Telemedicine is most frequently used in mental health care, where it has become the default delivery method for many providers. Nationally, three of the top five provider specialties billing for telehealth visits are mental health related: social workers, psychiatrists, and psychologists. Beyond behavioral health, telemedicine has settled into a stable role across primary care, neurology, chronic disease management, and employer-sponsored health plans, with about 4.4% of all office and outpatient visits delivered virtually as of 2023.
Mental Health Leads All Specialties
If you’ve used telehealth recently, there’s a good chance it was for a therapy or psychiatry appointment. In January 2022, social workers were the top specialty providing telehealth services nationally and in every U.S. region except the West (where primary care physicians held a razor-thin lead). Social workers alone accounted for 28.7% of all telehealth claim lines in private insurance data, rising to 32.2% in the Midwest.
The single most common telehealth billing code throughout 2021 and into early 2022 was the code for a one-hour psychotherapy session, representing 23.1% of all telehealth claims. Primary care physicians ranked second nationally, followed by psychiatrists and psychologists. The pattern is clear: mental health care drove telehealth adoption during the pandemic and continues to anchor it.
Which Medical Specialties Use It Most
Outside mental health, certain specialties converted to virtual visits at remarkably high rates. During the pandemic’s first year, pediatric neurology generated more telehealth visits than it had in-person clinic visits the year before, reaching over 130% of its pre-pandemic volume. Bariatrics (weight management) hit 109%, neurology reached about 89%, pediatric pulmonology about 81%, and diabetes services about 80%.
Broadly, pediatric nonsurgical specialties converted the largest share of their visits to telehealth (66.8% of prior-year clinic volume), followed by adult nonsurgical specialties (56%) and primary care (48.3%). The common thread is that these are conversation-heavy fields where a physical exam is helpful but not always essential. Surgical specialties, unsurprisingly, lagged behind.
Urban Areas, Not Rural Ones
One of the most persistent misconceptions about telemedicine is that it’s primarily a rural tool. The data tell the opposite story. CDC figures from 2022 show that 34.2% of adults in large central metropolitan areas used telemedicine in the past year, compared to just 19.6% of adults in the most rural areas. Usage drops steadily with each step toward rurality: large fringe metro (33.1%), medium metro (29.6%), small metro (23.4%), micropolitan (21.6%), and noncore rural (19.6%).
Regionally, the Northeast and West have the highest telehealth use, while the Midwest and South trail behind. Broadband internet access is a likely driver of this gap, though the CDC notes it wasn’t directly measured in its surveys. Rural communities, the population that could theoretically benefit most from remote access to specialists, face the steepest barriers to actually using it.
Who Uses Telemedicine Most Often
Telemedicine use rises with age, income, and education. Adults 65 and older had the highest usage rate at 43.3%, while adults aged 18 to 29 had the lowest at 29.4%. This likely reflects that older adults have more frequent healthcare needs and more chronic conditions requiring regular check-ins.
Income plays a significant role. Adults with family incomes at or above four times the federal poverty level used telemedicine at a rate of 40.7%, compared to 33.1% for those with the lowest incomes. Education follows the same gradient: 43.2% of adults with a college degree used telehealth, versus 28.7% of those without a high school diploma. Among racial and ethnic groups, American Indian or Alaska Native adults (40.6%) and non-Hispanic white adults (39.2%) reported the highest use.
Chronic Disease Management
Telemedicine has become a core part of managing ongoing conditions, particularly through remote patient monitoring. Patients with diabetes, heart failure, hypertension, chronic kidney disease, and chronic lung disease are the most natural fit for these programs. The goal is straightforward: track key health measures between office visits to catch problems before they lead to an emergency room trip.
The devices involved range from simple to sophisticated. Blood pressure cuffs, glucometers, and pulse oximeters send intermittent readings to care teams. Continuous glucose monitors, wearable heart rhythm trackers, and fall-detection sensors stream data more frequently. Medicare patients in health systems with high telehealth adoption showed fewer emergency department visits and better adherence to medications for diabetes and high cholesterol, filling more prescriptions for key drugs than patients in lower-adoption systems.
Remote monitoring also extends into less obvious areas: sleep apnea machines that report usage data, peak flow meters for asthma, digital scales for tracking fluid retention in heart failure, and app-based physical therapy programs for post-surgical rehabilitation.
Employer Health Plans
The vast majority of large employers now include telehealth in their benefits packages. Coverage grew from 27% of large employers in 2015 to 82% by 2019, even before the pandemic accelerated adoption. Among all firms with at least 50 workers, 69% covered telemedicine in their largest plan.
Availability and actual use are two different things, though. In 2018, only about 2.4% of large-group enrollees who had an outpatient visit used telehealth at least once, roughly 1 in 50. Those numbers have grown substantially since the pandemic, but the gap between “your plan covers it” and “you actually use it” remains one of the defining features of employer-sponsored telehealth.
The Post-Pandemic Baseline
After surging during COVID-19 lockdowns, telehealth usage didn’t collapse, but it did settle. The share of U.S. healthcare visits conducted via telehealth jumped from 1.84% in 2020 (reflecting a partial year of pandemic impact) to 4.53% in 2021, then stabilized through 2023 at about 4.4% of all office-based and outpatient visits. Among outpatient visits specifically, the telehealth rate was higher at 12.7% in 2023.
That stabilization suggests telemedicine has found its level. It isn’t replacing in-person care broadly, but it has carved out a permanent role in the specialties, populations, and settings where virtual visits work well. Mental health, chronic disease follow-ups, and urban populations with strong internet access remain its center of gravity.