Mental Health Screening in the Age of Telehealth

Delivering Mental Health Over Telemedicine

The age of telehealth is upon us. Telehealth, which encompasses the delivery of medical and mental health assessment and treatment, can be administered via telephone, live video conferencing, and other digital communication modalities. Although telehealth has existed for decades, its utilization increased exponentially beginning in 2020. Previously, it was primarily reserved for people living in rural areas and certain long-term care facilities, in no small part because insurance providers typically failed to adequately reimburse for telehealth services. The public health emergency of 2020 ushered in significant policy changes — including increased reimbursement for telehealth — that dramatically accelerated the development and utilization of telehealth across wide swaths of the healthcare industry. During that period, some medical practices reported conducting 50 to 175 times more telehealth visits compared to before.¹ Since then, telehealth has become a permanent feature of healthcare delivery: as of 2025, mental health conditions account for approximately 58–62% of all telehealth claims nationally, making mental health the dominant telehealth use case.⁵

Whereas some medical subspecialties (e.g., surgery, oncology) face significant obstacles regarding the viability of telehealth, mental health is particularly well suited for remote delivery. Telemental health, as it is often called, includes psychological screening, assessment, education, therapy, and medication management. Telemental health offers a variety of advantages over in-person care. Importantly, it substantially enhances access to mental health services for people in need of psychotherapy and psychotropic medications — addressing an ongoing problem in which nearly half of people experiencing mental illness do not receive care.² Many people find it less stigmatizing and intimidating to seek mental health care from the comfort of their own home. Telehealth also removes barriers related to transportation (e.g., cost, access, long commute, weather) and low motivation — which are among the most frequent obstacles to patients receiving mental health treatment.

Along with substantial benefits of telehealth, there are, of course, drawbacks and limitations. First, certain conditions and populations typically benefit from, or even require, a higher level of care than can be provided remotely. For example, young children may have difficulty engaging via telehealth, and individuals with serious psychotic symptoms or at high risk for suicide may require inpatient hospitalization or more frequent, high-intensity care than is practical via remote outpatient services, just as these same patients would not be appropriate for weekly outpatient in-person therapy. Second, for safety reasons, some psychotropic medications (e.g., lithium, clozapine) require therapeutic drug monitoring that requires some degree of in-person services (e.g., laboratory blood draws). There are also limitations regarding psychological testing via telehealth. Although many psychological tests can be validly administered remotely, others — particularly neuropsychological assessment instruments — require an in-person proctor. Limitations regarding access and capacity to effectively utilize technology can also present barriers. Lastly, some patients and providers simply prefer in-person care and believe that something of the human connection is lost in virtual care.

As telehealth has become a permanent part of the healthcare landscape, demand has remained strong — particularly in domains like mental health and routine primary care, which are so amenable to this modality. As of 2022, approximately 28% of mental health outpatients received all of their care via telehealth, with an additional 21.5% receiving hybrid care.⁶ The future of mental health assessment and treatment requires thoughtful adaptation to this reality. Fortunately, mounting evidence suggests that telemental health is both feasible and efficacious. A variety of psychological conditions (e.g., depression, anxiety, PTSD) can be adequately addressed via remote interventions, and some research suggests people are less likely to drop out of therapy prematurely when it is delivered remotely.³

There remains a significant opportunity, however, to improve upon valid and reliable remote assessment of mental health conditions. This pertains to both comprehensive assessment batteries conducted by licensed psychologists and to more efficient and circumscribed psychological screening completed by primary care providers (PCPs), who manage the majority of psychological conditions in the United States. Whereas many PCPs are accustomed to working in team-based settings, alongside mental health consultants (BHCs) in an integrated model of care, the expansion of telehealth changes this dynamic. It limits the availability of “curbside consults” between PCPs and BHCs and with them, the PCP’s opportunity to benefit from a mental health specialist’s clinical impressions and recommendations. As a result, it is increasingly important for PCPs to utilize effective and efficient psychological screening tools in their daily practice to enhance evidence-based clinical decision making.

Data from more than 4,000 individuals who used Connected Mind®‘s screening tool remotely over six months in 2020 revealed significant levels of mental health symptoms across a variety of categories (e.g., depression, anxiety, substance use). The relative prevalence of different symptom categories identified in this dataset corresponds with epidemiological knowledge about various mental health conditions (e.g., three to five times greater rates of unipolar than bipolar depression).⁴ These findings suggest the remote electronic administration of Connected Mind’s mental health screening tool is both viable and clinically nuanced. As telehealth continues to grow as a permanent delivery model, tools that are efficient, flexible, and adept at aiding in differential screening are critically important.

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Works Cited

1. Bestsennyy, O., Gilbert, G., Harris, A., & Rost, J. “Telehealth: A quarter-trillion-dollar post-COVID-19 reality?” McKinsey & Company (2021).

