Reimbursement Guide for Clinicians

Bill higher.
With objective data
behind every claim.

Therapists using measurement-based care can justify 20–50% higher reimbursement per session. TheraSignal gives you the clinical documentation, the session data, and the objective outcomes to back it up — starting today.

+$20–50 per session with stronger MBC documentation
$30–50 per patient/month from RTM codes
$0 new CPT codes needed — uses what you already bill

Your reimbursement roadmap.

There are three ways TheraSignal improves your billing. One you can use immediately. One coming online in the next year. One that's the future of digital mental health coverage.

Pathway 01 Available Now

Measurement-Based Care (MBC) — Bill More Per Session

+20–50%

reimbursement per session

You're already billing 90834 or 90837 for your sessions. The question is whether your documentation justifies the higher code — and whether payers can push back with denials. TheraSignal's objective session data changes that equation. Affect timelines, session engagement scores, and symptom trajectory data create a paper trail that payers can't argue with.

CPT Code Description Standard Rate With MBC Data
90834 Individual psychotherapy — 45 minutes $60–100 $80–130
90837 Individual psychotherapy — 53+ minutes $100–150 $120–180
90785 Interactive complexity add-on +$10–30 Easier to justify
90791 Initial diagnostic evaluation — 60+ min $100–150 $120–175

How TheraSignal makes this work:

01

Objective session documentation. Each session generates an affect timeline, engagement score, and key moment log. When you submit a 90837 claim for a 53-minute session, you have time-stamped evidence of clinical depth — not just a therapist's note.

02

Payer denial defense. Insurance companies routinely deny 90837 claims claiming sessions weren't long or complex enough. TheraSignal's session data gives you a documented clinical record to appeal with — and win.

03

Outcome tracking over time. When you show a payer that your patients are getting measurably better — tracked session by session via PHQ-9/GAD-7 correlates — you're demonstrating the clinical value of your work. Payers pay more for evidence-based practice.

04

No new codes needed. You continue billing exactly as you do today. TheraSignal improves the documentation behind your existing claims — no new billing workflows, no new insurance contracts.

Pathway 02 6–18 Months

Remote Therapeutic Monitoring (RTM) — New Revenue Stream

+$30–50

per patient per month, on top of sessions

As of January 2025, Medicare and many commercial payers now reimburse therapists for monitoring patients between sessions. RTM codes 98975–98981 allow you to bill for the time you spend reviewing patient-reported data and communicating with patients outside of scheduled appointments. TheraSignal's between-session monitoring features are built precisely for this pathway.

For a practice with 20 active patients billing RTM, this adds $600–1,000 per month in new revenue without adding sessions.

RTM Code What you're billing for Reimbursement
98975 Initial device supply + patient education (one-time per patient) $50–100
98976 First 20 min/month of clinical review + patient communication $20–30
98977 Each additional 20 min/month of clinical review $20–30

What the monthly billing cycle looks like:

01

Patient onboards with TheraSignal. They're set up to submit mood, symptom, and behavior data 2–3 times per week from their phone. You bill 98975 once for their initial setup.

02

Patient data flows into your dashboard. Between sessions, you see their mood trajectories, practice adherence, and any flagged changes in symptom patterns. All timestamped, all documented.

03

Monthly review + one touchpoint. Spend 20 minutes reviewing the month's data. Send your patient a brief message or discuss in session. That's your 98976 — documented and billed.

04

Stack on top of session codes. RTM codes can be billed in the same month as 90834 and 90837. They're additive — not a replacement for your session billing.

05

No FDA clearance required. Unlike DMHT codes, RTM codes don't require your software to be FDA-cleared. You just need a connected device that captures patient-reported data — which TheraSignal is.

Payer coverage as of 2025: Medicare now covers RTM codes for behavioral health. Commercial payers including Cigna, UnitedHealth, and Aetna are actively expanding RTM coverage in 2025–2026. TheraSignal will provide up-to-date payer coverage lists as we roll out RTM billing support.

Pathway 03 18–36 Months

FDA Digital Mental Health Treatment — National Coverage

G0552–

G0554 Medicare DMHT codes

Starting January 1, 2025, Medicare created new codes specifically for FDA-cleared digital mental health tools. Once TheraSignal achieves FDA clearance as a Software as a Medical Device (SaMD), therapists will be able to bill G0552–G0554 on top of standard session codes — adding an additional $50–200 per patient per month in reimbursable monitoring and management time.

TheraSignal is building toward this pathway in parallel with MBC and RTM. The clinical evidence collected through MBC pilots and RTM monitoring will directly support our FDA submission. Therapists using TheraSignal now are helping build the outcome data that accelerates this pathway.

Projected Medicare DMHT rates (2025 schedule)
G0552 Device supply + initial education $50–150 G0553 First 20 min/month management ~$20/mo G0554 Additional 20 min/month management ~$20/20 min

Want early access to our FDA pilot program? Reply to therasignal@polsia.app — we're recruiting 20–30 practices for the outcomes study that will support our regulatory submission.

Take this to your billing specialist.

Print this page as a one-pager summary of TheraSignal's billing pathways. It covers all three reimbursement tracks, the CPT and RTM codes, and the projected revenue impact — in plain language your billing team will understand.

Ready to bill what your work is actually worth?

TheraSignal is in early access. We're onboarding select practices who want to lead on measurement-based care and get ahead of the RTM billing curve.

Start Free Trial → Talk to Us
Billing disclaimer: Reimbursement rates shown are approximate ranges based on Medicare fee schedules and commercial payer data as of 2025. Actual reimbursement varies by payer, location, contract, and clinical documentation. This guide is for informational purposes only and does not constitute billing or legal advice. Consult a healthcare billing specialist before changing your coding practices. RTM reimbursement requires compliance with payer-specific documentation requirements.