Can a Practice Bill Medicare for Telehealth?

In the last quarter of 2023, more than 12.6 percent of Medicare beneficiaries received healthcare services via telehealth. Both in urban and suburban areas, people have benefited from increased access and improved convenience provided by telehealth. But, at this time, there are an increasing number of people asking, “Can a practice bill Medicare for telehealth?” Hansei Solutions is here to help. 

Key Points:

• Practices can bill Medicare for Telehealth.
• Though some changes to Medicare coverage for telehealth services are set to begin on January 1st, 2028, behavioral health practices using Telehealth should still be able to bill Medicare.
• Insurance companies often make billing more complicated than it needs to be. We help behavioral health providers find solutions so that they can focus on seeing their patients. 

Can a Practice Bill Medicare for Telehealth?

Can a practice bill Medicare for telehealth services? Yes. Through December 31st, 2027, beneficiaries can receive telehealth services covered by Medicare anywhere in the United States and territories. Starting on January 1st, 2028, except for behavioral health services, beneficiaries will usually need to be in a medical facility or rural area to get Medicare telehealth services. This means that behavioral health practices should still be able to bill Medicare for telehealth, even in 2028. 

How Can Hansei Solutions Help? Navigating Medicare for Telehealth as a Behavioral Health Provider

How can Hansei Solutions help? Navigating Medicare for telehealth as a behavioral health provider isn’t always easy. That’s where we come in. 

Behavioral Health Billing With Hansei Solutions

Getting help for Behavioral Health Billing With Hansei Solutions means that you can focus on what you need to: the health and well-being of your patients. Our services can help providers working with Medicare and other insurance plans at every stage of the process, from initial verification to denied claims. 

Verification of Benefits in Medical Billing 

Verification of Benefits in Medical Billing is often one of the first steps toward getting a client the care they need. With insurance companies paying fewer claims, however, the process can be complicated, confusing, and frustrating both for people seeking services and their providers. Our verification of benefits (VOB) process includes confirming:

• Client information.
• Type of insurance plan (including different Medicare plans).
• Status of individual policies.
• Details of plan coverage. 
• Co-pays and deductibles. 
• Pre-authorization.
• Lifetime maximums. 
• Payable benefits. 
• Co-insurances.
• Referrals. 

As your behavioral health practice grows, you’ll likely be dealing with an increasing number of claims. Our process minimizes future challenges, like denied claims, making everything more seamless for both providers and their clients. 

Claim Denial Management With Hansei Solutions 

In an ideal world, insurance would cover any services recommended by a healthcare provider. Unfortunately, denied claims are all too common. Claim Denial Management With Hansei Solutions helps non-hospital and behavioral healthcare settings:

• Identify denial trends.
• Reduce rejections.
• Streamline claims.
• Record the submission process.

We help you find out why your clients are getting denied, including Medicare recipients, and find solutions to make your and your team’s lives easier.

Contact Hansei Solutions for Help With Medicare Telehealth Billing

Hansei Solutions provides advanced, seamless behavioral health billing services to maximize revenue cycle management and profitability for addiction and mental health treatment providers. We serve all behavioral health professionals, including but not limited to private practices, clinics, and treatment centers. Contact Hansei Solutions for help with Medicare billing today by calling 888-574-4379 or book a demo with us online through our website to give it a try. 

(FAQs)

Why are telehealth services important in behavioral health?

Telehealth services are crucial in behavioral health for multiple reasons. They expand treatment access to people who live in rural areas or who may be unable to travel to in-person services for a variety of other reasons. When people need to see a specific type of provider or find one with whom they have a strong therapeutic alliance, telehealth often means they have more options. It is important that healthcare companies continue to cover telehealth services for these reasons. 

What are some common reasons insurance denies behavioral health services?

There are a variety of reasons that insurance might deny behavioral health services for a client. Some common causes of denied claims include: 

• Improper coding: Often, billing codes that seem to be correct are not. This is a very common reason for denied claims in insurance. We help providers find the right Current Procedural Technology (CPT) codes and modifiers (e.g., telehealth modifiers). 
• Lack of medical necessity: Even if you know a service is necessary for a client, insurance companies may deny claims due to a “lack of medical necessity.” Additional information and proper coding can help you appeal or get the service covered. 
• Other documentation issues: Various other documentation issues, such as a diagnosis that does not align with the type of treatment provided or a lack of progress, can lead to denied claims. 
• Policy limits and exclusions: Specific healthcare plans have unique policy limits and exclusions, some more than others. If a client has exhausted their allotted sessions or the type of treatment you’re billing for is not covered, their claim may be denied. 

Denials can be sneaky and unethical, holding people back from getting the care they require and deserve. If a claim is denied, clients have the right to make an appeal. Providers are able to help the process along. We’re here to maximize the effectiveness of the appeal process for behavioral health care professionals and their clients. 

What is a behavioral health practice in insurance?

Behavioral health practices include:

• Therapy and counseling (in-person and online visits with counselors, psychologists, therapists, and social workers). 
• Drug and alcohol detox (including acute and subacute withdrawal management). 
• Inpatient mental health and addiction treatment programs.
• Outpatient addiction and mental health treatment programs (in-person and online).
• Psychiatry (in person and online).

Usually, insurance companies cover these services. 

Does Medicare cover addiction treatment?

Yes. Medicare does cover addiction treatment. There are different types of Medicare plans. The specific Medicare plan a person has is a primary factor affecting where a person can get mental health and substance abuse treatment services.

Resources 

https://www.cms.gov/files/document/telehealth-faq-updated-02-17-2026.pdf 

https://www.ama-assn.org/topics/cpt-codes