Payments For Telehealth, Office Visits Unequal

By Katie Wike, contributing writer

Telehealth is gaining in popularity, but some payers refuse to reimburse providers the same amount for e-visits as in-person visits.

A study published in Telemedicine and e-Health found that, despite the growth of telehealth, reimbursement by private insurance companies for it lags behind when compared to standard, in-office appointments. “The survey found that telehealth services are being reimbursed by private payers but that progress in reimbursement has been relatively slow compared with earlier surveys,” explain researchers.

Fierce Health IT reports the study revealed 81 percent of respondents were getting paid when they billed for telehealth services. Why the other 19 percent were not being paid remains a somewhat of a mystery. Researchers could not determine whether it was due to providing the service through telehealth or that the service itself was not covered.

Of the 19 percent of respondents that said they were not reimbursed for telehealth services, 48 percent ceased to offer the service. According to iHealth Beat, when respondents compared telehealth reimbursement to their regular reimbursement, 9 percent said telehealth reimbursement took longer than usual. Another 40 percent said it took about the same amount of time to receive payment and 51 percent were unsure how they compared.

Respondents say there several reasons they believe telehealth is reimbursed differently than office visits, including differences in billing codes, preauthorization requirements, and the frequency of claim denials for telehealth services.

Researchers conclude, “Key findings from this study were that government payers as well as several major private payers are highly influential in payment policies for telehealth private payers, that private payers have administrative rules regarding telehealth reimbursement that are barriers to services and reimbursement, and that some providers would benefit from being better informed about billing and coding for telehealth services and how to advocate for telehealth services reimbursement.”