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Is Your Therapist Using Skype and Billing Your Insurance Illegally?

Many therapists are already using technology to extend their reach online, but aren’t being honest with the insurance companies about the location of the services they bill. Telehealth services, that is, online therapy, online counseling, Internet therapy, etherapy, webtherapy, Skype therapy – all these terms mean the same thing, and they typically require a special “qualifier” code when your insurance company is billed by your therapist. Otherwise, your therapist is billing them for “in-office” services — which online services clearly are not.


When mis-billed, such practice is technically known as insurance fraud, and a serious crime for which your therapist will be held responsible.

Of course, nothing will happen if you don’t get caught, much like speeding in your automobile. However, if you are complicit in fraud, and something goes wrong, you may be held responsible to some degree if you knew of the fraud. Make sure you know how your sessions are being billed to your insurance company, and double check to see if your therapist knows what they are doing both technically and with proper billing practices for the professional services they offer you.

Therapists can get a billing guide funded by the federal U.S. government by using the form in the upper right corner of this website: TeleMental Health Institute to get our newsletter. A free gift we give to professionals subscribing to the newsletter is an ebook called, “Telemedicine Reimbursement Handbook” and also available through CTEC.

What Else Can You Do?

Check with your insurance company. Just call them anonymously and ask if they pay for the specific type of technology your therapist is using, be it email, chat, video, telephone or anything else.

TIP:  if your insurance hasn’t traditionally paid for telephone based services, they most likely won’t pay for Skype or other non-HIPAA-compliant video services online, either.

The next step for you of course, is to send you insurance company a letter and voice your strong objection to their rejection of services that make access to mental health more possible for you. In fact, 12 states mandate paymentby insurance companies for telehealth. They just seem to be dragging their feet. Consumer complaints will make all the difference

Please post your questions or comments below!


Marlene M. Maheu, Ph.D. is the Founder and Editor-in-Chief of the SelfhelpMagazine since 1994. She is also the Executive Director of the TeleMental Health Institute, Inc., offering a Certificate training program in TeleMental Health for telepsychiatry, telepsychology, telesocial work, and online counseling or online therapy. Academic books authored by Dr. Maheu and colleagues include eHealth, Telehealth and Telemedicine and The Mental Health Professional & the New Technologies.



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16 Responses to “Is Your Therapist Using Skype and Billing Your Insurance Illegally?”

  1. Any recommendations on what to do for UK-based users?

  2. Luke » There are reputable videoconferencing platforms worldwide. Many companies you’ll see listed on this page are international:
    If you are already working with a therapist who is using Skype, ask them to buy a healthgrade platform as their online “office.” Then you can be assured your contact with them is private and secure. If they need training about such issues and a lot more, they can come to the TeleMental Health Institute, where they can not only get trained, but also certified: By doing so, they will know how to prevent or handle a long list of other potential problem when they work online.

  3. Thank you for this insight. All these issues never occurred to me, but indeed are important.

  4. Cyndi Hargett says:

    I am brand new to trying to bill or Skype sessions. When I call an insurance company and ask if Skype sessions are covered, they want me to give them the code so that they can tell me if the code is covered. My understanding is that there is no specific code for Skype sessions. I don’t know if I would use a face-to-face code such as 90847 or a telephonic code. I know the face-to-face code would be covered, but that is not going to let the insurance company know that it was a Skype session. We have never known phone therapy sessions to be covered when we have tried to bill it. Can you help me to know how we would bill for this and how I can try to find out if it’s covered when the insurance companies want me to just spit them out a code so they can say “yes” or “no”?

  5. Fantastic!

  6. Great weblog right here!

  7. Zachariah Roulston says:

    You made several nice points there. I did a search on the topic and found most people will have the same opinion with your blog.

  8. Emma Austin says:

    Have you ever considered writing an e-book or guest authoring on other blogs?

  9. interval training workouts says:

    I like your fantastic web site, I was searching for this all over.

    Best regards,

  10. Dr. Maheu says:

    Hello Emma,

    Thank you for your compliment! We have an ebook coming out soon. It will be available on our Facebook page.


  11. Dr. Maheu says:


    Thank you for your question. Sounds like you need some very specific coursework. We have over 65 CEU (or CME units if you are a physician). They are all available here: See the course about reimbursement:

    We also have a full Certificate Course (40units) so that you can take all your CEU or CMEs with us for up to 5 years and get all your required training from one place. When you are done, you get a Certificate that will signify you are trained to practcie online. See here:

    Best Regards,

  12. Obviously going through this information many will resonate with this because it is reality and its nice to see a web guy that is writing this publically to consider.

  13. We appreciate your writeup!

  14. Dennis Kiker says:

    You mention that there are 12 states that require insurance companies pay for telehealth. Which states are those?

  15. Dennis,

    The number has increased dramtically to 23. See this page for regular updates and other resources:

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