last updated: August 2, 2025
Running a private-practice in California means we spend almost as much time wearing a billing hat as we do our therapist hat. After too many rejected claims and late-night resubmits, I finally pulled together everything I wish I’d known about billing Medi-Cal for telehealth sessions. I hope it saves you some headaches.
Medi-Cal Therapy Billing in California (2025)
Video vs Audio-Only Telehealth: Modifier 95 vs 93
| Modifier | Modality | Quick rule-of-thumb | Does it change payment? |
|---|---|---|---|
| 95 | Real-time audio + video | Use when you and the client can both see and hear each other (e.g., Zoom, Doxy). | No. Reimbursed at the same fee schedule as in-person. |
| 93 | Real-time audio-only | Use when the client joins by phone and there is no video. | No. Same rate as in-person, but you must document medical appropriateness. |
Pro tip: Document a short clinical rationale if you switch from video to audio-only mid-session—auditors look for that note.
Medi-Cal explicitly states that “the use of modifier 93 [or 95] does not alter reimbursement for the CPT or HCPCS code.” (mcweb.apps.prd.cammis.medi-cal.ca.gov, dhcs.ca.gov)
Place of Service (POS)
- 02 – Telehealth provided other than patient’s home (most community situations)
- 10 – Telehealth provided in patient’s home (common for therapy)
If your managed-care plan (MCP) has its own POS preference, follow that, but most accept 02 across the board.
Which Individual Psychotherapy Codes Medi-Cal Covers
| CPT | Description | Typical length |
|---|---|---|
| 90791 | Diagnostic evaluation | 60 min |
| 90832 | Psychotherapy, 30 min | 25-35 min |
| 90834 | Psychotherapy, 45 min | 38-52 min |
| 90837 | Psychotherapy, 60 min | 53 min + |
All four are payable via telehealth when billed with 93 or 95, so long as you meet documentation standards. (mcweb.apps.prd.cammis.medi-cal.ca.gov) Keep track of time in your note—the code definitions haven’t changed.
Required Elements in Telehealth Documentation
- Location of client (city/ZIP) and provider.
- Telehealth modality used (audio-video or audio-only).
- Modifier (93/95) and POS (02 or 10).
- Client consent for telehealth (verbal or written) & date obtained.
- Clinical content that supports the CPT code—the same as in-person.
- Any technical issues and their impact on clinical care.
DHCS notes that no separate “telehealth form” is required, but the above must be present in the progress note. (dhcs.ca.gov)
Common Denial Reasons & Quick Fixes
| Denial reason | The fix |
|---|---|
| Missing modifier | Add 93 or 95 and resubmit. |
| Wrong POS | Use 02 or 10 consistently. |
| Timed service without duration | Document start/stop times or total minutes. |
| Non-covered code | Stick to 90791, 90832, 90834, 90837 for therapy. |
| Provider license lapse on file | Update CA license in MCP portal before resubmitting. |
I keep a copy-and-paste checklist in my EHR so nothing gets missed.
FAQs
Author
Mason Anglin, LMFT
Licensed Marriage & Family Therapist, California
I’ve been running a fully hybrid in-person/remote private-practice since 2022.
Not Legal or Billing Advice
This article is for educational purposes only and does not constitute legal, billing, or tax advice. Always verify requirements with DHCS and your Medi-Cal managed-care plan.
Sources
- Medi-Cal Provider Manual: Medicine – Telehealth (updated June 2025). (mcweb.apps.prd.cammis.medi-cal.ca.gov)
- All Plan Letter 23-007 – Telehealth Services Policy (DHCS, April 10 2023). (dhcs.ca.gov)
