Medicare Telehealth Visits for Behavioral Health Up Over 3,000% says HHS

The number of telebehavioral health visits provided to Medicare beneficiaries increased by 32x — or by 3,090% — in 2020 compared to 2019.

That’s according to a new report released by the U.S. Health and Human Services’ (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE).

The report analyzed claims data from the 34.9 million Medicare Fee For Services beneficiaries who had Part A or Part B coverage to provide policymakers more insights into data and trends as they consider whether or not to make the pandemic-era telehealth regulations permanent.

Across the three categories of providers assessed — behavioral health, primary care and specialty care — the number of telehealth visits increased about 63x, or by 6,176%, according to the ASPE report.

The federal government, through the Centers for Medicare and Medicaid Services (CMS) and the HHS Office of Civil Rights, used emergency authority to loosen regulations around where, when and how services could be compensated for by Medicare when offered via telehealth.

The report shows that behavioral health offered the largest portion of all visits via telebehavioral health in 2020: About 38% of all behavioral health visits were offered via telehealth. For primary care, telehealth visits grew to about 8.3% of all visits and specialty care saw about 2.6% of all visits go through telehealth.

At least within the context of Medicare, the report also shows that behavioral health was offering a greater show of visits through telehealth than the other two categories of providers in 2019, before the onset of the pandemic.

About 1.01% of behavioral health visits were offered via telehealth while primary care used telehealth to conduct 0.11% of visits and specialty care used it 0.02% of the time.

The report is more confirmation that the coronavirus pandemic pushed the U.S. into wide adoption of telehealth across all of health care. It also shows in stark contrast how poorly telehealth was adopted pre-pandemic.

In raw numbers, Medicare telehealth visits went from approximately 840,000 in 2019 to 52.7 million in 2020.

How CMS, a chief health care policymaker, reacted to those impacts has already shown to be consequential for behavioral health and the entire health care sector. Behavioral Health Business’ previous reporting shows that the impacts of Medicare’s policy decisions are inescapable and that the ascension of telebehavioral health is inevitable.

“This report provides valuable insights into telehealth usage during the pandemic,” CMS Administrator Chiquita Brooks-LaSure, said in a news release. “CMS will use these insights – along with input from people with Medicare and providers across the country – to inform further Medicare telehealth policies.”

In November, CMS announced that it would enumerate changes to Medicare compensation that would expand the use of telehealth in the behavioral health industry.

However, many of the changes to Medicare compensation that enabled wide adoption of telehealth could end when the federal government ends the regulatory relaxations afforded by the public health emergency declared by the Trump administration in March 2020.

Despite the increased adoption of telehealth as a means of helping connect to care while doing so in-person was not possible or safe, overall health care utilization among Medicare beneficiaries dipped in 2020 by 11.4%.