Coping with OCD during the COVID-19 outbreak

Teletherapy and telepsychiatry refer to the delivery of traditional behavioral health and psychiatric care using a phone or the internet. Video teleconferencing allows patients to continue therapy even if they can’t physically travel to an appointment. A pilot study found that exposure and response prevention delivered remotely via video teleconferencing was as effective as in-person treatment.

If you see a therapist or psychiatrist regularly for in-person visits, they may have already contacted you about temporarily transitioning your therapy to remote sessions using a video teleconferencing service. Getting therapy this way is sometimes called “teletherapy,” and has been increasingly utilized over the past decade to deliver mental health care with strong results in both adults and children with OCD.

If your therapist hasn’t contacted you to discuss teletherapy, you might be thinking about suggesting this as an option. You also might be wondering whether your insurance will cover teletherapy visits the same way they cover your in-person visits.

Here are some things to consider:

• Research has found that video teleconferencing can be an effective means for therapists to provide exposure and response prevention (ERP) for OCD in children and adults.

• Many of the providers in our Resource Directory already offer teletherapy as an option for their patients. You can narrow your search to only those who offer teletherapy by clicking on the “Teletherapy” filter under Treatment Strategies.

What to know about insurance coverage:

• Private: Insurance coverage for teletherapy varies considerably from state to state, and by insurance plan.

• Medicaid: Many state Medicaid plans cover teletherapy.

• Medicare: Medicare covers teletherapy for beneficiaries in rural areas, but you will likely need to travel to a healthcare facility to receive teletherapy services. A recent law makes it possible for Medicare to waive this requirement in an officially-declared emergency.

Providing teletherapy can be tricky for therapists because of the rules and regulations they need to follow. For example, even if your insurance covers teletherapy, your therapist may not be able to provide it to you if you live in a different state than where your therapist usually practices (this isn’t always the case — be sure to check with your therapist).

Steps you can take:

• Ask your therapist if they are offering teletherapy, or if they are planning to make it an option in the near future.

• If your therapist accepts insurance, ask if they are familiar with your insurer’s rules for reimbursing teletherapy.

• Call your insurer to see what options you have. You may need prior authorization in order for teletherapy services to be covered.

• Don’t give up! If you aren’t able to access teletherapy services due to decisions made by your insurer or therapist, consider asking again after some time has passed. Decisions about how to deliver care may be modified as the situation changes.

• You may need to see a new therapist if you are no longer residing in the state that the therapist you were seeing (e.g., if your school sent you home for the semester). In this case, if you do need a new therapist, be sure that they are willing to coordinate your care with your former therapist to assure that you maintain your gains in treatment.

• If your current therapist cannot do teletherapy with you and you would still like to pursue that option, ask them for a referral or find someone with OCD expertise who offers teletherapy. You may check the IOCDF’s Resource Directory, or go on your insurer’s website for options.

• If your insurer denies your request for prior authorization, consider filing an appeal.