SALT LAKE CITY — Last month, FOX 13 shared a story about a change in Select Health’s billing practices, which local therapists claiming they will not only create more work for them in an already strained environment, but would keep people who need mental health help immediately from getting the care they need.
After that story aired, we heard from a therapist who had concerns about a different change in Select Health’s billing that would affect another sub-section of clients.
“I work with complex trauma and attachment-related disorders with PTSD. I do a lot of EMDR, eye movement desensitization and reprocessing," says licensed clinical social worker Jessica Little. "Oftentimes with that, you need more than 60 minutes in order to be able to do a safe closure, in order to get the client back to a stable state so they’re not walking out flooded with emotions. It's standard practice.”
Select Health policy change raises concerns over delays in mental health care access:
But that standard has had to change for Little’s practice, The Green Lotus Center for Personal Growth & Wellbeing.
Back in 2023, the American Medical Association removed some modifier codes that allowed for billing for extended psychotherapy sessions. They came up with a workaround to bill two units of codes for people to still receive medically necessary services.
The problem is, there was a gap and insurance companies didn’t recognize the workaround, so many insurance companies said you can only perform one hour of service for these clients.
Fast forward to 2026...
“Insurance companies started to kind of come around," says Little. "Many of them did, and many of them still do the workaround. This January, Select Health notified us 15 days after the policy started that they would not be allowing that anymore and that extended psychotherapy sessions cannot be billed.”
This leaves patients that need 90-120 minute psychotherapy sessions without an appropriate outpatient reimbursement pathway.
Little claims the reason Select Health made the changes was from the American Medical Association guidelines. But she has been unable to find the guideline that codes limiting billing to one unit.
“I cannot find that. I’ve called AMA. I called CMH. I’ve called many people, the state of Utah and Medicaid Services, and everybody says you can use the two units," she said. "So I would ask them, where is the evidence of that?”
Little goes on to say, "I think two things: one, it’s a headache. I’m a sole proprietor. I run my own business. I don’t do billing outside. I don’t hire anybody else. This is a lot of work for me to do what I don’t get paid for, so it affects me as a business more so. We’ve had to move sessions for clients because they don’t pay for that anymore. We’ve had to get creative and do two sessions a week for one hour each, but that also requires clients to pay for additional co-pays.”
FOX 13 reached out to Select Health to see what they have to say about the change in billing for policy CR-110 and to answer Little’s questions.
They sent this statement in response:
"Select Health is committed to supporting access to high-quality behavioral health care for our members.
The policy referenced relates to established documentation requirements for time-based procedure codes. It is designed to support accurate and consistent billing practices and does not limit a provider’s ability to determine the most appropriate care or treatment plan for a patient.
We value our provider relationships and continue to work closely with providers to address questions and support member care."
We'll continue to keep you updated on Select Health's policy changes as we learn more about them.