An Analysis of Private Payer Telehealth Coverage During the COVID-19 Pandemic

Below is a summary of key findings from the review:

All of the national insurance carriers we examined voluntarily expanded telehealth coverage for their commercial health plans on a temporary basis during the PHE.

Payers typically issued blanket expansions for all covered or medically necessary services under a member’s existing coverage plan.

Nearly all major insurers (6 of 7) explicitly indicated that they waived cost-sharing for COVID-19 telehealth treatment services.

Most private payers (6 of 7) also extended cost share waivers to non-COVID telehealth services, typically for primary or urgent care or behavioral health visits.

Four major insurers agreed to cover limited out-of network telehealth services, with at least 1 major payer (Anthem Blue Cross Blue Shield) waiving cost share obligations for out-of-network telemedicine visits through Spring 2020.

Most private payers (6 of 7) agreed to reimburse providers at the in-person rate, including for audio-only services.

Private payers set varying expiration dates for their temporary telehealth policies. The majority of these expansions were set to expire by the end of 2020, while a limited number of payers
extended their expansions through the end of January 2021.