- A survey released on Tuesday by Epic Research found telehealth visits were more frequently billed as less complex compared to in-person office visits for both primary and specialty providers.
- Telehealth visits were more readily billed with lower level of service (LOS) codes than in-person visits, according to the study. Higher service codes correspond to more complex patient encounters, with LOS 1 being the least complex and LOS 5 the most complex.
- The results indicate patients might self-select in-person office visit over telehealth options if they feel they need a higher level of care. In addition, the proximity of additional tests and services at in-office visits may help providers give additional assessments to “increase the level of service” during care sessions, according to the report.
The Epic Research study comes after other research has suggested telehealth visits are more often utilized for less-complex medical visits, like medication management, chronic disease management and existing patient follow-up.
In a survey of LOS codes for over 1 million telehealth visits and over 5 million office visits from Jan. 1, 2022 through June 30, 2023, more than half of primary care telehealth visits for existing patients received lower-complexity LOS 3 coding compared with 43% of in-person appointments for established patients, according to the new study.
Likewise, for new patients, telehealth primary care visits were coded at LOS 3 49% of the time compared with 42% of in-person visits.
Telehealth visits for new and established patients were consistently billed at lower-complexity LOS codes, with the exception of specialty telehealth visits for new patients receiving slightly more LOS 5 visits than in-person visits.
The study noted additional research is necessary to assess what factors may contribute to the differences in coding.
The Epic survey on how providers bill telehealth visits follows a study from KFF published in January that found private insurers paid roughly the same for telehealth and in-person visits during the early days of the COVID-19 pandemic. The findings called into question the argument that telehealth saves the healthcare system money, according to researchers.