With Telemedicine Becoming a Workers’ Comp Mainstay, How Will Reimbursement Costs Play Out?

A recent study by WCRI compares data and pricing points between in-person health care visits and telemedicine.
By: | January 13, 2022
women viewing patient via telemedicine

Telemedicine, once a relatively quiet component of the health care system, is now a constant in how millions of people receive care. With its use soaring, mainly due to the pandemic, many injured workers also are able to receive medical care remotely.

As we approach the two-year mark of the pandemic, the data connected to telemedicine, especially when it comes to workers’ comp patients, is substantial.

A recent study by WCRI, “Telemedicine: Patterns of Use and Reimbursement,” looked at various points of data on telemedicine use versus in-person visits and compared usage, pricing and workers’ comp claim progress prior to the pandemic and after.

By the Numbers

  • 28 states were surveyed.
  • Between March and June of 2020 7-13% of medical claims involved the use of telemedicine services, compared to 2% of the same time period in 2019.
  • Correlation between physical medical services versus telemedicine services was 2% in the second quarter of 2020, compared to relatively no telemedicine use in the first quarter of 2020 and the last quarter of 2019.
  • Of all evaluation & management (E&M) patients who received their first visit via telemedicine, 65% followed up with their second appointment with telemedicine as well.
  • In regards to telemedicine payment, the second quarter of 2020 saw telemedicine account for 2% of all E&M payments, compared to 0.7% in the first quarter of 2020.
  • Prices for telemedicine and in-person medical visits were similar (price difference ranged less than 10%).
  • Among workers’ comp claims in the second quarter of 2020, 8% had at least one visit via telemedicine.

Telemedicine Now and Its Future

It’s likely that telemedicine services will still remain intact long after the pandemic ends.

In fact, “the Centers for Medicare and Medicaid Services requires the telehealth services on the list of services covered by Medicare to be paid at the same reimbursement rate as in-person care,” according to the study.

However, these reimbursement regulations for workers’ comp patients that are utilizing telemedicine are vary across the studied states.

As mentioned before, pricing data was compared between both in-person and telemedicine visits, where the type of care received by patients was the same. In these cases, the pricing between both of these services were relatively the same.

With both convenience and pricing/reimbursement on its side, telemedicine’s future seems to be bright, including in the treatment of workers’ comp patients. &

Emma Brenner is a staff writer with Risk & Insurance. She can be reached at [email protected].

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