Telehealth

FAIR Health also examined telehealth codes commonly used for respiratory infections and their costs. Of the top 10 telehealth codes most often associated with all respiratory infections, the predominant one in 2019 was CPT®1 99441 (physician/qualified healthcare professional telephone evaluation and management [E&M], 5-10 minutes), which accounted for 50 percent of all telehealth services for respiratory infections. The average charge for CPT 99441 is $43 and the average estimated in-network amount for those commercially insured is $34, making it the lowest-cost service of CPT codes that are used only for telehealth.


E&M codes billed both for telehealth and non-telehealth include 4 of the top 10 codes most often associated with respiratory infections. Among these codes, having telehealth as the place of service in most cases yields cost savings by comparison with all places of service for the same code.

FAIR Health President Robin Gelburd stated: "In this time of profound uncertainty and shared purpose, we hope that the information in this brief is useful to policy makers, payors, providers, researchers and other healthcare stakeholders, and to the country as a whole."

Marty Makary, MD, MPH, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health and a professor of surgery at the Johns Hopkins University School of Medicine, commented: "As we as a country mobilize every resource to fight COVID-19, people want to know how much it will cost. FAIR Health has helped put a price tag on medical services to care for these patients based on the best available projections using real-world data."


About FAIR Health
FAIR Health, a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the tax code, is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of private healthcare claims data, which includes over 30 billion claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health houses data on Medicare Advantage enrollees in its private claims data repository. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish and an English/Spanish mobile app, which enable consumers to estimate and plan for their healthcare expenditures and offer a rich educational platform on health insurance. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. FAIR Health also is named a top resource for patients in Dr. Marty Makary's book The Price We Pay: What Broke American Health Care—and How to Fix It and Elisabeth Rosenthal's book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.


SOURCE FAIR Health

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