In June 2023, the Percentage of Asynchronous Telehealth Claim Lines for Mental Health Conditions More than Doubled in the Midwest

Telehealth Utilization Was Stable Nationally but Decreased in the Midwest in June 2023, according to FAIR Health's Monthly Telehealth Regional Tracker

NEW YORK, Sept. 6, 2023 /PRNewswire/ -- In June 2023, the percentage of asynchronous telehealth claim lines for mental health conditions more than doubled in the Midwest, according to FAIR Health's Monthly Telehealth Regional Tracker.^1,2 In that region, mental health conditions rose from 15.9 percent of asynchronous telehealth claim lines in May to 36.0 percent in June and replaced hypertension as the number one diagnosis. Nationally, mental health conditions also rose, moving from number five to number four among the top five diagnoses via asynchronous telehealth. The data represent the privately insured population, including Medicare Advantage and excluding Medicare Fee-for-Service and Medicaid.

Telehealth Utilization

National telehealth utilization remained stable at 5.4 percent of claim lines in both May and June 2023. In the Midwest, however, telehealth utilization decreased by 2.4 percent, while in the three other census regions it remained unchanged (0.0 percent).

Top Five Telehealth Diagnoses

Nationally, the top five telehealth diagnoses remained the same in June 2023 as in May 2023, though their ordering changed. Joint/soft tissue diseases and issues rose from number four to number three in the telehealth diagnosis rankings, switching places with developmental disorders. Regionally, in the Northeast and West, joint/soft tissue diseases and issues diagnoses increased as well, entering the rankings in the Northeast at number five and making up a slightly higher percentage of claims in the West (rising from 2.2 percent in May to 2.3 percent in June) while remaining in second place.

In June, the percentage of telehealth claim lines for acute respiratory diseases and infections continued to decrease nationally and in all regions. This was the sixth straight month of national decreases, though it still ranked in second place and comprised 1.9 percent of claim lines in June. In the Northeast, Midwest and West, acute respiratory diseases and infections did not make the top five rankings at all in June, despite being ranked third in the Northeast and second in the Midwest in May. In the South, it remained in the number two position but dropped from 5.2 percent of claims in May to 3.8 percent in June.

Mental health conditions continued to dominate the top five telehealth diagnoses nationally and in all regions. From May to June 2023, it also increased in its percentage of claim lines in all areas.

Audio-Only Telehealth Usage

In June 2023, utilization of audio-only telehealth services decreased nationally and in all regions except the rural South, where it rose slightly from 5.0 percent to 5.1 percent. As in May 2023, utilization of audio-only telehealth services was higher in rural than urban areas of the Midwest, Northeast and West. Nationally, it was higher in urban areas (4.8 percent of telehealth claim lines) than rural areas (4.5 percent), while in the South it was much higher in urban (9.1 percent) than rural (5.1 percent) areas.

Telehealth Cost Corner

For June 2023, the Telehealth Cost Corner spotlighted the cost of CPT^®3 90837, psychotherapy, 1 hour. Nationally, the median charge amount for this service when rendered via telehealth was $166.95, and the median allowed amount was $103.41.⁴

About the Monthly Telehealth Regional Tracker

Launched in May 2020 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. Each infographic shows month-to-month changes in volume of telehealth claim lines and audio-only telehealth usage (urban versus rural); the Telehealth Cost Corner, which presents a specific telehealth procedure code with its median charge amount and median allowed amount; and that month's top five telehealth diagnoses and top five diagnoses via asynchronous telehealth.

FAIR Health President Robin Gelburd stated: "We welcome sharing these varying windows into telehealth utilization as it continues to evolve. This is one of the many ways we pursue our healthcare transparency mission."

For the Monthly Telehealth Regional Tracker, click here.

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About FAIR Health

FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal 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 42 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 Type 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, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. 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. 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.

¹ A claim line is an individual service or procedure listed on an insurance claim.

² Asynchronous telehealth is telehealth in which data are stored and forwarded (e.g., blood pressure or other cardiac-related readings transmitted electronically; A1c levels transmitted electronically). In the context of care for mental health conditions, asynchronous telehealth can include patient portal messaging, store-and-forward video and other interventions such as forwarding journal entries to be reviewed by a therapist.

³ CPT © 2022 American Medical Association (AMA). All rights reserved.

⁴ A charge amount is the provider's undiscounted fee, which a patient may have to pay when the patient is uninsured, or when the patient chooses to go to a provider who does not belong to the patient's plan's network. An allowed amount is the total negotiated, in-network fee paid to the provider under an insurance plan. It includes the amount that the health plan pays and the part the patient pays under the plan's in-network cost-sharing provisions (e.g., copay or coinsurance if the patient has met the deductible).

Contact:
Rachel Kent
Senior Director of Communications and Marketing
FAIR Health
646-396-0795
[email protected]

SOURCE FAIR Health