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.