Utilization and insurance coverage of tele-retinal imaging during the COVID-19 pandemic

ABSTRACT

Purpose: Greater utilization and insurance coverage for tele-retinal screening during the COVID-19 pandemic in 2020 may enhance awareness and expand remote retinal imaging services. In this study, we performed a retrospective, cross-sectional analysis of utilization and insurance payments of tele-retinal imaging services in the United States in 2020. Methods: We examined remote retinal imaging utilization and insurance payments from January 1, 2020, to December 31, 2020, using the OptumLabs® Data Warehouse (OLDW), a comprehensive database of de-identified administrative claims for commercial and Medicare Advantage enrollees in the U.S. We evaluated frequency of claims and insurance payment for services using Current Procedural Terminology codes 92227 and 92228 for remote eye imaging by any provider, and 92250 for fundus photography by non-eye care providers. Results: Use of remote retinal imaging declined rapidly from 3627 claims in February 2020 to 1414 claims in April 2020, but returned to 3133 claims by December 2020, similar to pre-pandemic levels in 2019 (2841 ± 174.8 claims). Proportion of insurance payments for remote imaging increased temporarily from 47.4% in February to 56.7% in April, then returned to 45.9% in December. Conclusions: Utilization of tele-retinal imaging declined steeply while insurance coverage increased during the initial COVID-19 lockdown in 2020, but returned to pre-pandemic levels by end-of-year. Changes in utilization and relaxed restrictions on insurance reimbursements for remote retinal imaging during the COVID-19 pandemic were not sustained.