Healthcare Insights

Top 25 Telemedicine Procedures During the COVID-19 Pandemic

As Americans grow accustomed to the unique requirements the COVID-19 pandemic has placed upon us; telemedicine adoption has skyrocketed. Patients and providers want to respect social distancing mandates while still practicing regular, preventative care.

According to Definitive Healthcare’s medical claims database, even the least popular telehealth procedures from 2019 have as much as quadrupled in use in 2020—and this is only based on data through June.

Because telemedicine growth has been so drastic and its benefits so tangible, CMS is proposing that providers permanently maintain more recent telehealth expansions. This change would mean improved telehealth access for all Medicare beneficiaries, but especially for those living in more rural areas of the U.S.—which are more likely to suffer from limited healthcare resources.

Let’s take a more in-depth look into how the top 25 most reported telemedicine codes have changed in usage from 2019 to 2020.

25 most reported telemedicine procedures in 2020

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Rank	CPT Code	CPT Description	Avg. Charge/Procedure	Total Charges	Total Procedures	Explore These Claims
1	99442	Telephone evaluation and management service by a physician; 11-20 minutes	$99	$220,413,115	2,221,767	Explore This Code
2	99441	Telephone evaluation and management service by a physician; 5-10 minutes	$58	$94,807,260	1,644,657	Explore This Code
3	99443	Telephone evaluation and management service by a physician; 21-30 minutes	$145	$162,828,061	1,120,206	Explore This Code
4	Q3014	Telehealth facility fee	$68	$33,948,427	496,598	Explore This Code
5	93295	Interrogation device evaluation(s) (remote), up to 90 days	$174	$37,741,690	216,676	Explore This Code
6	93228	External mobile cardiovascular telemetry with electrocardiographic recording; surveillance up to 30 days	$123	$7,731,019	62,994	Explore This Code
7	T1014	Telehealth transmission; per minute	$17	$681,839	40,632	Explore This Code
8	95941	Continuous intraoperative neurophysiology monitoring (remote or nearby); per hour	$5,999	$215,048,198	35,850	Explore This Code
9	93270	External patient and auto-activated electrocardiographic rhythm derived event; remote download capability up to 30 days	$220	$7,243,962	32,891	Explore This Code
10	93229	External mobile cardiovascular telemetry with electrocardiographic recording; surveillance center for up to 30 days	$1,756	$47,619,380	27,119	Explore This Code
11	G0406	Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth	$96	$1,879,384	19,667	Explore This Code
12	G0407	Follow-up inpatient consultation, limited, physicians typically spend 25 minutes communicating with the patient via telehealth	$156	$2,674,766	17,111	Explore This Code
13	99451	Interprofessional telephone/Internet/electronic health record assessment and management service; 5 minutes or more of medical consultative time	$87	$1,208,596	13,967	Explore This Code
14	99446	Interprofessional telephone/Internet/electronic health record assessment and management service; 5-10 minutes of medical consultative discussion and review	$59	$717,295	12,101	Explore This Code
15	99447	Interprofessional telephone/Internet/electronic health record assessment and management service; 11-20 minutes of medical consultative discussion and review	$110	$1,223,297	11,168	Explore This Code
16	92227	Remote imaging for detection of retinal disease with analysis and report under physician supervision	$70	$757,241	10,744	Explore This Code
17	G0425	Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth	$219	$1,497,187	6,847	Explore This Code
18	G0408	Follow-up inpatient consultation, physicians typically spend 35 minutes communicating with the patient via telehealth	$190	$1,297,437	6,828	Explore This Code
19	99449	Interprofessional telephone/Internet/electronic health record assessment and management service; 31 minutes or more of medical consultative discussion and review	$188	$1,240,387	6,585	Explore This Code
20	G0426	Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth	$345	$2,124,023	6,149	Explore This Code
21	G0427	Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth	$410	$1,679,729	4,100	Explore This Code
22	G0459	Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy	$129	$290,783	2,259	Explore This Code
23	92228	Remote imaging for monitoring and management of active retinal disease with physician review, interpretation, and report	$843	$1,894,580	2,248	Explore This Code
24	99444	Online evaluation and management service provided by a physician	$78	$137,428	1,759	Explore This Code
25	98969	Online assessment and management service provided by a qualified nonphysician	$48	$35,145	736	Explore This Code

Fig. 1: Data from Definitive Healthcare’s Medical Claims database. Data is from the calendar year 2020 through June (most recent available). Commercial claims data is sourced from multiple medical claims clearinghouses in the United States. Data is updated monthly—accessed August 2020.

