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Business of Medicine/Practice Management

(543) Virtual Care Reimbursement in Otolaryngology

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Madeline Goosmann, MD

    Otolaryngology Resident
    Henry Ford Hospital
    Detroit, Michigan, United States

    • Co-Author(s)

  • CS

    Courtney Stevens, MsEM

    Henry Ford Health, USA

  • MN

    Michael D. Nauss, MD

    Senior Staff Physician, Department of Emergency Medicine
    Henry Ford Health
    Northville, Michigan, United States

    • Senior Author(s)

  • ID

    Ilaaf Darrat, MD, MBA

    Division Head -Pediatric & General Otolaryngology & Neurotology
    Henry Ford Health
    Northville, Michigan, United States

Disclosure(s):
Madeline Goosmann, MD: No relevant relationships to disclose.
Michael D. Nauss, MD: No relevant relationships to disclose.
Ilaaf Darrat, MD, MBA: No relevant relationships to disclose.


Introduction: The purpose of this study is to examine how reimbursement for telehealth services compares to in-person services in the post pandemic time in a single academic institution.

Methods: A retrospective study was performed at a single academic institution from 2020-2021. Encounters were recorded as either audio-only, video, or in-person. Encounters were labelled as either new or established; they were also recorded as audio-only, video, or in-person. Total charged amount, adjusted amount (accounts for contract amount with various payors), insurance amount covered, and patient expense was then gathered. Level of encounter (1-5) was included as well.

Results: 42,596 audio-only, video, and in-person encounters were included of both new and established patients. There were 347 audio-only, 633 video, and 41,373 in-person encounters.
The total charged amount for all audio-only visits was $45,099 ($130/ visit), the total for video visits was $73,908 ($116/ visit), and the total for in-person visits was $5,746,122 ($138/visit). The sums of adjusted amount for all audio visits was $21,613 ($62/visit; 48% of charged amount), the total for video visits was $26,465 ($41/visit; 36% of charged amount), and the total for in-person visits was 2,060,797 ($49/visit; 36% of charged amount).
The sums of insurance payments for all audio-only visits was $14,890 ($42/visit; 33% of charged amount), the total for video visits was $35,562 ($56/visit; 48% of charged amount), and the total for in-person visits was $2,568,164 ($62/visit; 45% of charged amount).
The sums of patient payments for all audio-only visits was $4,303 ($9/visit; 10% of charged amount), the total for video visits was $6,924 ($10/visit; 9% of charged amount) and the total for in-person visits was 751066 ($18/visit; 13% of charged amount).

Conclusions: Reimbursement from audio-only and video visits are comparable with in-person visits. Virtual care will likely have a role in the future, as it appears financially feasible for many practices to continue.