If you are looking to add telepractice (ASHA’s preferred term for teletherapy) to your private practice, here are some points to keep in mind. Like all aspects of private practice, starting with a clear guide will help you be successful! Here is part 1 of my 2-part blog series, Telepractice in Action!

What Is Telepractice?

Before we talk about how to offer telepractice, let’s define it. According to ASHA, telepractice is

Telepractice sessions can be offered via 3 styles:

• synchronous, meaning that they are conducted via an interactive audio and video connection in real time, which creates an in-person experience similar to that achieved in a traditional encounter;

• asynchronous (AKA “store-and-forward”), meaning that images or data are captured and transmitted for viewing or interpretation, such as transmission of voice clips or therapy session videos. This type is not covered by most insurers.

• hybrid, which, as the name suggests, combines synchronous, asynchronous, and/or in-person services.

In my own practice, I generally follow a hybrid model with the initial consultation or evaluation in person followed by regular sessions via telepractice. I have found that this works best for my evaluation process, which always includes an oral-mech assessment, and also helps clients feel like they really “meet” me. Synchronous video and audio is amazing, but it can’t replicate a handshake or the body language that you get from meeting someone in person.

When you are thinking about whether to offer telepractice services, consider your ideal client AND your current client base- would they use or be open to trying a new method of therapy provision? Do the disorders you treat (or want to specialize in) lend themselves to telepractice? A nice thing about private practice is that you do not have to set your therapy format in stone- starting in person or via teletherapy does not mean that all sessions thereafter have to be in that format. Find what works best for you and your clients, and don’t be afraid to change things up if they are not working!

I wrote a blog post all about making the most of teletherapy in your private practice, including marketing and referral tips, here.

Telepractice Billing Rules

Some payers have restrictions on teletherapy services. For example, as of March 2020, Medicare does not cover sessions via teleherapy for SLPs or audiologists. Medicaid does allow it in some states, but as with any therapy format, check your contact for any specifics. ASHA has a lot of information on their Reimbursement of Telepractice page, as well as a list of telepractice rules by state.

You bill the SAME rate for in-person therapy as you do for teletherapy! Remember, it is just a different SETTING, not different therapy.

In general, billing for teletherapy using the CMS-1500 claim form is very similar to billing for an in-person therapy session. The only differences are:

• Place of service code (Box 24B): use code 02 (“The location where health services and health-related services are provided or received through a telecommunication system”)

• Modifiers:

  • For CPT codes: use -95 (only covers synchronous teletherapy)

  • For HCPCS: use modifier GQ (for asynchronous teletherapy) or GT (for synchronous teletherapy)

Everything else is the same, because teletherapy is the same as in-person therapy, just in a different setting!

Final tip:

You must have all teletherapy clients sign an Informed Consent for Teletherapy. I have an editable version in my Freebie Library.

Those are my tips! Do you have any other tips ? Share them below!

For more information, check out part 2 of this Telepractice in Action blog series: How to Choose A Telepractice Platform.

I offer individual, personalized consultations to help you set up your own telepractice services. I can help you choose the best platform for your needs, walk you through setting it up, and even train you and your team how to use it!

I curated a list of my favorite teletherapy materials and resources- things I use every day! Check them out on Amazon!

If you want more information about starting a practice, including a guide to setting up a teletherapy space, it's available in my Private Practice Foundations course - a one-stop guide to starting your private practice. 

I spoke with Venita from the Speechie Side Up podcast about telehterapy. We covered

• How to switch from private practice to telepractice.

• Teletherapy + insurance

• How do you choose a teletherapy platform? (more info in this blog post)

• My go-to teletherapy resources

• A good story and therapy fail

• 3 things I can’t work without

• Things I enjoy doing outside of work

• A piece of advice I would tell my younger self

You can listen to my episode here.