Telepsychiatry Guidance During COVID-19 Emergency

AACAP envisions a time when all children with psychiatric illness have access to the care they need. However, an increased demand for mental health care has not been met by an expansion of services. Further, most child and adolescent psychiatrists practice in major urban and coastal areas leading to a deficit in, and maldistribution of, the child and adolescent psychiatry workforce. As a consequence, a majority of affected children do not receive the psychiatric care they need, a situation that is anticipated to continue into the foreseeable future. New models of care are needed to address this need. 

The Centers for Medicare and Medicaid (CMS) supports the use of telemedicine to deliver care remotely to under-served communities. CMS defines telemedicine as the delivery of healthcare services through real-time interactive videoconferencing. Both auditory and visual capabilities are required to meet this definition. 

When telemedicine is used to provide psychiatric services, the term telepsychiatry is used. Increasingly, both public and commercial insurers are reimbursing telepsychiatry services and private agencies are contracting for telepsychiatry services. Thus, telepsychiatry offers a major advance in helping communities build their capacity for providing necessary psychiatric services.  

Telepsychiatry is no longer a service delivery model used solely to reach underserved communities. It offers an alternative to families experiencing other barriers to care, such as work demands and school activities. Home-based services are especially helpful to families and offer psychiatrists an ecologically valid perspective of their patients’ environment. Telepsychiatry services are offered to many community settings such as schools, mental health centers, primary care centers, correctional settings, and residential treatment facilities.  The benefits of telepsychiatry are not restricted to increasing access to care: Telepsychiatry also helps providers diversify their practices. Benefits include reaching new populations in need of specialized care, such as autism or obsessive compulsive disorder. Providers may reach out to communities of interest without travel and time away from families. Telepsychiatry contracts help providers build new revenue streams.

This section provides aspiring and established telepsychiatrists resources for their practices. 

Coding for Telemedicine Services With the onset of COVID-19, the Federal Government has recommended that health care professionals utilize telemedicine technologies for patient visits and has provided flexibility to do so without fear of HIPAA violations.

Telepsychiatry Toolkit The Child and Adolescent Telepsychiatry Toolkit represents a collaboration between AACAP and the American Psychiatric Association (APA) that optimizes resources, efficiency, and visibility for those interested in incorporating telepsychiatry into their practice.

The Clinical Update: Telepsychiatry with Children and Adolescents, Oct. 2017 The AACAP Committee on Telepsychiatry and Committee on Quality Issues present procedures for conducting telepsychiatry services and optimizing the clinical experience.

Guidelines and Policies Links to resources from AACAP on practice guidelines and information for families.

Useful Websites Useful websites providing practical information regarding telemental health practice, including information on reimbursement for telepsychiatry services.

Glossary A list of commonly used words or phrases to describe telehealth activities, equipment and requirements. Further information regarding terminology can be found at the web sites for each of the federally funded Telehealth Resource Centers and at the American Telemedicine Association.

AACAP Committee on Telepsychiatry The AACAP Committee on Child and Adolescent Telepsychiatry was originally appointed in 2001 by Marilyn Benoit MD, past AACAP President. The Committee’s charge was to develop member resources to facilitate the use of telepsychiatry to deliver needed services to under-served youth. With the rapid adoption of telepsychiatry across the nation, the AACAP Telepsychiatry Committee has become the leading resource for identifying the evidence-based, clinically sound, and ethical practice of telepsychiatry with children and adolescents.