortage area and in a clinical setting, such as a clinic or another provider’s office. Many private insurance companies are covering telehealth services if those same services are covered when delivered in-person. Currently, 31 states plus D.C. have enacted state insurance coverage mandates for telehealth services. And Medicaid programs in all 50 states have some sort of coverage for certain telehealth services.
Also, there are no separate telehealth or telepsychology current procedural terminology (CPT) billing codes. Rather, you use the appropriate CPT code that describes the service provided and use the GT modifier which indicates that the service was provided using audio-video conferencing, not an in-person visit.
It is also important to note whether your state’s psychology licensing laws recognize telepsychology as part of the legal scope of practice. While many states have recognized the use of telehealth or telepractice within the state, not all states have. And if you are considering telepsychology for a patient in another state, make sure you know the other state’s policies. While your patient could be self-pay and not using insurance benefits, the question of interstate practice is a licensing issue, not an insurance issue.
It is always good to remember that whenever you use technology (e.g., web-based platform) as part of your practice, the technology needs to be compatible with HIPAA/HITECH requirements. The best rule of thumb is to use a product or service that not only says it is HIPAA-compliant but offers or is willing to sign a business associate agreement.
Practice Organization members who have questions about telehealth practices can contact the Office of Legal and Regulatory Affairs by email or by phone at (202) 336-5886.
*Legal issues are complex and highly fact-specific and state-specific. They require legal expertise that cannot be provided in this article. Moreover, APA/Practice Organization attorneys do not, and cannot, provide legal advice to our membership or state associations. The information in this article does not constitute and should not be relied upon as legal advice, and should not be used as a substitute for obtaining personal legal advice and consultation prior to making decisions.