Before the pandemic, Medicare and Medicaid rarely paid for visits conducted via phone because these visits didn’t really exist. After the pandemic banned nonessential in-person visits, the federal Medicare program, nearly every state Medicaid program and many private insurers began paying for phone visits as telehealth visits.
As the pandemic wanes, state Medicaid programs are unsure if they should classify audio-only visits as telehealth. Some states that have already passed laws that define phone visits as telehealth include Colorado, Connecticut, Delaware, New Hampshire, New York and Vermont.
Lawmakers in California are debating a bill that would require the state’s Medicaid program to keep reimbursing phone, video and in-person visits at the same rate in most settings. The California Health Benefits Review Program analyzed the bill and found that audio-only visits were utilized mostly by patients of color and those who are older or live in rural communities.
The California Health Benefits Review Program argues that reimbursing audio-only visits at the same rate as video visits ensures greater healthcare access in vulnerable populations. On the other hand, the California Department of Health Care Services wants the state to reimburse some phone visits at 65 percent of in-person or video rates, arguing phone visits don’t provide the same level of quality as video visits.
Since they are so new, there is little conclusive data on the efficacy of audio-only visits.
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