Telehealth coded as less complex than in-person care: Study

Telehealth visits, whether for primary or specialty care, tend to be assigned lower-level billing codes more often compared to in-person office visits within the same specialty, a new study from Epic Systems found

Researchers analyzed billing codes for 1.31 million telehealth visits and 5.25 million office visits from Jan. 1, 2022, through June 30, 2023, and found that for primary care, both telehealth and office visits were most often coded with a level of service of 3 or 4. Higher LOS codes represent more complex patient encounters, with 5 being the highest.

But researchers found that 53.7 percent of primary care telehealth visits for established patients were coded LOS 3 compared to 43.3 percent for office visits. 

For LOS 4, 40.8 percent of telehealth visits received this designation compared to 52.5 percent for office visits for established patients.

When it came to specialty care, telehealth and office visits were coded LOS 4 most frequently, with 64.1 percent of specialty office visits being coded LOS 4 or 5 compared to 56.8 percent of specialty telehealth visits.

Overall, telehealth visits were consistently billed at a lower level of service than office visits of the same type, according to the Sept. 12 study. 

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