Billing for Telehealth Sessions: A Complete Guide for Therapists in Canada and France (2026)

Telehealth has become mainstream in private practice — but telehealth billing hasn't standardized yet. Depending on your province, your client base, the service type, and the insurer involved, the rules shift. And in 2026, with France's Grande Cause Nationale for mental health and expanding reimbursement frameworks in Quebec, questions are multiplying fast.

This guide cuts through the noise: what to bill, how to bill it, and which codes to use — in Canada and France.

Why Telehealth Billing Is Different

Technically, a video session is a session like any other. But for insurers, public programs, and professional orders, several parameters matter:

Location of service: Is the client at home? In another province? Abroad?
Platform used: Is it compliant (encrypted, data hosted in Canada/France)?
Service code: Some plans explicitly distinguish "in-person" vs. "virtual" codes
Professional type: Psychologist, social worker, psychotherapist — rules vary

Canada: Billing Telehealth by Reimbursement Type

Group Insurance (Assurances Collectives)

Most major Canadian insurers (Blue Cross, Sun Life, Manulife, Great-West, Desjardins) reimburse video sessions at the same rate as in-person sessions, provided:

The professional is recognized by the insurer (verify your order membership status)
The receipt specifies the service modality (in-person / virtual)
A secure, compliant platform is used

What to include on the receipt:

Full name and professional title
Order membership number (OPQ, OTSTCFQ, CPO, OCSWSSW, etc.)
Date and duration of session
Modality: telehealth / video consultation
Amount and service description (e.g., "Individual psychotherapy — 50 min")

EAP Programs (Employee Assistance Programs)

EAP providers (Lifeworks, Morneau Shepell, Optum) generally cover telehealth sessions. Each program has its own billing codes and templates. Check your provider agreement — some require you to note "telehealth" explicitly in the service field.

Out-of-Province Clients

If your client lives in another province, your home province license generally applies — but some professional orders require temporary registration in the client's province. Verify your order's rules before starting a cross-provincial distance relationship.

WSIB / CNESST

These workers' compensation programs don't typically cover private practice psychotherapy, in-person or virtual. For rare cases where a mandated professional is authorized for a telehealth session, the modality must be pre-approved by the responsible adjudicator.

Quebec Specifically: RAMQ and Private Practice

The RAMQ does not cover psychology or social work services in private practice — whether in person or via telehealth. Private practice billing in Quebec is fully out-of-pocket for the client, with possible reimbursement through group insurance.

For psychologists participating in Psy à votre santé (government program), virtual sessions have been admissible since 2023. Billing codes and rules are set by the program, not by the individual practitioner.

France: Telehealth and the Grande Cause Nationale 2026

Mon Soutien Psy and the Reimbursement Framework

In France, the Mon Soutien Psy program allows patients to see a registered psychologist with Social Security coverage. In 2026, the program was expanded under the Grande Cause Nationale santé mentale:

8 reimbursable sessions per year (renewed for 2026)
Reimbursement: €50/session (Assurance Maladie + supplementary depending on contract)
Telehealth sessions are now included in the framework

To bill a Mon Soutien Psy telehealth session:

Use the official platform (e-PS or ARS-approved equivalent)
Submit the reimbursement request through the registered professional portal
The patient must provide a GP referral letter (except in urgent cases)

Independent Psychologists Outside Mon Soutien Psy

If you practice privately without Mon Soutien Psy registration, telehealth fees are freely set. Reimbursement depends entirely on the patient's mutuelle. Your receipt must include:

Your RPPS number (Répertoire Partagé des Professionnels de Santé)
Modality: "Téléconsultation" or "Video consultation"
Service: "Individual psychological consultation — follow-up"
Fee and duration

Mandatory e-Invoicing — September 2026

Starting September 2026, self-employed psychologists in France must be able to receive electronic invoices. The requirement will progressively extend to issuing e-invoices to patients. Your practice management software needs to handle this format now.

The Most Common Telehealth Billing Mistakes

1. Not specifying the service modality A receipt that doesn't mention "telehealth" or "video session" may be rejected by some insurers. Always add the explicit note.

2. Using a non-compliant platform Consumer-grade Zoom, FaceTime, or WhatsApp don't meet Law 25 (Quebec) or GDPR (France) requirements. Use a secure platform: a clinical video tool or one integrated into your Canadian/EU-compliant practice software.

3. Billing across provinces without checking accreditation A Quebec therapist seeing an Ontario client remotely should verify the rules of the relevant Ontario professional order before billing.

4. No record of the virtual session In case of an audit or claim dispute, you need to prove the session occurred. A connection log, platform confirmation, or dated clinical note serves as proof.

How FYL.care Simplifies Your Telehealth Billing

FYL.care lets you generate compliant receipts in seconds — with service modality already included. Whether you're seeing clients in person or via video, the receipt is automatically ready for insurance submission. No double entry. No missing fields.

You also manage your schedule, automated reminders, and session notes in the same place. No patchwork of tools. No $80/month subscription.

👉 Try FYL.care free at fyl.care — Free. No credit card. Forever.

FAQ

Are my telehealth sessions covered by group insurance in Canada?

Yes, in most cases. Major Canadian insurers (Blue Cross, Sun Life, Manulife, etc.) reimburse virtual sessions at the same rate as in-person sessions, as long as your receipt explicitly mentions "telehealth" and you're in good standing with your professional order.

What software should I use for Law 25-compliant telehealth in Quebec?

Your video platform must host data in Canada and apply end-to-end encryption. Consumer Zoom (US servers — problematic under Law 25), Coviu, or a solution integrated into your Canadian practice software are common options. FYL.care handles your client file and billing; the video platform remains your choice.

In France, can I bill a telehealth session without being registered in Mon Soutien Psy?

Yes. As an unregistered private psychologist, you set your own fee and bill your patient directly. Reimbursement depends on their mutuelle. You must include your RPPS number and note "téléconsultation" on your receipt.