Web Secret #107: Teletherapy

As recently as two years ago I had an elitist, snotty attitude about teletherapy.

Actually, that’s putting it mildly. I thought any therapy that didn’t take place in a bricks and mortar office wasn’t “real therapy.” Well times have changed, and so have I. (If you're curious, I wrote about my “conversion” in an earlier blog post.

Two years is a long time in the rapidly changing tech universe and as I write this, teletherapy is gaining acceptance in the US at warp speed. Why? Because,

“Two–thirds of Americans with a mental illness do not receive treatment due to cost, stigma, inconvenience, and low access, particularly in rural areas.” Connected Care Blog 9/19/09

Definition, please. Teletherapy is quite simply the delivery of mental health services through secure video, phone, and web.

Teletherapy is:

• Effective: over fifteen years of research confirm that telemedicine is as effective as in–person treatment.
  
• Convenient: 50% of therapy clients drop out after a few sessions, but research shows teletherapy can boost retention to over 90%. Because clients can hold sessions anywhere with phone or internet access, they are much more likely to stay in treatment.
  
• Affordable: telemedicine sessions can cost 10 to 50% less due to reduced overhead, travel time, and staffing needs.
  
• Accessible: research shows the fit between clients and mental health providers is essential to positive outcomes. Most people will not travel to a provider beyond fifty miles, but telemedicine lets clients work with the best licensed provider regardless of location.
  
• Confidential: 80% of therapy clients worry about the stigma of treatment. Telemedicine’s earliest adoptees were in Asian countries where psychotherapy carries a very negative stigma.
  
• Legal: Teletherapy is legal and expanding, and regulated by state–specific guidelines. Government and licensing boards are also rapidly evolving legislation to expand teletherapy access. Currently providers only “see” clients in states where the provider is licensed. Providers can typically apply for licensure in multiple states, either directly through state licensing boards or third–party services that streamline the application process.
  
• Reimbursable: Teletherapy is reimbursable. Since 2004, Medicare and the AMA have issued CPT codes to identify and reimburse teletherapy services. A list of eligible services and codes include:
  • Individual psychotherapy: CPT 90804 – 90809
    
  • Consultations: CPT 99241 – 99255
    
  • Office or other outpatient visits: CPT 99201 – 99215
    
  • Pharmacologic management: CPT 90862
    
  • Psychiatric diagnostic interview examination: CPT 90801
    
  • Neurobehavioral status examination: CPT 96116
  CPT code descriptions can be found on the American Medical Association's CPT directory. The modifier GT may be necessary to identify that services were delivered via telemedicine. More details on reimbursement are available through the American Telemedicine Association.

Other teletherapy resources:

Want to publicize that you offer teletherapy? Post your services on breakthrough.com.

Want more information on teletherapy ethics and best practices? Learn more about the Online Therapy Institute.