Telehealth and Its Endurance Beyond the COVID-19 Pandemic

Data from FAIR Health—a national, independent nonprofit that houses the nation’s largest private healthcare claims collection—provide insight into the changing nature of telehealth during and in the wake of the COVID-19 pandemic and the role telehealth continues to play in the healthcare system. 

Using its comprehensive collection of telehealth data, FAIR Health has tracked telehealth’s evolving contours since the spring of 2020, when this approach to care grew markedly. In January 2020, prior to the pandemic, telehealth accounted for 0.24 percent of all medical claim lines nationally. By April 2020, when patients and providers were turning to telehealth to reduce the risk of COVID-19 transmission associated with in-person visits, telehealth made up 13 percent of all medical claim lines. Telehealth’s year-over-year growth was also notable, increasing its share of all medical claim lines nationally from April 2019 to April 2020. 

After the first months of the pandemic, many of the restrictions on elective in-person care expired, and telehealth usage declined (though it remained high in comparison with 2019). For example, in August 2020, telehealth’s share of medical claim lines declined to 6.1 percent nationally. As time progressed, changes in the use of virtual care were seemingly driven by the course of the pandemic. 

In January 2021, telehealth accounted for 7 percent of all medical claim lines nationally; this increase from the summer of 2020 can likely be attributed to the high rates of COVID-19 in the new year. In spring and summer 2021, telehealth claim lines dropped as vaccination levels increased, accounting for just 4.2 percent of medical claim lines in July. 

In fall and winter 2021, however, use of telehealth rose again as the Delta and Omicron variants led to increased COVID-19 cases, rising to 5.4 percent of medical claim lines by January 2022. For the rest of the year, telehealth’s share of claim lines fluctuated between 4.9 percent and 5.4 percent, demonstrating its staying power by remaining distant from pre-pandemic utilization rates. 

Treating a Wide Variety of Conditions 

The endurance of telehealth may be a result of the diversification of procedures and diagnoses rendered virtually during the pandemic. Pre-pandemic, the services most commonly performed through telehealth were telephone visits, shorter evaluation and management (E&M) services, and patient self-management education. Telehealth was largely used to diagnose conditions such as influenza and pneumonia and skin infections and issues. By the end of 2020, the top procedure codes had largely stabilized, consisting of psychotherapeutic/psychiatric services and longer E&M visits. 

The pandemic ushered in the use of telehealth to treat a wider variety of conditions. The top diagnoses treated via telehealth quickly evolved as the pandemic took hold, with medical claims revealing that telehealth was—and still is—being used to treat conditions such as developmental disorders, joint/soft tissue diseases and issues, and hypertension. 

One of the most persistent findings from FAIR Health’s data is the steady dominance of mental health conditions as the most common telehealth diagnosis category throughout the pandemic. Researchers have discovered that COVID-19 has had a profound impact on mental health, and access to virtual care has helped to meet the heightened demand for mental health services. This is demonstrated by month-over-month increases in mental health conditions’ share of telehealth claim lines nationally, rising from 30 percent in January 2020 to 65.9 percent by the start of 2023. Consistent with those findings, Current Procedural Terminology (CPT) 90837 (60-minute psychotherapy) has ranked as the top telehealth procedure nationally since January 2021. 

FAIR Health’s findings underscore telehealth’s crucial role in maintaining access to healthcare services both during the pandemic and beyond. After three years of COVID-19, telehealth continues to remain relevant and seemingly embedded in the nation’s healthcare delivery system as it gets used for a wide array of health conditions and services that were once overwhelmingly provided in an office setting. 

As the healthcare landscape further modernizes in the wake of COVID-19, health information professionals should stay apprised of the demand for telehealth services and its influence in the healthcare industry. Understanding how these trends continue to take shape will be crucial to advancing programs and technologies for synchronous telehealth services and, in particular, asynchronous services, where there is potential for innovations that expand providers’ abilities to meet their patients’ needs without sacrificing quality of care. 

To support stakeholders as they develop such interventions, FAIR Health is committed to continue monitoring the evolving nature of telehealth and its future as a component of the healthcare system.  

Robin Gelburd, JD, is President of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and health insurance information. FAIR Health possesses the nation’s largest collection of private healthcare claims data. The company’s Monthly Telehealth Regional Tracker is a free, online resource for healthcare stakeholders to understand and keep pace with telehealth’s function within the healthcare continuum.