AS COVID-19 SPREAD across the nation from March to April 2020, use of telehealth services continued to grow. 

That surge is shown by FAIR Health’s Monthly Telehealth Regional Tracker, which uses our database of over 31 billion private health care claim records – the largest such repository in the nation – to track the month-by-month evolution of telehealth.

According to the tracker, telehealth claim lines increased 8,336% nationally, from 0.15% of medical claim lines in April 2019 to 13% in April 2020. (A claim line is an individual service or procedure listed on an insurance claim.)


In a sign that this increase was related to the COVID-19 pandemic, the change continued and deepened a trend that began in March of this year, when the pandemic started its rapid escalation in the United States. The growth in telehealth from April 2019 to April 2020 almost doubled its 4,347% growth from March 2019 to March 2020.

In the Northeast, the region of the country where the pandemic hit hardest in March and April, telehealth growth was even greater. Telehealth claim lines in the Northeast increased 26,209%, from 0.07% of medical claim lines in April 2019 to 19.69% in April 2020. This increase was even larger than the already substantial 15,503% growth in the Northeast from March 2019 to March 2020.


The swift growth of telehealth in March and April of this year is in keeping with expert predictions. Telehealth permits health care services to be delivered without in-person contact, reducing the risk of disease transmission, and frees up health care resources for COVID-19 patients. For those reasons, federal and state regulations related to telehealth have been relaxed, and private payors have expanded access to telehealth. In addition, with fewer elective procedures occurring around the country due to widespread restrictions, the telehealth share of total medical claim lines was expected to increase.

Telehealth grew markedly from April 2019 to April 2020 in other U.S. regions, but not as much as in the Northeast. In the West, the increase as a percentage of medical claim lines was 3,967%; in the Midwest, it was 6,754%; and in the South, growth was 6,039%. In each region, the increase from April 2019 to April 2020 was greater than from March 2019 to March 2020.

Rural vs. Urban

The Monthly Telehealth Regional Tracker also tracks telehealth utilization in rural versus urban areas. Nationally and in all regions except the Midwest, telehealth had a greater share of medical claim lines in urban than rural areas in April 2019 and April 2020. In the Midwest, telehealth had a greater share in rural areas in April 2019, but urban areas claimed a larger percentage in April 2020.[ 


Other notable findings of the Monthly Telehealth Regional Tracker concern the top five telehealth diagnoses. In the Midwest, diabetes mellitus appeared as one of the top five diagnoses in April 2020, a position it had not occupied in April 2019. This suggests that because in-person care was less accessible during the pandemic, telehealth was being used increasingly to treat chronic conditions like diabetes as well as acute ones.

Joint/soft tissue diseases and issues were not in the top five diagnoses in April 2019 nationally or in any region except the West, but in April 2020, they were in the top five nationally and in every region. This indicates that telehealth was being used during the pandemic for conditions for which it was previously less commonly used.

Hypertension, or high blood pressure, rose from No. 4 in the top five diagnoses nationally in March 2020 to No. 3 in April 2020. This may be related to increased stress during the pandemic and to increased telemonitoring of patients with hypertension.

Month by month, the Monthly Telehealth Regional Tracker is showing the impact of COVID-19 on telehealth. Our data continues to suggest that this venue of care is being rapidly transformed.

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