How Teletherapy Billing Should Work: A Policy Guide for Clinics

A teletherapy billing policy is a short written document that sets out what virtual sessions cost and how payment works. Patients read and accept it before their first virtual session.

It is different from your billing workflow. The policy says what you charge and when; the workflow is how your system carries it out.

For the workflow side, read our guide to how telehealth billing works in practice management.

A clear policy also protects staff. Reception and finance can point to agreed rules instead of negotiating each case.

A teletherapy billing policy should include fees, payment timing, cancellation terms, technical failure rules and payer arrangements. Keep it to one page in plain language.

• Fees in KES for each virtual session type and length.
• When payment is due: at booking, before the session or after it.
• Accepted payment methods, such as M-Pesa, card or bank transfer.
• Late cancellation and no-show terms, including the notice period.
• What happens if the call fails, depending on who caused the problem.
• How packages, refunds and unused sessions are handled.
• How insurer, SHA or employer cover applies to virtual sessions.

Many clinics charge the same fee for virtual and in-person sessions, because the clinician's time and expertise are the same. Others set a different rate. Either can work if it is explained.

Consider your costs honestly. Virtual sessions may save room costs, but they add platform, support and administration costs.

Whatever you decide, avoid surprises. Show the fee at booking, and confirm it again in the reminder message.

Some clinics offer shorter virtual check-ins at a lower fee. If you do, define them clearly as a separate session type.

Set up a teletherapy billing policy by agreeing the rules internally, writing them simply and building agreement into intake. Then review them after a few months of use.

1. List every virtual session type you offer and its fee.
2. Agree payment timing and accepted payment channels.
3. Define cancellation, no-show and technical failure rules with your clinical lead.
4. Check each insurer's and SHA's rules on virtual care, and note any exclusions.
5. Write the policy in plain language, in the languages your patients use.
6. Capture the patient's agreement during intake, alongside teletherapy consent.
7. Review the policy after a few months, using attendance and payment data.

Billing agreement and clinical consent belong together. Our article on teletherapy consent and why it must be built in explains how to combine them.

Clinics in Kenya should consider mobile money, mixed payers and data costs when setting teletherapy billing rules. These shape what feels fair to patients.

M-Pesa makes prepayment simple, but patients need a clear receipt and refund route. State how long refunds take and how they are paid.

Issue receipts in KES straight after payment, by SMS or email.

The Social Health Authority (SHA) replaced NHIF in October 2024, and cover rules may differ by facility and service. Confirm current rules for virtual mental health care rather than assuming.

Connectivity problems are common in some areas, so a fair technical failure rule protects trust. For the finance side, see our guide on reconciling M-Pesa, cash, card and insurance payments.

The most common mistake is applying in-person rules to virtual sessions without thinking through new situations. Technical failures and late joins need their own terms.

• Charging a no-show fee when the patient could not connect because of a platform fault.
• Leaving fee information out of booking confirmations.
• Not checking whether an insurer covers virtual sessions before the claim is made.
• Changing the policy without telling existing patients.

Each of these damages trust. A clear policy, applied consistently, prevents most billing disputes.

Review billing disputes every quarter. Patterns often show where the policy wording needs to be clearer.

Can we charge a no-show fee for teletherapy?

Yes, if your policy says so and the patient agreed in advance. Apply it only when the patient was responsible, not when the session failed because of a fault on your side.

Do patients need to sign a billing policy?

They should actively agree to it, for example through an intake form or portal checkbox. Keep a dated record of that agreement in the patient's file.

Do insurers in Kenya cover teletherapy?

Cover varies by insurer and scheme. Check each payer's current rules for virtual mental health sessions before booking, and record any pre-authorisation.

Should teletherapy prices be shown on our website?

Showing prices builds trust and reduces enquiries. If fees vary, show a starting price in KES and explain what affects the final cost.

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