Use of New Audio-Only Telemedicine Claim Modifiers.
JAMA Netw Open
; 6(12): e2348224, 2023 Dec 01.
Article
in En
| MEDLINE
| ID: mdl-38109111
ABSTRACT
Importance Policymakers at both the state and federal levels face decisions about coverage of audio-only telemedicine amid a dearth of reliable data due to changes and variation in billing practices. Objective:
To describe early trends in the use of new audio-only telemedicine claims modifiers 93 and FQ in Washington State, which were introduced to improve the designation and identification of audio-only telemedicine claims. Design, Setting, andParticipants:
This retrospective cohort study analyzed claims data from the Washington All-Payer Claims Database from January to November 2022. Participants included 4.3 million children and adults insured for at least 6 months in 2021 through public or private insurance plans. Exposures Use of audio-only telemedicine was compared by age, race, ethnicity, insurance type, rurality, and Social Vulnerability Index. Main Outcomes andMeasures:
Audio-only telemedicine services were identified by claims appended by Current Procedural Terminology (CPT) code modifiers 93 or FQ or that included telephone-only CPT codes. Modifiers 93 and FQ denote audio-only telemedicine services for any reason and for behavioral health concerns, respectively.Results:
In 2022, there were a total of 917â¯589 audio-only telemedicine services, of which 345â¯941 (38%) were appended with modifier FQ and 55â¯352 (6%) with modifier 93. Audio-only telemedicine services with these modifiers were most frequent for behavioral health diagnoses or routine prenatal and postpartum care. Individuals who used telemedicine exclusively via audio-only modality were more likely to be older (mean [SD] age, 46.0 [22.5] vs 42.0 [21.4] years) and insured by Medicare (41â¯758 of 196â¯225 [21%] vs 95â¯962 of 707â¯626 [14%]) than those who used at least 1 audiovisual service. Conclusions and Relevance In this cohort study of a statewide all-payer claims database, modifiers 93 and FQ offered the important capability to identify audio-only telemedicine services beyond telephone-only CPT codes, but their uptake remained low. Audio-only telemedicine appears to offer an important means for access to behavioral health and perinatal care access, but further work is needed to study outcomes and quality of care.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Medicare
/
Telemedicine
Limits:
Adult
/
Aged
/
Child
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Female
/
Humans
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Middle aged
/
Pregnancy
Country/Region as subject:
America do norte
Language:
En
Journal:
JAMA Netw Open
Year:
2023
Document type:
Article