Reimbursement News

Telehealth Billing Leveled Out in August, But Still Up 3,552%

Telehealth billing from July to August 2020 was relatively the same as providers ramped up in-person visits after strict lockdowns due to COVID-19.

Telehealth billing plateaus, but still up

Source: Getty Images

By Jacqueline LaPointe

- Providers are still treating a significant number of patients virtually or by phone, but telehealth billing has plateaued compared to earlier this year, according to updated data from FAIR Health.

Telehealth claim lines increased by a whopping 3,552 percent in August 2020 compared to the same period the previous year, rising from 0.17 percent of medical claim lines in August 2019 to 6.07 percent in August 2020.

However, the telehealth share of medical claim lines only increased by 1.2 percent month to month. Telehealth claims lines rose from 6.00 percent in July 2020 to 6.07 percent in August 2020, the independent non-profit organization reported in using the latest data from its Monthly Telehealth Regional Tracker.

FAIR Health has been releasing the Monthly Telehealth Regional Tracker since May. The effort aims to track how telehealth is evolving from month to month among the privately insured population since COVID-19 spurred the rapid adoption of virtual care services.

Telehealth claim lines jumped by 4,347 percent increase from March 2019 to March 2020, when President Trump declared COVID-19 a national emergency, FAIR Health previously reported. At that time, communities also started to shut down to stymy the spread of the virus. This included the provision of elective healthcare services, which prompted a shift to virtual and telephonic care.

Communities started to reopen over the summer as positive COVID-19 cases declined in many areas. This may have contributed to some decline from month to month, FAIR Health reported.

However, telehealth utilization as demonstrated by telehealth billing data remains high compared to last year and continues to grow in regions in which COVID-19 cases increased at an accelerated pace over the summer, the organization added. In the South, for example, telehealth claim lines increased the most at 9.7 percent by August 2020.

“After several months of the COVID-19 pandemic, telehealth has persisted in showing high utilization across the country. FAIR Health’s Monthly Telehealth Regional Tracker will continue to provide a window into how this venue of care is evolving,” stated Robin Gelburd, FAIR Health president.

The healthcare industry generally agrees that telehealth utilization is here to stay now that providers have turned on virtual care capabilities and patients seem to be comfortable with receiving services electronically.

Telehealth has been especially helpful with treating mental health conditions, which was the number one telehealth diagnosis nationally and in every region since March 2020, FAIR Health found.

Other top telehealth diagnoses from July to August 2020 included acute respiratory diseases, which rose from fifth most common nationally to fourth.

Flexibilities granted to providers by private and public payers supported the switch from in-person care to telehealth services. Chief among the flexibilities was telehealth reimbursement parity or at least, increased rates for virtual care services.

However, the vast majority of flexibilities, including telehealth reimbursement parity, are temporary and are slated to expire once the COVID-19 public health emergency ends.

Providers have called for permanent implementation of telehealth reimbursement parity to sustain virtual care capabilities beyond the pandemic.

CMS officials have indicated that they are assessing potential rate increases for services delivered to Medicare beneficiaries via telehealth. Meanwhile, Congress and state lawmakers have eyed policies to expand telehealth coverage in Medicaid and local markets.

Whether telehealth claim lines continue to account for a higher proportion of all medical claim lines could hinge on whether payers and lawmakers follow through with telehealth reimbursement and coverage expansions.