Like most answers I give regarding being a mental health therapist and having a private practice, “yes” and “no.”
WHY SHOULD MENTAL HEALTH PROFESSIONALS CHARGE FOR PHONE CALLS?
Phone calls can take a lot of time and time is what we’re paid for.
If you don’t charge for these phone calls, you are potentially leaving a lot of money on the table and spending a lot of time at your expense. For example, you may need to coordinate care for an adult when speaking with a case worker, PCP, psychiatrist, nutritionist, attorney, etc.
Anyone who treats children knows that speaking with the school counselor, the testing psychologist, the psychiatrist, and PCP is necessary for good treatment. Speaking with parents is practically mandatory.
All of this takes time – a lot of time. Time away from your practice, time away from your personal life. And we’ve all heard the old cliché, “time is money.”
DIFFERENT TYPES OF PHONE CALLS
Whether you charge or not also depends on who’s on the other end of the call, if the client uses their insurance, and the contract with the insurance company.
- Calls to the client: This one is more straightforward, whether the client is paying out of pocket or using insurance. Typically, therapists will charge for phone calls with the client if the conversation exceeds a certain amount of time.
- Calls to family members: Sometimes therapists need additional information from family members, especially if the client is a child.
- Case consultation: A documented meeting of at least 15 minutes’ duration, either in person, by telephone, or mail between the treating provider and other behavioral health/medical clinicians or physicians, concerning an individual who is a client of the behavioral health provider (in-other-words, case consult is between providers).
- Collateral contact: This is a call to a person with a source of information that is knowledgeable about the client’s situation and serves to support or corroborate information provided by a client. That person would include, but is not limited to, school and day care personnel, state agency staff, human services agency staff, court appointed personnel, religious/spiritual leaders, and/or other community resources (in-other-words, collateral contacts are between anyone else in the client’s life who is not a provider). It is also a documented meeting of at least 15 minutes’ duration, not only by phone but also in person, or mail. Keep in mind that regulations may vary by state, so check your own state’s regulations.
HOW MUCH DO I CHARGE?
You can charge what you want. Some mental health therapists have a special rate they charge for phone consults. I bill at my full rate, the one I charge for a session, which is the same rate I bill the insurance company even though we accept their contracted rate. As therapists, our rate needs to be consistent. If you discount your rate, you need to justify the discount in writing and have a standard process by which you make that determination. Whatever you decide, just be clear and upfront about how much you charge.
EXPLAIN THIS CHARGE IN YOUR OFFICE POLICIES!
My policy states that I will talk on the phone for up to 10 minutes, but after that, I will charge the client starting from the time the call originated. The charge is in 15-minute increments. You can always be generous and round down if you want but don’t sell yourself short. If you charge for calls with family members, case contacts, and collateral contacts, include this explicitly in your policies. Especially if a client is paying out of pocket, they should be informed of this prior to or during the first session.
WHEN YOU CAN’T CHARGE FOR PHONE CALLS
If someone is a private pay client and not using insurance, always bill for your time, and like I said before, just be clear about your policies up front. But when someone is using insurance, it’s not always possible to bill for calls. Some insurance companies will reimburse the therapist for phone calls and some won’t. Medicaid often compensates for collateral contacts and case consultations. Most private insurance companies do not. Insurance companies will not pay for phone calls with the client unless it is a full session and the insurance company endorses that practice. Check with the insurance company.
Be on the safe side
- Review your office policies, also known as Informed Consent, with the client or the client’s parent/s, or guardian, etc. during the first session.
- Have the policy signed by the client, parents, foster parents, or guardians as affirmation that they were informed and understand.
- Remind the client, parent, etc., about this policy the first time you find yourself spending more than 10 minutes on the phone, as a courtesy because people forget.
- Reminder: If the client is using insurance, check with the client’s insurance company. Some companies, like many Medicaid companies, pay for case and collateral consultations because they involve children and these consults are mandatory for good care. Most private insurance companies often don’t pay for them. If our contract allows it, you can bill for your time.
I find that most of my clients understand and respect my policy. I’ve had very few who complain or ask for special favors. Plus, it’s always possible to not charge if you decide this is the right choice. If you do, document that you didn’t charge and why.
DOCUMENT. DOCUMENT. DOCUMENT.
Don’t forget to document these calls! Remember, if it isn’t written down, it didn’t happen. Anything that’s part of mental health treatment needs to be documented and in the client file. (I know, it’s more work, but in this litigious climate, I choose safety over the potential to be sorry. It could save you from a legal nightmare.) Not only does this protect you legally, it’s important to document your calls with family members, case contacts, and collateral contacts when a client is paying out of pocket so they can see why they are paying you for time outside of their therapy sessions.
OUR TIME IS ALL WE HAVE
Other professionals charge for these consults or build the consult into the fee. Just because psychotherapists and mental health professionals are kind, compassionate, and understanding, we should not be expected to give our time away. We provide a needed service and should be fairly compensated for it.
If you want a quick, compliant, and efficient way to document your case and collateral consultations, Documentation Wizard TM provides a streamlined process that cues you to include everything you need. Check out Master Clinical Forms.