Telehealth utilization has declined almost 4%

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In October 2022, after three months of relative stability, national telehealth utilization declined 3.7%. Looking at one specific metric, telehealth went from 5.4% of medical claim lines in September, to 5.2% in October, according to FAIR Health's Monthly Telehealth Regional Tracker.

The decline in telehealth utilization was larger than the national average in the South (6.8%), Midwest (4.9%) and West (4.1 %), while there was an increase in utilization of 1.7% in the Northeast.

The data represents the privately insured population, including Medicare Advantage and excluding fee-for-service Medicare and Medicaid.

WHAT'S THE IMPACT?

That same month, COVID-19 continued to fall among the top five telehealth diagnoses, nationally and in most regions, as it had in September. In October, nationally and in the Midwest COVID-19 fell from third to fifth place in the rankings. In the Northeast, it fell from second to third place, and in the South, it fell from fifth place out of the rankings. In the West, COVID-19 had already been out of the top five telehealth diagnoses since September.

As in September, acute respiratory diseases and infections in October climbed in the rankings of the top five telehealth diagnoses. In the Northeast, from September to October, this diagnosis rose from third to second place; in the West, it rose from fourth to second place. Nationally and in the Midwest and South, it remained at second place, but increased in percentage share of telehealth claim lines. Nationally, for example, it rose from 3.1% of telehealth claim lines to 4.1%.

The rankings of the top five telehealth specialties did not change nationally or regionally from September to October 2022. Social workers remained the number one telehealth specialty nationally and in every region.

Meanwhile, the rankings of the top five telehealth procedure codes did not change nationally or in any region when compared to the prior eight months. The number one telehealth procedure code nationally and in every region remained one-hour psychotherapy.

THE LARGER TREND

In order to help beneficiaries maintain access to care amid stay-at-home orders aimed at reducing COVID-19 related exposure, CMS used emergency waiver authorities enacted by Congress, as well as existing regulatory authorities, to implement policies expanding access to telehealth services during the pandemic.

These included waiving several statutory limitations, such as geographic restrictions, and allowing beneficiaries to receive telehealth in their home. 

The omnibus spending package that passed in December extended telehealth – and hospital-at-home programs – beyond the end of the public health emergency. The legislation extends waivers for both programs. Telehealth flexibilities are now in effect through the end of 2024.
Outside of the public health emergency, Medicare is generally restricted to payment for telehealth services in certain, mostly rural areas, and when beneficiaries leave the home and go to a clinic, hospital or other medical facility for the service.

In the physician fee schedule rule released in November, CMS announced that for the first time outside of the COVID-19 PHE that Medicare would pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via interactive video-based telehealth, including audio-only telephone calls.

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com