25 most reported telemedicine procedures in 2019

Rank	CPT Code	CPT Description	Avg. Charge/Procedure	Total Charges	Total Procedures	Explore These Claims
1	Q3014	Telehealth facility fee	$49	$17,707,493	359,836	Explore This Code
2	93295	Interrogation device evaluation(s) (remote), up to 90 days	$175	$61,884,420	354,151	Explore This Code
3	99441	Telephone evaluation and management service by a physician; 5-10 minutes	$21	$5,118,548	242,080	Explore This Code
4	93228	Remote imaging for monitoring and management of active retinal disease with physician review, interpretation, and report	$121	$15,874,133	130,915	Explore This Code
5	99442	Telephone evaluation and management service by a physician; 11-20 minutes	$29	$2,700,217	93,259	Explore This Code
6	99444	Online evaluation and management service provided by a physician	$51	$4,732,859	92,604	Explore This Code
7	95941	Continuous intraoperative neurophysiology monitoring (remote or nearby); per hour	$5,557	$474,554,860	85,399	Explore This Code
8	98969	Online assessment and management service provided by a qualified nonphysician	$49	$4,110,542	84,669	Explore This Code
9	93270	External patient and auto-activated electrocardiographic rhythm derived event; remote download capability up to 30 days	$224	$18,367,689	81,857	Explore This Code
10	93229	External mobile cardiovascular telemetry with electrocardiographic recording; surveillance center for up to 30 days	$1,752	$95,786,613	54,661	Explore This Code
11	92227	Remote imaging for detection of retinal disease with analysis and report under physician supervision	$63	$3,180,386	50,143	Explore This Code
12	99443	Telephone evaluation and management service by a physician; 21-30 minutes	$39	$1,091,001	28,298	Explore This Code
13	92228	External mobile cardiovascular telemetry with electrocardiographic recording; surveillance up to 30 days	$620	$10,121,345	16,314	Explore This Code
14	99451	Interprofessional telephone/Internet/electronic health record assessment and management service; 5 minutes or more of medical consultative time	$76	$922,794	12,094	Explore This Code
15	T1014	Telehealth transmission; per minute	$22	$259,371	11,529	Explore This Code
16	G0426	Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth	$364	$2,104,257	5,778	Explore This Code
17	G0425	Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth	$263	$1,455,588	5,533	Explore This Code
18	G0407	Follow-up inpatient consultation, limited, physicians typically spend 25 minutes communicating with the patient via telehealth	$156	$848,109	5,440	Explore This Code
19	G0406	Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth	$92	$490,575	5,330	Explore This Code
20	G0427	Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth	$491	$1,898,397	3,863	Explore This Code
21	G0459	Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy	$115	$369,802	3,210	Explore This Code
22	99446	Interprofessional telephone/Internet/electronic health record assessment and management service; 5-10 minutes of medical consultative discussion and review	$75	$228,873	3,064	Explore This Code
23	G0408	Follow-up inpatient consultation, physicians typically spend 35 minutes communicating with the patient via telehealth	$242	$737,654	3,049	Explore This Code
24	99447	Interprofessional telephone/Internet/electronic health record assessment and management service; 11-20 minutes of medical consultative discussion and review	$129	$292,066	2,258	Explore This Code
25	99449	Interprofessional telephone/Internet/electronic health record assessment and management service; 31 minutes or more of medical consultative discussion and review	$175	$246,454	1,408	Explore This Code

Fig. 2: Data from Definitive Healthcare’s Medical Claims database. Data is from the calendar year 2019 (most recent full-year data available). Commercial claims data is sourced from multiple medical claims clearinghouses in the United States. Data is updated monthly—accessed August 2020.

Top Telemedicine codes in 2019 vs. 2020

For 2019, the most used telehealth procedure code was telehealth facility fee (Q3014), a CPT code used to request reimbursement for standard technology maintenance. Providers can report this code alongside any telehealth service given for assistance with any associated maintenance costs.

We see that in 2020, however, the telehealth facility fee has fallen to only the fourth most reported telehealth procedure. Interestingly, the average charge per procedure for Q3014 was $49 in 2019—but we see this number jump up to $68 per procedure for the 2020 average.

Telehealth claims increased by as much as 2400% in 2020

If we shift gears and look at the most reported telehealth procedure code for 2020, we see that telephone evaluation and management service by a physician; 11-20 minutes (99442) has been used approximately 2,221,767 times. By comparison, this code was used only 93,259 times in 2019. Again, this is a comparison of six months’ worth of 2020 data with the full year of 2019. The difference here is staggering, yet perfectly understandable given the circumstances surrounding COVID-19.

The claims growth here perfectly exemplifies the national push toward telemedicine experienced throughout 2020. Patients have not been visiting their providers in-person, especially during the peaks of the COVID-19 outbreak, and telephone encounters afford patients the safety of a socially-distant visit, while still allowing providers the opportunity to address a wide variety of healthcare concerns. Several other codes lie within the same group as 99442 and indicate very similar scenarios. We see two of them immediately following the first position in the 2020 dataset above.

CPT codes telephone evaluation and management service by a physician; 5-10 minutes (99441) and telephone evaluation and management service by a physician; 21-30 minutes (99443) are the second and third most reported telehealth procedure codes for 2020 at the time of this article’s publishing. These codes are effectively the same as 99442 but represent different call durations.

We can compare usage of the code telephone evaluation and management service by a physician; 5-10 minutes (99441) from 2019 to 2020 as well. In 2019, we see that code 99441 was reported 242,080 times, while 2020 data shows it has been used approximately 1,644,657 times already. The average charge per procedure has increased from $21 per to $58 per as well—nearly three times the cost.

There is a lot to analyze in these two datasets, the themes, however, remain consistent. Telehealth use in the first half of 2020 has seen exponential growth compared to prior years. As CMS continues to push for a more permanent, widespread adoption of telehealth technologies—we can expect that, while usage numbers may decrease moving forward, it is unlikely telehealth use will return to its humble roots any time soon. Consequently, software and IT vendors able to smooth current telehealth friction points for providers will find many new partnership opportunities in this market.