ABSTRACT:
Objective: This study characterizes telehealth claims for mental health and substance abuse (MH/SA) services by using national private claims data.
Methods: Telehealth-related mental health service claims were identified with private claims data from 2009 to 2013. These data—provided by the Health Care Cost Institute—included claims from Aetna, Humana, and UnitedHealth for more than 50 million individuals per year.
Results: In 2009–2013, there were 13,480 MH/SA telehealth provider claims out of 3,986,159 claims, with the majority of telehealth claims submitted by psychiatrists. For telehealth services, there was a decreasing trend for average reimbursements ($54.61 in 2009 to $43.28 in 2013). Average reimbursements for telehealth claims were half those for nontelehealth claims. Reimbursements for nine of the top 10 telehealth services were lower in 2015 dollars than for the same services provided during face-to-face treatment.
Conclusions: Widespread adoption and use of costly telehealth technologies for mental health services may be limited by low reimbursements for telehealth services.