Medicare Telehealth Encounters Data Tool:
Change from 2019 to 2020
Data Tool Description
Definitions
Notes: Use the drop-down boxes at the top of each page to view data for a specific year, state, provider specialty, and/or provider type. Click the icons on the top right of the tables and figures to view additional metrics or download the data. Click any column heading in the tables to sort the data by that heading.
Page 1 - Description & Definitions: Medicare Telehealth Encounters Data Tool: Change from 2019 to 2020 description, definitions, data source, and data cleaning procedures.
Page 2 - Overview: Maps and table showing the change in Medicare telehealth encounters from 2019 to 2020 by state.
Page 3 - Provider Type Maps: Maps showing the change in Medicare telehealth encounters from 2019 to 2020 by state and provider type.
Page 4 - Behavioral Health Providers: Maps showing change in Medicare telehealth encounters among behavioral health providers from 2019 to 2020 by state and provider type.
Page 5 - Primary Care Providers: Maps showing change in Medicare telehealth encounters among primary care providers from 2019 to 2020 by state and provider type.
Page 6 - Nurse Practitioners & Physician Assistants: Maps showing change in Medicare telehealth encounters among nurse practitioners and physician assistants from 2019 to 2020 by state and provider type.
Page 7 - Other Providers: Maps showing change in Medicare telehealth encounters among other providers from 2019 to 2020 by state and provider type.
Page 8 - Provider Type Tables - US: Tables summarizing the change in Medicare telehealth encounters in the US from 2019 to 2020 by provider type and provider specialty.
Page 9 - Provider Type Tables - States: Tables summarizing the change in Medicare telehealth encounters from 2019 to 2020 by state, provider type, and provider specialty.
Allowed services: Number (count) of services that Medicare allowed, covered, and reported. This is equivalent to the number of services that were submitted to Medicare minus the number of services that Medicare denied.
Allowed services per 10K: Number (count) of services that Medicare allowed, covered, and reported per 10,000 Medicare beneficiaries in each state for the given year(s).
Allowed charges: Total Medicare professional allowable amount (in USD) for the allowed services.
Allowed charges per 10K: Total Medicare professional allowable amount (in USD) for the allowed services per 10,000 Medicare beneficiaries in each state for the given year(s).
NCH Payment: Total amount (in USD) Medicare paid for the allowed services after patient deductibles, co-insurance, etc.
NCH Payment per 10K: Total amount (in USD) Medicare paid for the allowed services after patient deductibles, co-insurance, etc. per 10,000 Medicare beneficiaries in each state for the given year(s).
Physician/Supplier Procedure Summary (PSPS) data from 2015 through 2020 were downloaded from the Centers for Medicare & Medicaid Services (CMS) website. These data provide a yearly summary of Medicare Part B carrier and durable medical equipment fee-for-service claims. These data include only provider information, not patient information.
When downloading the PSPS data, a filter was used to obtain only the telehealth data. This filter returned claims with a place of service code 02; any of the GT, GQ, or 95 procedure code modifiers; or any of the following procedure codes:
• E-visit: 98970, 98971, 98972, 99421, 99422, 99423, G2061, G2062, G2063
• Remote monitoring: 99091, 99453, 99454, 99457, 99458, 99473, 99474, G2010
• Video: G0406, G0407, G0408, G0425, G0426, G0427, G0459, G0508, G0509
• Telephone: 98966, 98967, 98968, 99441, 99442, 99443
• Telephone or internet: 99446, 99447, 99448, 99449, 99451, 99452
Data Source
Data Cleaning Procedures
All claims from facility and transmission fees (procedure codes Q3014, T1014, and S9083) were removed since they represent duplicate telehealth claims. All claim lines where the submitted services, submitted charges, and NCH payment amount were equal to zero were removed, as well as all claim lines where the allowed services and allowed charges were equal to zero. These claim lines represent a combination of suppressed claims (claim lines with fewer than 11 submitted services) as well as cases in which all of the submitted claims were denied. All claim lines with Puerto Rico, the U.S. Virgin Islands, or DMAC listed as the carrier state were removed. Lastly, all claim lines where the error indicator code did not equal zero were removed.
The specialty codes from the PSPS file were categorized into eight different provider types: Psychiatrists, Psychologists, Social Workers, SUD/OUD Providers, Primary Care Providers, Nurse Practitioners & Physician Assistants, Medical Specialists, and Other Providers.