July 18, 2022

Telemedicine Patterns of Use and Reimbursement

The Workers’ Compensation Research Institute (WCRI) published Telemedicine: Patterns of Use and Reimbursement, 2020Q1 – 2021Q2 – A WCRI FlashReport.

Though COVID-19 cases have declined, it is assumed that the utilization of telemedicine, which was embraced during the height of the pandemic, will continue to remain significantly above pre-pandemic levels, though not as high as they were during peak pandemic levels.

The report investigates utilization and reimbursement trends for telemedicine, particularly for evaluation and management (E&M), as well as physical medicine services (PM), from Q1 of 2020 up through Q2 of 2021 across 28 states, while also reviewing actual prices paid for the most frequent services delivered via telemedicine, versus in-person across the study states.

The data reviewed for this study represents 79% of workers’ comp benefits paid in the U.S., limited to non-COVID-19 claims.

Telemedicine services increased substantially from March-June 2020, then decreased in subsequent quarters. However, through the first half of 2021, the use of telemedicine for EM services was still higher than prior to the pandemic, though the use of telemedicine for PM services have become closer to their pre-pandemic levels.

EM services delivered via telemedicine went from 0.2% in Q4 of 2019 to 10.2% in Q2 of 2020, later stabilizing to 3% by Q1 of 2021. PM services delivered via telemedicine was at 0% in Q4 of 2019, increasing to 2% in Q2 of 2020, then decreasing to 0.1% by Q2 of 2021.

The share of payments for telemedicine services saw similar changes. EM services delivered via telemedicine were at 0.2% in Q4 of 2019, increasing to a high of 8% in Q2 of 2020, then declining to 2.2% by Q2 of 2021. For PM services, payment share for telemedicine started at 0% in Q4 of 2019, increasing to a high of 2.1% in Q2 of 2020, then dropping to 0.1% by Q2 of 2021.

Prices paid for EM and PM services via telemedicine were similar to prices paid for in-person services in a majority of states throughout the study period.

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