Trends in Telerehabilitation Utilization in the United States 2020-2021

Objective: To examine telerehabilitation utilization in the United States (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 using telerehabilitation from 2020 to 2021. Telerehabilitation was identified based on the 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 using outpatient physical or occupational therapy (PT/OT) (N=2,007,524). 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. Archives of Physical Medicine and Rehabilitation 2024;105:1299 -304 (c) 2024 by the American Congress of Rehabilitation Medicine.