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.
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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.
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| 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.
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.
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.