How Telehealth Use Has Changed
By Jarrod Fowler, MHA, FMA Director of Healthcare Policy and Innovation | July 13, 2023
Between 2018 and 2020, the percentage of physicians who reported using telehealth in their practice rose from 25% to 79%i. Additionally, more than 75% of respondents to the AMA’s Telehealth Impact Physician Survey indicated that telehealth helped them care for their patients during the COVID-19 pandemic, with 60% reporting that telehealth resulted in improved patient health, and 55% citing increased work satisfaction as a result of telehealthii. That said, research from The Physicians Foundation found that, in 2021, six out 10 physicians frequently experienced feelings of burnout, up from four in 10 in 2018iii.

According to the latest data from FAIR Health’s Monthly Telehealth Regional Tracker, which includes data from April 2023, more than 60% of synchronous telehealth diagnoses in the South were related to mental health conditions. The only other diagnosis to appear on more than 5% of claims lines were active respiratory diseases and infectionsiv. As far as audio-only use, 8.9% of telehealth claim lines in urban areas were audio-only, versus 5.3% in rural areas. Insofar as telehealth costs are concerned, a 99213 had a median charge amount of $150 and a median allowed amount of $79.29v.

The regulatory environment surrounding telehealth related to Medicare has also changed drastically, with some flexibilities becoming permanent and others being extended through 2024vi. Perhaps most significantly, Medicare suspended the requirement that telehealth services be performed from a specified “originating site” subject to geographic restrictionsvii. This will continue to permit qualifying practitioners, including physicians, to bill for telehealth services under Medicare while patients remain at home through 2024. The use of qualifying audio-only telehealth services will also continue to be reimbursed under Medicare through 2024viiixi. Regarding behavioral and mental health services specifically, many of the changes surrounding the use telehealth are being made permanentx.

The prescribing of controlled substances via telehealth was also relaxed during the pandemic, although the U.S. Drug Enforcement Administration has been reviewing these requirements, which may be subject to future changesxi. Physicians should also be sure to keep up with the latest requirements for DEA-registered practitionersxii. (The FMA now provides an online course that meets the new, one-time requirement for all DEA-registered practitioners to complete eight hours of training on the treatment and management of patients with opioid or other substance use disorders.)

Please note that this brief article is not intended as a comprehensive overview. The state and national telehealth landscapes are complex and still evolving. For instance, just this year, the Florida Legislature clarified that audio-only telephone calls meet Florida’s statutory definition of telehealth, although without requiring private insurers to pay for them. An additional Florida law was passed authorizing qualified physicians to use telehealth for the physical examination component when issuing certification renewals for the medical use of marijuana, if the physician has previously seen the patient in person.

More detailed information is available via the links below. Many of these sources provide additional links to official information on these and other telehealth-related matters.

FMA members who have questions about telehealth use in Florida or other issues regarding state law can contact us at (850) 224-6496 for assistance. A general guide on the use of telehealth is available here. The FMA will continue providing articles and additional resources to keep our members informed about the use of telehealth.

On a final note, physicians should continue to check with private insurance companies regarding reimbursement for telehealth services, as private insurers may place additional or differing terms and conditions on the use of telehealth services.

In summary, the COVID-19 pandemic forever changed the telehealth landscape nationally and in Florida. Though more changes are inevitable, it is clear that the increased use of telehealth as a treatment modality is here to stay indefinitely. The topic is also continually being studied, and new articles and reports are continually being published. As time moves forward, we will have a greater understanding of telehealth’s impact on the practice of medicine.


i https://www.ama-assn.org/system/files/2021-06/j21-cms-report-8.pdf
ii Id.
iii https://physiciansfoundation.org/wp-content/uploads/2022/09/2022-Survey-of-Americas-Physicians-Part-2-of-3-Understanding-the-State-of-Physicians-Wellbeing-and-Assessing-Solutions-to-Address-It.pdf
iv https://s3.amazonaws.com/media2.fairhealth.org/infographic/telehealth/apr-2023-south-telehealth.pdf
vId.
vi https://telehealth.hhs.gov/providers/telehealth-policy/policy-changes-after-the-covid-19-public-health-emergency
vii Id.
viii https://www.cms.gov/files/document/physicians-and-other-clinicians-cms-flexibilities-fight-covid-19.pdf
ix https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-audio-telehealth/index.html
x https://telehealth.hhs.gov/providers/telehealth-policy/policy-changes-after-the-covid-19-public-health-emergency
xi https://www.dea.gov/press-releases/2023/05/09/dea-samhsa-extend-covid-19-telemedicine-flexibilities-prescribing
xii https://flmedical.inreachce.com/Details/Information/1078c14c-0830-4d57-a906-4f7646f3cdae