The Pandemic Spark That Ignited a Lasting Shift
In 2020, the U.S. health care system experienced a seismic shift—one driven by necessity, accelerated by technology, and anchored in behavioral health. According to a report from Fair Health, behavioral health conditions made up nearly half of all telehealth visits during the first year of the COVID-19 pandemic. This figure marked not just a moment of adaptation but the beginning of a long-term trend in behavioral health telehealth utilization.
As patients sought safe and accessible care during a time of unprecedented disruption, behavioral health providers rose to the challenge. Many already had experience with virtual platforms, and when combined with regulatory flexibility and urgent demand, the result was an explosion in telehealth use across the behavioral health spectrum.
Behavioral Health Already Led the Way
Even before the pandemic, behavioral health telehealth utilization was on the rise. In 2019, 35% of telehealth visits were for mental health conditions—far ahead of other medical specialties. This early adoption helped create a smooth transition in 2020, when the nation shifted toward remote care at an unprecedented pace.
Fair Health reports that in 2020, mental health, developmental disorders, and substance use disorders made up 48% of all telehealth claims. Specifically:
- Mental health accounted for 44%,
- Developmental disorders for 3%,
- Substance use disorders for 1%.
These numbers clearly indicate that behavioral health telehealth utilization was not just an emergency solution—it was a well-aligned method of care delivery ready to meet a growing need.
A Historic Telehealth Boom
The growth of telehealth during the pandemic was nothing short of historic. In 2020 alone, telehealth utilization increased 7,060% compared to 2019. When compared to 2015, the jump was even more staggering—a 42,000% increase, according to Fair Health’s data.
This incredible growth was supported by temporary but sweeping changes in policy. Government regulations allowed for expanded reimbursement, looser HIPAA enforcement for video conferencing platforms, and cross-state licensure waivers, making it possible for millions to access therapy, psychiatry, and addiction counseling from home.
A Lasting Shift in Behavioral Health Delivery
While many sectors of health care have seen telehealth usage decline as in-person visits resume, behavioral health telehealth utilization remains strong. As of January 2024, telehealth represented just 5.4% of all medical claims nationally. However, mental health services made up 58.9% of all those telehealth claims—a testament to the durability of virtual care in this field.
What’s more, three psychotherapy billing codes ranked among the top five most reimbursed telehealth procedures, representing nearly 38% of all claims. And since January 2021, the proportion of telehealth visits attributed to mental health issues has never dropped below 51%.
Industry-Wide Confirmation of the Trend
Fair Health is not alone in highlighting the surge in behavioral health telehealth utilization. Trilliant Health, a predictive analytics firm based in Tennessee, found that 57.9% of all telehealth visits in 2021 were for behavioral health diagnoses. Their analysis concluded that for mental health, telehealth wasn’t just a replacement for in-person visits—it was a viable and effective long-term care model.
UnitedHealthcare, one of the largest national insurers, offers similar insights. In 2019, just 1.5% of behavioral health claims were for virtual care. By 2021, that number had jumped to 66%, further cementing the dramatic rise in behavioral health telehealth utilization.
Why Behavioral Health and Telehealth Are a Natural Match
There are several reasons why behavioral health telehealth utilization has stayed high, even as other sectors have returned to more traditional care models:
- No need for physical exams: Most mental health services are conversational and can be conducted safely and effectively via video or phone.
- Increased access: Telehealth removes barriers like transportation, time off work, and geographic distance.
- Lower stigma: Patients may feel more comfortable seeking care from the privacy of their home.
- Provider flexibility: Telehealth allows therapists, psychiatrists, and counselors to expand their reach and increase availability.
These factors make telehealth a particularly strong fit for ongoing behavioral health treatment, and they continue to drive high behavioral health telehealth utilization rates even after the pandemic’s peak.
Looking Ahead: Policy and Infrastructure Will Be Key
With continued investment and supportive policy, behavioral health telehealth utilization can play a central role in addressing America’s growing mental health needs. That means ensuring reimbursement parity for telehealth services, streamlining licensure for interstate care, and expanding digital infrastructure, especially in rural areas.
Fair Health’s massive claims database—now exceeding 36 billion private and public health plan records—shows that telehealth is not a passing trend. It’s a fundamental component of the modern behavioral health ecosystem.
Conclusion: Behavioral Health Anchors Telehealth’s Future
The COVID-19 pandemic may have forced health care to go virtual, but behavioral health made that transformation sustainable. Today, behavioral health telehealth utilization remains the dominant driver of virtual care in the U.S., not just because of necessity, but because it works.
As we move forward, the challenge will be to maintain and strengthen the systems that support this innovation. If done right, the telehealth revolution will be remembered not just as a temporary solution—but as the catalyst that permanently expanded access to essential mental health care.
