Differences In Level-Of-Service For Telehealth Visits As Compared To In-Office Visits For Cancer And Hematology Patients Seen In Practices Within The Asco Practicenet Learning Network.

Introduction: In response to the need for social distancing and infection prevention during the COVID-19 pandemic, there has been increased use of telehealth services to manage cancer and hematology patients. Throughout March and April of 2020, the Medicare and Medicaid programs expanded coverage of telehealth services, allowing cancer and hematology patients to receive certain telehealth services from their home during the public health emergency. We analyzed data from ASCO’s PracticeNET learning network to examine the reported level-of-service for telehealth services compared to standard in-office visits. Methods: 20 practices submitted their billing data for analysis; practices were located in 14 states and ranged in size from 2 to 29 hematologists/oncologists. We analyzed a total of 33,435 established patient evaluation and management visits performed by hematologists/oncologists from March 15 to April 18, 2020. 3,062 (9.1%) visits were performed via telehealth and 30,373 were performed in a physician office or outpatient hospital department. The level-of-service of each visit was identified through the reported Current Procedure Terminology (CPT) code, where levels 1-5 correspond to CPT codes 99211-99215, respectively, and level 5 represents the highest complexity visit. Telehealth visits were identified through use of the modifiers 95, GQ, and GT, as appended to the applicable CPT code. Results: The level-of-service distribution for telehealth-based visits was level 1 (1%), level 2 (4%), level 3 (35%), level 4 (50%), and level 5 (11%). This contrasted with in-office visits: level 1 (3%), level 2 (2%), level 3 (27%), level 4 (51%), and level 5 (18%). Differences were greatest in level 3 visits (35% vs. 27%) and level 5 visits (11% vs. 18%). Differences in level-of-service persisted when exploring various disease cohorts, including patients with solid neoplasms, blood neoplasms, benign hematology disorders, and circulatory disorders. Conclusions: Analysis of established patient visits showed that telehealth visits were reported at lower level-of-service as compared to in-office visits. This finding may be related to directing straightforward visits to be performed via telehealth or due to limitations in using telehealth by patients with complex medical problems. Citation Format: Brian Bourbeau, Mou Guharoy, Stephen Grubbs, Elizabeth Garrett-Mayer, Kevin Olson, Richard L. Schilsky. Differences in level-of-service for telehealth visits as compared to in-office visits for cancer and hematology patients seen in practices within the ASCO PracticeNET learning network [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-015.