Telehealth Claims Decline in Q1: Things To Know

Telehealth Claims

Based on FAIR Health’s Monthly Telehealth Regional Tracker, the national decline in private insurance telehealth claims reached 5.4% in April, comprising 5.3% of all medical claims. This reduction can be observed across all four U.S. census regions: the Midwest (4.7%), Northeast (6.3%), South (6.8%), and West (6.4%). On average, patient visits lasted between 20 and 29 minutes, with a median charge of $167.77 and a median allowed amount of $89.70.According to the data collected from privately insured populations, including Medicare Advantage and excluding Medicare fee-for-service and Medicaid, audio-only telehealth experienced a decline in both rural and urban areas nationwide and in every region except the West. Interestingly, in the West, it decreased in rural areas but saw an increase in urban areas.

Across the board, mental health conditions remained the most prevalent telehealth diagnosis, maintaining their top-ranking position nationally and in every region. In March, they accounted for 67.4% of telehealth claim lines nationally, rising to 68.4% in April. This marks the fourth consecutive month of national increases in mental health-related telehealth diagnoses.

Claims for acute respiratory diseases and infections, the second most-common telehealth consultation, fell nationally in April from 3.2% in March to 2.7% in April, the fourth straight national monthly decrease for this diagnosis.

In April, there was a decline in national telehealth claims for acute respiratory diseases and infections, which dropped from 3.2% in March to 2.7%. This marks the fourth consecutive monthly decrease for this particular diagnosis. Developmental disorders saw an increase, moving up to the third most-common telehealth consultation, while joint/soft tissue diseases and issues fell to fourth place.

Among the top five diagnoses nationally for asynchronous telehealth, urinary tract infections (UTIs) experienced a rise, moving to the third position, while UTIs fell to fourth place.

The utilization of asynchronous telehealth claims for hypertension saw a notable increase nationally in April, reaching 12.5% compared to 9.7% in March. This rise was observed in every region. Hypertension climbed from second to first place in the West and from fourth to second place in the South. It maintained its position as the second most common diagnosis nationally and in the other regions, holding second place in the Northeast and first place in the Midwest.

In the realm of asynchronous telehealth diagnoses, sleep disorders made notable advancements in the rankings. In the Northeast, they climbed from the fifth position to the fourth position, while in the West, they saw a significant jump from the fourth position to the second position.

Furthermore, diabetes mellitus experienced an upward trend in the rankings across three regions. In the Midwest, it rose from the fifth position to the third position, in the Northeast, it moved from the fourth position to the third position, and in the West, it advanced from the fifth position to the fourth position.