2. National Alliance on Mental Illness. “Mental Health By the Numbers.” NAMI (2024). View on NAMI

3. American Psychological Association. “How well is telepsychology working?” Monitor on Psychology 51.5 (2020).

4. Palsson, O. S., Ballou, S. K., & Gray, S. “The U.S. National Pandemic Emotional Impact Report.” (2020).

5. FAIR Health. “Telehealth Trends: January–March 2025.” FAIR Health (2025). Mental health conditions accounted for 58–62% of telehealth claims nationally.

6. Cantor, J., et al. “Telemental Health, Hybrid, and In-Person Outpatient Mental Health Care in the US.” JAMA Network Open (2025). 27.8% all-telehealth, 21.5% hybrid, 50.6% in-person.

Related Resources

• Screening in primary care — Why PCPs are the front line for mental health
• Comorbid mental health screening — Why multi-condition assessment changes outcomes
• CPT 96127 FAQ — Brief emotional/behavioral assessment billing guide
• CPT 96130 FAQ — Psychological testing evaluation services
• CPT 96136 FAQ — Test administration by a provider
• CPT 96138 FAQ — Test administration by a technician
• CPT codes for psychological testing — Overview of the 2019 code changes
• Mental Health Parity Act — Your rights when payers deny claims

Frequently Asked Questions

Can mental health screening be done via telehealth?

Yes. Many psychological screening instruments can be validly administered remotely via electronic platforms, telephone, or live video conferencing. Mental health conditions account for approximately 58–62% of all telehealth claims nationally, making mental health the dominant telehealth use case.

Is telehealth screening as accurate as in-person screening?

Evidence supports that remote electronic administration of validated screening tools is both viable and clinically nuanced. Data from remote screening encounters shows that the relative prevalence of different symptom categories identified remotely corresponds with epidemiological knowledge about various mental health conditions. However, some neuropsychological assessment instruments require an in-person proctor.

What percentage of mental health care is delivered via telehealth?

As of 2022, approximately 28% of mental health outpatients received all of their care via telehealth, with an additional 21.5% receiving hybrid care (a mix of telehealth and in-person visits). About 50% continued to receive all in-person care. Mental health conditions represent 58–62% of all telehealth claims nationally.

What are the benefits of telemental health?

Telemental health substantially enhances access to mental health services, particularly for people who would not otherwise receive care. It reduces barriers related to transportation, cost, long commutes, weather, and low motivation. Many people find it less stigmatizing to seek mental health care from the comfort of their own home. Research also suggests people may be less likely to drop out of therapy prematurely when it is delivered remotely.

What are the limitations of telehealth for mental health?

Certain conditions and populations may benefit from or require a higher level of care than can be provided remotely. Young children may have difficulty engaging via telehealth, and individuals with serious psychotic symptoms or at high risk for suicide may require inpatient hospitalization. Some psychotropic medications require therapeutic drug monitoring via in-person laboratory blood draws. Some neuropsychological assessment instruments also require an in-person proctor.

What conditions can be effectively screened or assessed via telehealth?

A variety of psychological conditions including depression, anxiety, ADHD, bipolar disorder, substance use disorder, somatic symptom disorder, and PTSD can be adequately screened and assessed via remote interventions. Multi-condition screening tools that use branching logic to evaluate multiple conditions simultaneously are particularly well suited for telehealth delivery.

How has telehealth adoption changed since 2020?

Telehealth utilization increased exponentially beginning in 2020, with some medical practices reporting 50 to 175 times more telehealth visits than before. Since then, telehealth has become a permanent feature of healthcare delivery. As of 2024, 25% of Medicare fee-for-service users had at least one telehealth service, and mental health remains the dominant telehealth use case.

Why is mental health particularly well suited for telehealth?

Unlike medical subspecialties that require physical examination or procedures, mental health services — including screening, assessment, education, therapy, and medication management — can be effectively delivered via telephone, live video conferencing, and other digital communication modalities. The clinical content of mental health encounters translates well to remote delivery.

Can primary care providers use telehealth for mental health screening?

Yes. Primary care providers, who manage the majority of mental health conditions in the United States, can administer validated screening tools during telehealth encounters. As telehealth has expanded, the availability of in-person curbside consults between PCPs and mental health consultants has decreased, making efficient remote screening tools even more important for evidence-based clinical decision making.

Does insurance reimburse for telehealth mental health screening?

Yes. CMS has approved CPT 96127, 96130, 96136, and 96138 for use with telemedicine through December 31, 2026. Policy changes that expanded telehealth reimbursement have been largely maintained, with 25% of Medicare fee-for-service users accessing telehealth services in 2024.