In October 2023, COVID-19 No Longer in Top Five Telehealth Diagnoses Nationally or in Any Census Region
Diabetes Mellitus Rose from Fifth Place to Fourth Place Nationally in the Top Five Rankings of Asynchronous Telehealth Diagnoses
Telehealth Utilization Decreased Nationally in October 2023 While Rising in Northeast and West, according to FAIR Health's Monthly Telehealth Regional Tracker
NEW YORK, Jan. 9, 2024 /PRNewswire/ -- In October 2023, COVID-19 fell out of the top five telehealth diagnoses nationally and in the Midwest and Northeast, according to FAIR Health's Monthly Telehealth Regional Tracker. It remained absent from the top five telehealth diagnoses in the other two US census regions, the South and West, as it had in September. The data include claims for the privately insured population and Medicare Advantage but exclude Medicare Fee-for-Service and Medicaid.
Nationally, COVID-19 had been in fourth place in September, but in October hypertension supplanted it in that position. The diagnosis of substance use disorders, which had been in fifth place nationally in September, was replaced by endocrine and metabolic disorders in October.
In the Midwest, COVID-19 had been in fourth place in September. Sleep disorders, which had been in fifth place in September, rose to fourth place in October, while developmental disorders joined the list in fifth place.
In the Northeast, COVID-19 had been in second place in September. The diagnoses that had been ranked third to fifth in September (respectively, acute respiratory diseases and infections, substance use disorders and developmental disorders) moved up one position in the rankings in October, while joint/soft tissue diseases and issues joined the list in fifth place.
Telehealth Utilization
In October 2023, telehealth utilization decreased nationally by 2.0 percent, falling from 4.9 percent of medical claim lines in September to 4.8 percent in October.1 This decrease continued a larger (9.3 percent) national decline in September, but whereas there had been a decrease in telehealth utilization in every region in September, the regional trends in October were more varied. In the South, telehealth utilization fell 5.0 percent, but in the Northeast it rose 3.6 percent, and in the West it rose 4.7 percent. In the Midwest, telehealth utilization stayed stable at zero percent change.
Asynchronous Telehealth
In October 2023, as in September, hypertension was the top asynchronous telehealth diagnosis nationally and in the Midwest, Northeast and West.2 As in September, it ranked second in the South.
In October, diabetes mellitus rose from fifth place to fourth place nationally in the top five rankings of asynchronous telehealth diagnoses.
Audio-Only Telehealth Usage
In October 2023, as in previous months, rural areas showed higher utilization of audio-only telehealth than urban areas in every region except the South, where the pattern was reversed. Nationally, audio-only telehealth usage increased in rural areas but stayed stable in urban areas after decreasing the month before. After two months of decreases in the urban South, there was an increase in urban areas of the South in October.
Telehealth Cost Corner
For October 2023, the Telehealth Cost Corner spotlighted the cost of CPT®3 97153, adaptive behavior treatment by technician using an established plan, each 15 minutes. Nationally, the median charge amount for this service when rendered via telehealth was $21.85, and the median allowed amount was $13.05.4 The median charge amount varied from a high of $37.45 in the Midwest to a low of $16.68 in the West. The median allowed amount varied from a high of $18.33 in the Midwest to a low of $11.23 in the West.
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 44 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. 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).
3 CPT © 2023 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
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