Abstract
Enhanced telehealth flexibilities in response to the COVID-19 pandemic have prompted heightened use across many physician specialties; yet, national trends have not been assessed within dermatology, specifically. In this longitudinal review of 2017 to 2020 Medicare billing data, we identified a 210-fold increase in teledermatology evaluation and management (E&M) visits between 2019 and 2020, which helped to slightly offset the substantial 20.1% decline in in-person E&M visits. Teledermatology comprised an overall greater proportion of E&M visits in states with the largest declines in in-person visits. Teledermatology E&M visits were primarily comprised by established patient video visits (74.3%); yet, the relatively more substantial role of telephone-only visits in certain rural states may reflect limitations in technologic access in these areas. Asynchronous teledermatology (including store-and-forward dermatology) also increased by 34-fold in 2020, supporting its utility for evaluation of a changing lesion or for triage purposes. The findings underscore the growing role of telehealth in dermatologic care and are important given that certain telehealth flexibilities are set to expire at the end of the public health emergency without additional congressional intervention.