Behavioral Health in the ED

The use of telehealth is rapidly growing. In just four years, claims related to telehealth grew 624% for all medical claims. In 2018 alone, non-hospital-based provider-to-patient telehealth visits made up 84% of all telehealth claims, compared with 52% in 2014. This astounding growth is the result of increased patient satisfaction and corresponding changes to reimbursement for virtual care.

New advances in technology continue to increase medicine’s technological capabilities, offering new ways to provide patient care. In the past, we have covered how telepsychiatry can help reach patients after natural disasters, prevent physician burnout, and improve inpatient and emergency care. Recent patient satisfaction surveys show that patients have taken note of this new care option. A recent paper in the British Medical Journal found that 98% of patients are interested in future telemedicine visits, and 99% would recommend this method of patient care.

Across medical specialties, patients are rating telemedicine visits equal to, or better than traditional in-person visits. Telemedicine received high marks for convenience and quality, furthermore many patients stated that they still felt a strong personal connection to their provider with virtual visits.

Growth of Telepsychiatry

Psychiatric care is one of the fastest-growing specialties within telehealth. 22% of telemedicine visits were for behavioral health services, including anxiety, depression, childhood or adolescence disorders, and bipolar disorder. Studies have shown that patients have substantially improved outcomes when given access to virtual visits with caregivers and providers. Additionally, studies have demonstrated that telepsychiatry has had the largest positive impact on patients of any healthcare specialty.

The increasing use of telepsychiatry has led to changes in policy development as well. The Mental Health Telemedicine Expansion Act, introduced in 2018, would amend the Social Security Act to provide coverage to Medicare beneficiaries for telepsychiatry services. Currently, Medicare patients must be present at an originating site (provider office, nursing facility, hospital) for all virtual visits. This bill would waive that requirement, allowing patients to receive telepsychiatry care wherever they are.

Today, 29 states require both private insurance and Medicaid to cover telemedicine services. The largest national health insurance companies (BCBS, Aetna, Cigna, and United Healthcare) also cover telemedicine services nationwide. Many states even require that reimbursement rates for virtual visits be equal to that of an in-person visit.

Navigating Reimbursement

Reimbursement requirements can vary by state and services, but some basic tips can be applied to increase your success rate.

Medicare: As previously mentioned, Medicare patients must be located at an approved originating site to receive virtual care. The patient must also be located in a designated Health Professional Shortage Area. To see if your health facility qualifies, type in your address here. You can also check the CMS Website to find a complete list of CPT and HCPCS codes that are eligible for telemedicine reimbursement.

Currently, Medicare reimburses the same rate for virtual visits as in-person appointments. If your site is an originating site, you may be eligible for reimbursement for hosting the visit. Details can be found under the HCPCS code Q3014.

Private Payers: There are many different HCPCS and CPT codes for telehealth services. It is important to choose the right code based on the services provided to receive proper reimbursement. For example, telehealth consultations that take place in an emergency department are billed under G0425-G0427, while individual or group behavior assessments fall under 99307-99310.

MindCare’s team of healthcare professionals can provide your facility or practice with everything you need to set up a thriving and successful telebehavioral health practice, including access to board-certified psychiatrists and behavioral health professionals. Our customizable technology platform integrates with your current workflow to ensure scalability and ease of use. Our services can help increase your patients’ satisfaction rates and bring your clinic new opportunities for reimbursement.

For further information, contact dweiss@mindcaresolutions.com