For Clients: FAQ
What is online counseling and telepsychiatry?
Online counseling is the delivery of counseling by mental health professionals via secure video, phone, chat, email, and other technology mediums. Telepsychiatry can include the delivery of prescription medications by psychiatrists under legal and ethical guidelines.
Is online counseling effective?
Yes, peer-reviewed and published studies from leading institutions show online counseling is as effective as in-person treatment. Online counseling also increases client retention, reduces costs, and enables mental health providers to expand their practice. However, online counseling is not a replacement for in-person help and we do not recommend it for clients in crisis or with severe conditions.
What forms of counseling does Breakthrough support?
Breakthrough enables sessions via secure video, phone, email, chat, and in-person. Breakthrough makes forums available for informal interactions among clients and providers of mental health services, but does not recommend individual services through public forums.
Is online counseling legal?
Yes, online counseling is recognized and regulated by state, federal, and licensing board regulations. Medicare and Medicaid recognize and reimburse online counseling through specific guidelines.
To meet and exceed compliance requirements, Breakthrough only allows mental health professionals to see clients in the states where professionals are credentialed. Mental health professionals can usually apply for credentials in multiple states and should contact their state licensing board for more information.
Government regulations and licensing boards are rapidly evolving to expand telemedicine access. Clients and providers of online counseling should become familiar with the regulations governing online counseling in their state before engaging in sessions.
Is online counseling secure?
Yes, Breakthrough encrypts data via 256-bit SSL encryption and is building its infrastructure to comply with the Health Insurance Portability and Accountability Act (HIPAA). All communication between a client and provider is encrypted in transit and deleted from Breakthrough's servers after a session. Breakthrough does not ask for a client's name or address, only a phone number and email address in case of emergencies.
For your security, we strongly recommend that you do not use Breakthrough on public computers. We also recommend that you do not store your Breakthrough password through your web browser or other software.
Is online counseling covered by insurance?
Since 2004, online counseling and telepsychiatry is reimbursable through Medicare, Medicaid, and a growing number of insurance plans.
The CPT codes that identify services for reimbursement are constantly changing. Here are codes that can be considered for online or offline mental health services:
- Individual psychotherapy: CPT 90804 – 90809
- Consultations: CPT 99241 – 99255
- Office or other outpatient visits: CPT 99201 – 99215
- Pharmacologic management: CPT 90862
- Psychiatric diagnostic interview examination:CPT 90801
- Neurobehavioral status examination: CPT 96116
CPT code descriptions can be found on the American Medical Association's CPT directory. The modifier GT may be necessary to identify that services were delivered via telemedicine.
For Medicare reimbursement, clients generally must receive treatment at an eligible originating site, such as a doctor's office, hospital, nursing facility, mental health clinic, or similar facility. Private payers often do not have the same locality restrictions. More details on reimbursement are available through the American Telemedicine Association.
What technology do I need to use Breakthrough?
Your technology needs will depend on what types of counseling you choose. At a minimum you will need an internet connection and a web browser.
For phone counseling, you should have a landline, cell phone, or Voice over Internet Protocol (VoIP) number. For video counseling, you should have a webcamera and microphone or headset. For email and chat counseling, an internet connection and web browser are sufficient.
Can providers prescribe medication remotely?
In many states, providers with prescription privileges may prescribe medications via telemedicine when compliant with state, federal, and credentialing board regulations. Breakthrough strongly recommends that providers only prescribe medications after seeing a patient in-person and maintaining a doctor-patient relationship.
Are providers licensed/credentialed?
Breakthrough takes best efforts to confirm mental health professionals are credentialed and in good standing. However, you should separately confirm a provider's credentials through your state's licensing board.
Astrologists, psychics, and other non-credentialed providers are not allowed to use Breakthrough.
How are providers paid?
Clients currently pay providers before or after a session through PayPal. Clients may use a credit card, bank account, or PayPal balance to pay a provider. Currently, providers must sign up for PayPal to receive payment. Soon, providers will be able to receive payment through additional options, require pre-session payments, and auto-bill clients based on session times.
Why can't I see a mental health professional outside of my state?
Breakthrough strives to maintain compliance with state, federal, and licensing board regulations of mental health professionals. These regulations are not always detailed on how mental health services should be delivered via electronic mediums. States generally allow online mental health services when professionals are licensed in the client's state and practicing within ethical and legal guidelines.
Because a mental health professional's credentials are highly dependent on the professional's state and scope of practice, Breakthrough can not certify a professional's credentials are sufficient for his or her practice. We will continue to iterate our policies as regulations evolve.
What does "online now" mean?
Online Now indicates that a provider is logged into the Breakthrough system and likely available for an immediate session. Providers may sometimes step away from their computer. If a provider is not answering a request for a session, consider scheduling a future appointment.