Display professionalism when you are billing for your therapy services.
Q: Should therapists charge less for telepractice sessions than they do for same-location sessions?
Don't use two different rates for your time. There is a risk that telepractice service delivery will be devalued if we charge less for telepractice sessions than same-location sessions. Your time is your time.
Be loyal to your telepractice colleagues. You might find that telepractice limits your ability to do assessments and therapy the old way. You might feel that it is not as good as being in the same location. Be careful. This is only your experience so far. It is a steep learning curve and others are further along. Your colleagues might be experiencing unprecedented success as telepractice professionals.
Let me emphasize that concept again. You are billing for your time in offering clinical services. Don’t use two different rates.
Q: Should I ask funders to give consent for telepractice service delivery?
Insurance companies and funding agencies require your dates of service, your hourly rate and the length of your session. Most of them want to see the words “assessment” or “therapy” on the invoice.
In my opinion, there should be no requirement to specify if the session was delivered by telepractice. Imagine how silly it would seem to ask a funder for permission to provide services at a small blue table. I believe that in the future telepractice will be recognized as a normal type of service delivery. It won’t be seen as something that requires consent from a funding source. I should add the disclaimer that this not necessarily how insurance companies and funders are currently responding.
Q: Should I bill for software licenses that I am using in therapy?
No, the software that you need for your clinical caseload is your expense. Most funders have no interest in reimbursing you or your client for software. Furthermore, it conveys a lack of professionalism to ask for funding for any kind of supplies or expenses. I came to this conclusion early in my career, when I billed a client for a long-distance call. The client laughed at me.
Don’t add unnecessary details to your invoices. Just set your hourly rate high enough to cover your expenses. I used the generic description “speech language therapy services” on all my invoices. I paid for online licenses and shipped commercial therapy products to clients at my expense. I encourage you to define your services as therapy, not software or product sales.
Q: Should I bill for asynchronous services?
Yes. ASHA’s definition of telepractice is a brilliant, future-proof definition. Synchronous service is easy to comprehend. Your client is in attendance. Take a moment to reflect on services that you provide that are asynchronous or a hybrid. Do you bill for time the time you spend looking at user generated data on a server? Traditionally, therapists would call this “monitoring.”
Do you bill for assessments and progress reports that are generated by software? You should. Those reports guide your therapeutic process.
How we communicate with funders will shape the future. Let me say it one more time, your time is your time! Don't devalue the asynchronous methods that help your clients reach their goals. As a telepractice professional, your clinical services will look different than they did in the past. Embrace this concept and teach others to embrace it.
