A new report from the U.S. Department of Health and Human Services (HHS) found that massive increases in the use of telehealth helped maintain some health care access during the COVID-19 pandemic, with specialists like behavioral health providers seeing the highest telehealth utilization compared to other providers.

The report was produced by researchers in HHS's Office of the Assistant Secretary for Planning and Evaluation (ASPE) and analyzed Medicare fee for service (FFS) data in 2019 and 2020. Researchers found a 32-fold increase in behavioral health care through telehealth. In addition, telehealth services were accessed more in urban areas than rural communities, and Black Medicare beneficiaries were less likely than white beneficiaries to use telehealth.

“Pre-pandemic telehealth visits for Medicare beneficiaries went from hundreds of thousands to tens of millions, with many utilizing telehealth for the first time,” HHS Acting Assistant Secretary for Planning and Evaluation Rebecca Haffajee said in an announcement, adding that the report offers a detailed data analysis on important trends for policymakers.

The Centers for Medicare & Medicaid Services (CMS) will use the study findings along with input from Medicare members and providers across the country to further inform telehealth policies, CMS Administrator Chiquita Brooks-LaSure said.

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The report found that in 2020:

  • The share of Medicare visits conducted through telehealth increased 63-fold, from approximately 840,000 in 2019 to 52.7 million.
  • States with the highest use of telehealth included Massachusetts, Vermont, Rhode Island, New Hampshire, and Connecticut.
  • States with the lowest use of telehealth included Tennessee, Nebraska, Kansas, North Dakota, and Wyoming.
  • Telehealth visits comprised a third of total visits to behavioral health specialists, compared to eight percent of visits to primary care providers and three percent of visits to other specialists.

To help protect access to care, CMS said that beyond the COVID-19 public health emergency (PHE), Medicare will pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via interactive video-based telehealth, including audio-only telephone calls. CMS will also permanently eliminate geographic barriers and allow patients in their homes to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders, including via audio-only communications technology. These provisions were included in the Consolidated Appropriations Act of 2021.

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CMS said that Medicare services added to the telehealth services list temporarily during the PHE will remain in place through December 31, 2023, while the agency continues to evaluate whether to permanently add them to the Medicare telehealth services list.

To provide more transparency and visibility into telemedicine usage, CMS is also releasing a new snapshot that shows the number of people with Medicare who used telemedicine services between March 1, 2020 and February 28, 2021. The snapshot includes Medicare FFS claims data, Medicare Advantage encounter data, and Medicare enrollment information.