Asynchronous messaging reimbursement varies based on the client’s plan type and client's state of residence. Below, we break down the Session-Based and Engagement-Based reimbursement models, along with key policies and guidelines to ensure appropriate usage. Base rates will vary state to state, meaning different rates will apply accordingly.
Session-Based Reimbursement Model
This model applies to EAP (Employee Assistance Program) and Behavioral Health (BH) plans. Providers are reimbursed for these asynchronous messaging sessions based on submitted progress notes.
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EAP plans: Asynchronous Messaging Sessions for clients on EAP plans are reimbursed at rates between $27.50-$35.60 per submitted session (depending on client state of residence, see below).
- CPT Code selection is not applicable for EAP Plans.
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Behavioral Health (BH) plans: Asynchronous Messaging Sessions for clients on BH plans are reimbursed based on the CPT Code submitted for the session (rates are dependent on session duration and client state of residence, see below for reference). The CPT Code submitted for the session should be based on the approximate duration of the session as shown in the product.
- The platform will show an approximate duration, calculated at a rate of 40wpm for typed messages (PDFs count as 150 words), in addition to the actual duration of any audio or video messages. You can use the displayed approximate duration as guidance, but the length of the session and level of clinical engagement are ultimately up to your clinical discretion.
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Important Submission Guidelines:
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Engagement-Based Reimbursement Model
The Engagement-Based Payout Model is the current reimbursement model for Asynchronous Messaging Sessions for Self-Pay / Direct-to-Consumer (D2C) and Direct-to-Employer (DTE) plans.
- Asynchronous Messaging Sessions are reimbursed at rates between $12.50-$15.50 per 1000 words (depending on client state of residence, see below) for text, audio, and video messages exchanged between provider and client.
- Audio and video asynchronous messages are transcribed internally for word count calculation.
- PDFs will be counted as 150 words
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Provider-to-Client Word Count: To ensure balanced communication, a 3:1 provider-to-client word count ratio will be implemented. This means that for every word a client sends, only three of the provider's words will be counted.
- This ratio also includes transcribed words from audio and video messages.
- For non-engaged clients, providers can send up to 750 words before the 3:1 word count cap is applied.
- The maximum asynchronous messaging payout per room will be capped at $150 per payout period.
Base Rate Breakdown
This table below will demonstrate the base rates per session type for Providers treating California-based clients.
| Session Type | Base Rate |
| BH Async 60-min | $47.50 |
| BH Async 45-min | $35.60 |
| BH Async 30-min | $23.75 |
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EAP Async (7 days of access) |
$35.60 |
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DTE/B2C Async (per 1000 words) |
$17.50 |
This table below will demonstrate the base rates per session type for Providers treating clients based in New York, Washington, Maryland, Massachusetts, Virginia, and Washington D.C.
| Session Type | Base Rate |
| BH Async 60-min | $41.25 |
| BH Async 45-min | $31.00 |
| BH Async 30-min | $20.75 |
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EAP Async (7 days of access) |
$31.00 |
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DTE/B2C Async (per 1000 words) |
$15.50 |
This table below will demonstrate the base rates per session type for Providers treating clients in all other states.
| Session Type | Base Rate |
| BH Async 60-min | $37.00 |
| BH Async 45-min | $27.50 |
| BH Async 30-min | $18.50 |
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EAP Async (7 days of access) |
$27.50 |
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DTE/B2C Async (per 1000 words) |
$14.50 |