Health Plan News

Telehealth Claim Lines Increase 2,980 Percent Nationally

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.

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.


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