Less than 1% of Medicare patients billed for patient portal messages

Patient portal messages make up only a small percentage of the healthcare services providers bill for, a new study found.

Only 0.8% of fee-for-service Medicare beneficiaries were charged for at least one patient portal message from 2020 to 2022, according to research published April 3 in Health Affairs Scholar. So-called e-visits comprised 0.9%, 0.5% and 0.5% of all evaluation and management services codes in 2020, 2021 and 2022, respectively.

"These findings can help alleviate concerns regarding the potential overuse of portal message and e-visit billing," wrote the researchers from Ann Arbor-based University of Michigan and University of California, San Francisco. However, they were unable to measure the number of patient portal messages that weren't billed, limiting their ability to determine providers' uncompensated workload.

Primary care providers were most likely to charge for patient portal messages, accounting for more than half of all e-visits, the study found. Nearly a third of all the billed messages required the highest amount of provider time (more than 21 minutes). The most common diagnoses addressed were hypertension (21%), diabetes (2.3%) and COVID-19 (2%), while the only distinguishable demographic feature of the patients was that few lived in rural areas.

Several health systems have started billing for MyChart and other patient portal messages in recent years to get a handle on the increasing amount of electronic communications clinicians are encountering.

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