Telehealth Claim Lines Increase 2,980 Percent Nationally When Comparing September 2019 to September 2020

Telehealth Claim Lines Fall by 16.5 Percent Nationally from August to September 2020

In Northeast in September, Substance Use Disorders Rise from Fifth to Fourth Place among Telehealth Diagnoses, according to FAIR Health's Monthly Telehealth Regional Tracker

News provided by

FAIR Health

Dec 01, 2020, 10:01 ET

NEW YORK, Dec. 1, 2020 /PRNewswire/ -- Telehealth claim lines¹ increased 2,980 percent nationally from September 2019 to September 2020, rising from 0.16 percent of medical claim lines in September 2019 to 5.07 percent in September 2020, according to new data from FAIR Health's Monthly Telehealth Regional Tracker. However, from month to month, the telehealth share of medical claim lines fell 16.5 percent nationally from 6.07 percent in August 2020 to 5.07 percent in September 2020. The data represent the privately insured population, excluding Medicare and Medicaid.

Trends in the four US census regions (Midwest, Northeast, South and West) were similar to those in the nation as a whole. In each region, there were large percent increases in volume of claim lines from September 2019 to September 2020, but relatively small decreases from August 2020 to September 2020.

Higher telehealth utilization from March to September 2020 in comparison with the same months in 2019 was likely a result of the COVID-19 pandemic. In March and April 2020, many states prohibited in-person rendering of elective procedures, making telehealth a viable alternative. Many of these prohibitions expired in May as states began to open up. But despite some decline from month to month, telehealth usage remained high in comparison to 2019, as the pandemic continued.

Another notable finding of the September Monthly Telehealth Regional Tracker concerns the top five telehealth diagnoses by volume. Mental health conditions, the number one telehealth diagnosis nationally and in every region since March 2020, continued to rise in every region as a share of all telehealth diagnoses, growing nationally from 48.93 percent in August 2020 to 51.83 percent in September 2020.

The trend toward increased delivery of mental health services via telehealth was also apparent in the top telehealth procedure codes by utilization. In the Northeast, CPT^®2 99213, a 15-minute established patient office visit, was the number one procedure code in August 2020, followed by two psychotherapy codes, CPT 90834 (45 minutes) and CPT 90837 (60 minutes). In September 2020, CPT 90834 and CPT 90837 rose to number one and two, respectively, while CPT 99213 fell to number three.

Also of note, from August to September 2020, substance use disorders rose from the number five telehealth diagnosis in the Northeast to the number four rank. This is consistent with an increase in mental health conditions and substance use disorders that has been noted during the COVID-19 pandemic by the Centers for Disease Control and Prevention and others.

About the Monthly Telehealth Regional Tracker
Launched in May as a free service, the Monthly Telehealth Regional Tracker uses FAIR Health data to track how telehealth is evolving from month to month. An interactive map of the four US census regions allows the user to view an infographic on telehealth in a specific month in the nation as a whole or in individual regions. In addition to data on the volume of claim lines, diagnoses and procedure codes, each infographic includes findings on urban versus rural usage.

FAIR Health President Robin Gelburd stated: "Telehealth has persisted in showing high utilization across the country throughout the COVID-19 pandemic. FAIR Health's Monthly Telehealth Regional Tracker will continue to provide insights into the evolution of this venue of care."

For the Monthly Telehealth Regional Tracker, click here.

About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of private healthcare claims data, which includes over 32 billion claim records and is growing at a rate of over 2 billion claim records a year. FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish and an English/Spanish mobile app, which enable consumers to estimate and plan for their healthcare expenditures and offer a rich educational platform on health insurance. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. FAIR Health also is named a top resource for patients in Dr. Marty Makary's book The Price We Pay: What Broke American Health Care—and How to Fix It and Elisabeth Rosenthal's book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. For more information on FAIR Health, visit fairhealth.org.

Contact:
Dean Sicoli
Chief Communications Officer
FAIR Health
646-664-1645
[email protected]

¹ A claim line is an individual service or procedure listed on an insurance claim.^.
2 CPT © 2019 American Medical Association (AMA). All rights reserved.

SOURCE FAIR Health