Telemedicine is the process of providing health care from a distance through technology, often using videoconferencing. Telepsychiatry, a subset of telemedicine, can involve providing a range of services including psychiatric evaluations, therapy (individual therapy, group therapy, family therapy), patient education, and medication management.

Telepsychiatry can involve direct interaction between a psychiatrist and the patient. It also encompasses psychiatrists supporting primary care providers with mental health care consultation and expertise. Mental health care can be delivered in live, interactive communication. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review.

Telepsychiatry appointments are secure and HIPAA compliant, done in the privacy and comfort of the patient’s own home or office. All you need is high-speed internet access and a computer, tablet, or smartphone with a microphone and webcam. If you can FaceTime or Skype, then you can do telepsychiatry appointments. Vitoria sees patients located within the states of  Oregon, New Mexico, and Arizona.

Video-based telepsychiatry helps meet patients’ needs for convenient, affordable, and readily accessible mental health services. It can benefit patients in a number of ways, such as:

• Improve access to mental health specialty care that might not otherwise be available (e.g., in rural areas)
• Bring care to the patient’s location
• Help integrate behavioral health care and primary care, leading to better outcomes
• Reduce the need for trips to the emergency room
• Reduce delays in care
• Improve continuity of care and follow-up
• Reduce the need for time off work, childcare services, etc. to access appointments far away
• Reduce potential transportation barriers, such as lack of transportation or the need for long drives
• Reduce the barrier of stigma

While some people may be reluctant or feel awkward talking to a person on a screen, experience shows most people are comfortable with it. Some people may be more relaxed and willing to open up from the comfort of their home or a convenient local facility. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life.

Telepsychiatry allows psychiatrists to treat more patients in distant locations. Psychiatrists and other clinicians need to be licensed in the state(s) where the patient they are working with is located. State licensing boards and legislatures view the location of the patient as the place where “the practice of medicine” occurs.

Although telepsychiatry has the disadvantage of the patient and psychiatrist not being in the same room, it can create enhanced feelings of safety, security and privacy for many patients.

Telepsychiatry has been found to be effective in the treatment of depression, anxiety, and PTSD. Research has found high patient satisfaction with telepsychiatry among patients, psychiatrists, and other healthcare professionals. Telepsychiatry patients report an overall good experience among varying age groups, and there is evidence of successful treatment effectiveness, high quality of care, and patient satisfaction.

Currently, 43 states and the District of Columbia have laws that govern private-payer reimbursement for telehealth.

Fifty states and Washington, D.C. reimburse for some form of live video telehealth in Medicaid fee-for-service. Comparatively, only 16 state Medicaid programs reimburse for store-and-forward services (“asynchronous telemedicine”).

That said, state Medicaid policies, rules, and laws are continuing to evolve. Medicare will reimburse for telepsychiatry services if the community is considered rural, and requires the patient to report to an “Originating Site,” unless that patient has a substance use disorder (Medicare will also cover any co-occurring diagnosis), under the SUPPORT Act. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Our service rate can be found HERE