Telemedicine Critical Care Billing Among Hospitalized Medicare Fee-For-Service Beneficiaries: Trends, Determinants, and Implications from 2018 to 2024

Highlights

• Telemedicine critical care (TCC) billing, previously negligible, increased significantly during the COVID-19 pandemic, reflecting expanded telehealth reimbursement policies.
• Internal medicine and critical care specialists accounted for nearly half of TCC bills during the pandemic period.
• TCC utilization was more common in minor teaching and safety-net hospitals but less frequent in rural, small, and critical access hospitals, highlighting disparities in telecritical care access.
• Despite growth, TCC billing remains a minor fraction of overall critical care claims, underscoring underutilization and the need to study associated clinical and economic impacts.

Background