Psychiatrists who provide telemental healthcare to patients with Medicare are more likely to practice in rural communities and tend to have been in practice for less time, according to study results published in JAMA Psychiatry.

Investigators used a 20% random sample of Medicare fee-for-service claims from 2014 to 2016 and identified 28,567 psychiatrists who billed for ≥1 evaluations and management or outpatient consultations, then multiplied the number of visit estimates by 5. They compared characteristics of psychiatrists who provided telemental healthcare visits with psychiatrists who did not. Telemental health psychiatrists were defined as psychiatrists with ≥1 visits with a telehealth modifier code GT/GQ or telemedicine-specific visit (G0425-G0427).

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Overall, 5.4% of the psychiatrists delivered 377,440 telemental healthcare visits. Of these, 40.2% provided 100 or more such visits. States with the highest percentages of telemental healthcare visits were North Dakota (24.2%) and Wyoming (19.6%), compared with only 0.1% in Massachusetts.

Psychiatrists who provided telemental healthcare visits were more likely to practice in rural locations (24.0% vs 6.0%; P <.001) and been in practice for less time (0 to 19 years: 26.9% vs 22.8%; 20 to 30 years: 29.9% vs 23.1%; 31 to 40 years: 21.5% vs 23.7%; and >41 years: 12.8% vs 22.4%; P <.001). They were less likely to have peer-reviewed publications (21.2% vs 25.0%; P <.001) or be in solo practice (9.1% vs 23.6%; P <.001).

The study was limited to psychiatrists who provide care in the Medicare fee-for-service program and may not be a representative sample of all psychiatrists.

“In some states, less than 1% of psychiatrists provide telemental health visits, while in other states approximately 20% provide telemental health visits. This variation might be driven by needs of the local community and state laws and regulations governing reimbursement of telemedicine and licensure,” investigators concluded.

Reference

Choi S, Wilcock AD, Busch AB, et al. Association of characteristics of psychiatrists with use of telemental health visits in the Medicare population [published online March 20, 2019]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2019.0052