Reimbursement News

Telehealth Billing Increased 8,336% from April 2019 to April 2020

Providers increasingly engaged with telehealth billing as the pandemic took hold, with telehealth claim lines growing from 0.15% of medical claim lines in April 2019 to 13.00% in April 2020.

Telehealth billing experienced a boom in April 2020 as the COVID-19 pandemic raged on in the US

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By Jacqueline LaPointe

- Telehealth billing continued to surge amid the COVID-19 pandemic, with telehealth claim lines increasing by 8,336 percent in April 2020, according to a new FAIR Health data.

New data from FAIR Health’s Monthly Telehealth Regional Tracker showed that telehealth claim lines increased from 0.15 percent of medical claim lines in April 2019 to 13.00 percent a year later. The data represented the privately insured population and excluded Medicaid and Medicare claims.

The data underscores telehealth’s critical role in the healthcare industry’s response to COVID-19.

FAIR Health reported that the April numbers “continued and intensified a trend” that started the month before, in March 2020, when the number of coronavirus cases rapidly increased. At that time, telehealth claim lines increased by 4,347 percent compared to the previous year – about half of the increase observed in April 2020.

Telehealth billing especially accelerated in the Northeast, where some of the first COVID-19 hotspots emerged.

Telehealth claim lines in the region increased by 26,209 percent, from 0.07 percent of medical claim lines in April 2019 to 19.69 percent in April 2020, FAIR Health reported. The increase in telehealth billing was even larger than the already significant 15,503 percent growth observed in the region from March 2019 to March 2020, researchers pointed out.

In comparison, telehealth claim lines increased by 3,967 percent in the West from April 2019 to April 2020; 6,754 percent in the Midwest; and 6,039 percent in the South. 

The increase in telehealth billing from April 2019 through April 2020 was greater in each region compared to the increase observed by FAIR Health from March 2019 to March 2020. But these trends could accelerate in future months as cases in the Northeast stagnate or fall and new epicenters emerge in the South and MidWest.

“The swift growth of telehealth in March and April of this year fulfills expert predictions related to COVID-19,” FAIR Health stated in a press release. “Telehealth permits healthcare services to be delivered without in-person contact, reducing the risk of disease transmission, and frees up in-person healthcare resources for COVID-19 patients.”

“For those reasons, federal and state regulations related to telehealth have been relaxed, and private payors have expanded access to telehealth. In addition, with fewer elective procedures occurring around the country due to widespread restrictions, the telehealth share of total medical claim lines was expected to increase,” the organization added.

Telehealth billing grew markedly in urban areas, FAIR Health found. Nationally and in all regions except the Midwest, telehealth accounted for a larger share of medical claim lines in urban versus rural areas in April 2020, the organization reported.

In the Midwest, telehealth billing shifted more to urban areas, but rural providers still sent medical claims with more telehealth claim lines compared to their urban peers in April 2020.

FAIR Health also found that diabetes mellitus emerged as one of the top five telehealth diagnoses in the MidWest in April 2020, indicating telehealth’s increasing use as a means to treat chronic conditions during the pandemic. Diabetes mellitus had not been a top five telehealth diagnosis in April 2019.

Additionally, hypertension rose from the fourth top telehealth diagnosis to third between March 2020 and April 2020, FAIR Health reported.

“This may be related to increased stress during the pandemic and to increased telemonitoring of patients with hypertension,” the organization reported.

Finally, FAIR Health pointed out that joint/soft tissue disorders and issues did not appear in the top five telehealth diagnoses in April 2019 nationally or in any region except the West. By April 2020, however, joint/soft tissue disorders and issues were in the top five nationally and in every region.

“This suggests that telehealth was being used during the pandemic for conditions for which it was previously less commonly used,” the organization stated.