Is Telehealth A Moving Target?

F.J. Thomas

Sarasota, FL ( – Telehealth continues to be a bit of a moving target as the Centers for Medicare and Medicaid Services (CMS) recently announced the removal of 4 telehealth service codes that were previously added as billable codes. In December of last year, CMS approved over 60 telehealth codes in an attempt to address the increased need for virtual medicine due to COVID-19.

On March 17th, CMS announced that four codes were inadvertently added in error to the Category 3 list of approved services. The codes slated for removal effective back to the first of the year include Neurobehavioral status exam code 96121, as well as initial hospital care codes 99221, 99222, and 99223.

While the Category 3 codes will remain valid until the end of the year, a new study from research experts RAND Corporation in Boston, Mass., suggests telehealth isn’t necessarily utilized in the way that was intended, and that the primary demographic utilizing the availability of telehealth isn’t necessarily those that have the biggest hurdles to access.

The study, Who Is (and Isn’t) Receiving Telemedicine Care During the COVID-19 Pandemic, was written by Jonathan Cantor PhD , Ryan K. McBain PhD, MPH , Megan F. Pera MS, Dena M. Bravata MD, MS, and Christopher Whaley PhD and was published this month in the American Journal of Preventative Medicine. Researchers reviewed claims from employer-based plans from 2019 through 2020, and found that telehealth was utilized more frequently by patients with higher incomes.

Researchers reviewed claims from 13.2 million health plan beneficiaries enrolled in over 200 employer plans. Around half of the participants were female, with an average age of 33.4 years. Claims for telephone and video encounters were included.

The researchers from the RAND study found that urban dwellers averaged 50 telehealth visits per 10,000 people, compared to 31 visits for those that lived in rural areas.

Additionally, the analysis found a disparity by income. Counties with low poverty levels averaged 48 telehealth visits per 10,000 residents. Those counties with high poverty levels averaged around 15 telehealth visits per 10,000 residents.

The study calls for more effort to reach those populations opting for in-office visits instead of telehealth methods. The researchers state that the healthcare guidelines should be updated to encourage more use by physicians, and that a review of policy and reimbursement are needed.

Several studies have indicated a substantial increase in the use of telehealth. In fact, according to data from the Department Of Health And Human Services (HHS), 43.5 percent of Medicare primary care visits occurred via telehealth in 2020. However, HHS also found that rural physicians saw a much smaller increase than physicians located in urban areas.

The full study is available on the American Journal of Preventative Medicine website.

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