Telehealth Billing in Behavioral Health: Compliance, Coding & Reimbursement Changes in 2026

The rise of telehealth has permanently reshaped behavioral and mental health care delivery. What began as a temporary solution has now become a core component of psychiatric, therapy, and substance use disorder services.

However, while access has improved, billing telehealth services in behavioral health has become more complex than ever. Providers must navigate evolving compliance rules, coding requirements, and payer-specific reimbursement policies to avoid denials and revenue loss.

In 2026, success in tele-behavioral health is no longer about offering virtual care—it’s about billing it correctly and compliantly.

The Growth of Tele-Behavioral Health Services

Behavioral health is one of the largest adopters of telehealth, due to its suitability for virtual care.

Key changes shaping the industry include:

• Removal of geographic restrictions (patients can receive care from home)

• Expanded coverage for psychotherapy, psychiatric evaluations, and counseling

• Continued support for audio-only visits when video is unavailable

• Reimbursement parity extensions through 2026

These changes have improved patient access—but have also introduced new billing risks and compliance challenges.

Understanding Telehealth Compliance in Behavioral Health

Compliance is the foundation of telehealth billing. Failure to meet payer requirements can result in denials, audits, or repayment demands.

1. Documentation Requirements

Behavioral health telehealth services require detailed documentation, including:

• Medical necessity for each session

• Mode of service (video or audio-only)

• Patient location (home or facility)

• Duration of the session

• Treatment plan and progress notes

Incomplete documentation is a leading cause of telehealth denials.

2. Audio vs Video Compliance

Payers distinguish between:

• Audio + Video Visits (standard telehealth)

• Audio-Only Visits (limited eligibility)

Medicare and many payers allow audio-only visits for behavioral health—but only when:

• The patient cannot use video

• The provider documents the reason

Modifier 93 is often used to identify audio-only services

3. Patient Location Rules

Telehealth billing now depends on where the patient is located, not the provider.

• POS 10 → Patient at home

• POS 02 → Patient at another location

Incorrect POS coding is one of the top causes of claim denials

Telehealth Coding for Behavioral Health Services

Accurate coding is critical for reimbursement. Most telehealth services use standard CPT codes with modifiers and POS indicators.

Common Behavioral Health CPT Codes

The following CPT codes are widely used for tele-behavioral health:

• 90791 / 90792 – Psychiatric diagnostic evaluations

• 90832 / 90834 / 90837 – Individual psychotherapy (30, 45, 60 min)

• 90847 – Family therapy

• 90853 – Group therapy

Telehealth Modifiers

Modifiers indicate how the service was delivered.

Modifier Use
95 Live audio-video telehealth

93 Audio-only telehealth

GT Used by some Medicaid/commercial payers

Place of Service (POS) Codes

POS Code Description POS 10 Telehealth in patient’s home
POS 02 Telehealth outside the home

Example of Correct Telehealth Billing

A 45-minute virtual therapy session:

• CPT Code: 90834

• Modifier: 95

• POS: 10

➡️ 90834-95, POS 10

Reimbursement Changes in 2026

Telehealth reimbursement continues to evolve under Medicare, Medicaid, and commercial payers.

1. Reimbursement Parity

CMS has extended telehealth parity, meaning:

• Telehealth visits are reimbursed similarly to in-person visits

• Home is now an approved originating site

This ensures providers are paid fairly for virtual care

2. Behavioral Health Integration (BHI) Codes

New reimbursement opportunities include:

• 99484 – General behavioral health integration

• 99492 / 99493 – Collaborative Care Model

These codes support monthly care coordination and psychiatric collaboration

3. Audio-Only Reimbursement

Audio-only visits remain reimbursable for behavioral health:

• Must meet payer requirements

• Must be properly documented

• Often requires modifier 93

4. New Telehealth Billing Opportunities

Expanded services include:

• Remote patient monitoring (RPM)

• Digital E/M services

• Virtual check-ins

These create new revenue streams for behavioral health practices

Common Telehealth Billing Mistakes in Behavioral Health

Even experienced practices struggle with telehealth billing errors. The most common mistakes include:

1. Missing Modifiers

Claims without modifier 95 or 93 are often denied.

2. Incorrect POS Codes

Using POS 02 instead of POS 10 can reduce reimbursement.

3. Billing Non-Covered Services

Not all services are eligible for telehealth reimbursement.

4. Lack of Medical Necessity Documentation

Payers require clear justification for each session.

5. Audio-Only Billing Errors

Billing audio-only services without eligibility leads to denials.

How to Optimize Telehealth Billing in 2026

To maximize reimbursement and reduce denials, behavioral health practices should:

✔ Verify Payer Policies

Telehealth rules vary between Medicare, Medicaid, and commercial insurers.

✔ Conduct Regular Billing Audits

Review telehealth claims for compliance and accuracy.

✔ Train Providers on Documentation

Providers must document telehealth requirements properly.

✔ Track Policy Changes

Telehealth regulations change frequently—stay updated.

✔ Use RCM Expertise

Outsourced billing services can improve accuracy and reduce denials.

Why Telehealth Billing Is a Revenue Strategy

Telehealth is no longer just a convenience—it’s a critical revenue channel for behavioral health providers.

Practices that fail to adapt risk:

• Increased claim denials

• Compliance violations

• Lost revenue opportunities

• Audit exposure

On the other hand, providers who master telehealth billing can:

• Improve collections

• Expand patient access

• Stabilize cash flow

• Scale services efficiently

Final Thoughts

Telehealth has transformed behavioral health care—but it has also added complexity to billing, coding, and compliance.

In 2026, successful practices understand that:

👉 Telehealth billing is not just administrative—it’s strategic
👉 Compliance is essential to avoid audits and denials
👉 Accurate coding directly impacts reimbursement

By staying updated on telehealth policies, CPT codes, and payer rules, behavioral health providers can turn telehealth into a powerful growth and revenue tool.

Need Help with Behavioral Health Telehealth Billing?

At Everest A/R Management Group, we help behavioral health providers:

• Reduce telehealth denials

• Ensure coding compliance

• Maximize reimbursements

• Streamline revenue cycle management

👉 Contact us today to optimize your telehealth billing strategy in 2026.