Trends in Telerehabilitation Utilization in the United States 2020-2021

Objective To examine telerehabilitation utilization in the US during the first 2 years of the pandemic. Design We performed a retrospective analysis of outpatient insurance claims from the IBM MarketScan Commercial Claims and Encounters Database to identify the number and proportion of patients utilizing telerehabilitation from 2020-2021. Telerehabilitation was identified based on presence of specific code modifiers and place of service. Setting Retrospective claims analysis Participants Individuals living in the United States with employer-sponsored insurance plans utilizing outpatient physical or occupational therapy (PT/OT). Interventions Not applicable. Main Outcome Measure Number and proportion of outpatient PT/OT visits completed via telerehabilitation. Results We identified 21,026,608 PT/OT visits among 2,007,524 patients. Overall, 49,974 (2.5%) patients received ≥1 telerehabilitation visit during the specified timeframe. We observed trends in utilization over time, with utilization peaking in April 2020 when 10.9% of all PT/OT visits were conducted by telerehabilitation. We also observed geographic trends with lower rates of utilization identified in rural areas. State-by-state utilization rates ranged from 10.4% (California) to 0.3% (Wyoming). Conclusion Telerehabilitation may be underutilized as a means of improving access to PT/OT, especially in rural areas of the country. Further research is needed to examine contributing factors to low observed utilization rates, such as provider and patient perceptions of telerehabilitation.