Using CPT Charges as an Economic Proxy for Telehealth and Non-telehealth Emergency Department Utilization

The Rural Health Telehealth Resource Center has published a new brief.

Economic analysis of health care utilization is a pressing priority. However, procuring economic data presents many challenges. One approach is to obtain charge and reimbursement data within a single health care organization, but this approach lacks external validity. Another approach is to obtain charge and reimbursement data across health care organizations by analyzing claims databases (e.g., Medicare, Medicaid claims). But this approach restricts the sample to covered beneficiaries (e.g., older, disabled), which restricts generalizability. We aimed to obtain economic data on emergency department (ED) visits from a number of unrelated rural hospitals and sought an approach for doing so. It appeared feasible to have rural hospitals report the Current Procedural Terminology (CPT) code (AMA, 2021) and associated charge for a sample of ED visits, since CPT codes would be generated for billing and insurance claims submission. The specific aim of this analysis is to explore the characteristics of the resulting dataset in terms of distribution and association with related variables.

Please click here to read the brief.