COVID-19 Coronavirus Resources for Mental Health Therapists

While none of us are glad there is a current pandemic across the globe, there are some positive ways we can use this time, such as trying out online therapy sessions and reviewing our policies and procedures.

I’ve compiled a list of resources and guidance below so that you’re prepared and confident while continuing your therapy practice throughout the Coronavirus quarantine period. Here’s what is included in this article:

1. Documentation Considerations for Emergencies

2. Documentation and Telehealth Services for Psychotherapists

3. Training on Telehealth Specific to Mental Health Therapists

4. Telehealth Coverage by Medicare, Medicaid, and Private Insurance

5. Questions and Complications of Insurance Coverage of Telehealth Services

Documentation Considerations for Emergencies

In general, your regular documentation (such as forms, progress notes and treatment plans) shouldn’t need to be any different. However, this is a great time to review some policies and make sure your paperwork is up to date!

Here is what I recommend you review in your policies to make sure you’re prepared for any type of natural disaster, pandemic, or other emergency:

• Emergency Contact Info- Check with your clients to make sure you still have the correct emergency contact information.

• Local Emergency Resources- Make sure you have a list of the local resources and phone numbers for all your clients. For example, when I had a therapy practice in Orange County, California my clients often lived in neighboring cities that had a different police or sheriff’s department from my office location. If you ever need to call for a welfare check on a client, you’ll want to call the local authorities based on your client’s physical address.

• Consent forms- If you are starting online counseling with clients as a new service, you’ll need an updated consent form and want to review specifics with them related to online therapy. See the section below this (Documentation and Telehealth Services for Psychotherapists) for more details.

• Cancellation Policy- Many therapists have a 48 hour cancellation policy, which may not be realistic in this rapidly changing environment. Consider your cancellation policy and how practical it is in the current situation. You may want to make a temporary change, a permanent change, or even just remind your clients about the policy.

• Sick Policy- Now is a good time to consider having a sick policy. Coronavirus or not, having sick clients attend in person sessions puts yourself and all your other clients at risk. Let clients know that you do NOT want them to come into the office if they are sick and outline the options you offer as a replacement, such as phone or video sessions.

• Professional Will- The truth is that any of these emergencies might apply to you, rather than your clients. Make sure you have a professional will in place and that at least two trusted people have access to it. Check out this article for more guidance on how to prepare a professional will for your psychotherapy practice.

• Consider moving your documentation online- While it is perfectly ethical (and still fairly common) to handwrite your documentation, I’m offering you a friendly reminder that paper documents, along with digital documents on your computer hard drive, are vulnerable documents. I personally know therapists who have lost client documentation due to an office fire, office flood, and theft. At this point in time, the safest documentation is actually online using a cloud service or electronic health record (EHR). An added benefit is that you can easily access these documents from any location, so there is no need to transport paperwork if you want or need to work from home.

Documentation and Telehealth Services for Psychotherapists

There are certain things you need to consider when documenting online therapy services. These requirements can vary by state, so it is important to know what your local laws may have to say about telehealth. But in general, here is what I recommend you consider for documentation of online counseling sessions:

• Have a Consent for Telehealth Form that outlines the specific benefits and risks of telehealth, along with any practice policies specific to online therapy. For most therapists, this will be a separate form that you only need to review with clients when they start online sessions. If you do all your sessions with all clients online, then you might want to simply incorporate this form into your general Informed Consent document.

• Document in your intake note that you reviewed the specific policies and nuances related to online counseling sessions. This might include things such as:

  • How to log in to the session

  • How you’ll contact the client if the internet goes out or the connection is unstable

  • What type of physical environment is best for effective therapy sessions (e.g. not sitting at the computer in their living room if they live with multiple people who might overhear or interrupt the session)

  • How you might respond if the client has an emergency

  • Online security measures, etc. (check out the telehealth training resource in the next section for more details)

• Document in your progress notes that this was a telehealth session, rather than in person session. You might create a simple check box in your progress note template or have a statement that you include in every note for online counseling sessions.

• If online sessions will be a regular part of counseling, include this in your treatment plan. If you’re just starting up online psychotherapy sessions due to Coronavirus concerns, make a note in your treatment plan about the adjustment. It could be quick and simple, such as: “As of 03/16/2020, all sessions will move to online due to social distancing recommendations as a result of the COVID-19 pandemic.”

Training on Telehealth Specifically for Psychotherapists

If you are new to online therapy, you’ll want some training. Keep in mind that certain states, such as Georgia, require a full certification program for you to offer online counseling. Most states are not this stringent, but it’s still best practice (and fairly easy!) to take a course and make sure you truly understand the nuances of therapy online.

My go-to resource for anything online is Person-Centered Tech. That’s because I know the folks over there personally, and continue to be impressed by them professionally. PCT offers a wealth of resources, including telehealth training courses, a telemental health certification program, guidance on HIPAA in real life practice, and reviews of tech resources like video meeting software and EHRs.

Person-Centered Tech has prepared a FREE online training, Telemental Health Practice Checklist, and Telemental Health Informed Consent that you can download to quickly acclimate yourself and support your clients during quarantine.

Click here to access the free resources from Person-Centered Tech.

While you’re over there, take advantage of the discount they are offering for all Telemental Health Trainings through March 31st! And yes, sign up for their newsletter so you can stay up to date post-quarantine.

Telehealth Coverage by Medicare, Medicaid and Private Insurance

The Center for Connected Health Policy created a great resource that outlines what types of services are covered under various insurance plans. This includes what is covered, restrictions to coverage, and what CPT codes to use for billing.

Click here to download the TELEHEALTH COVERAGE POLICIES IN THE TIME OF COVID-19 handout (last updated March 16, 2020).

Questions and Complications of Insurance Coverage of Telehealth Services

Despite promises heard in news broadcasts, the question still remains: Will insurance increase coverage of telehealth services due to Coronavirus?

Dr. Ajita Robinson, founder of Mastering Insurance, has a valuable and FREE Facebook group related to all things insurance (billing, credentialing, documentation, etc.). She even recently offered a free training on telehealth inside the group.

Most importantly, this group has over 5,000 mental health professionals and is a great place to get answers to your insurance specific questions and access resources from colleagues.

Click here to join the Mastering Insurance Facebook Group.

Barbara Griswold of Navigating the Insurance Maze wrote a great article summarizing how insurance coverage is rapidly adjusting to the increased need for coverage of telehealth for therapy and counseling. She has some great tips, like emailing the plan to ask about coverage instead of calling, due to increased wait times over the phone. She also offers guidance on exactly what to ask the plan so you know whether or not your clients have coverage for telehealth sessions.

Click here to read the article on Barbara’s website.

Additionally, Barbara is curating a list of all private insurance companies and their coverage for phone and video sessions in response to COVID-19. This is an epic resource!

Click here to see the list of private insurance coverage for phone and video psychotherapy sessions.

And while you’re over there, make sure to sign up for her newsletter! I recommend every therapist subscribe to her monthly newsletter because it really is that valuable.