Medicare covers telehealth visits, but the coverage depends on the type of visit, your plan, and where you live

Medicare Part B (the medical insurance part) pays for telehealth visits with doctors, nurse practitioners, physician assistants, and other may have access to providers. The payment is usually the same as an in-person visit to that provider's office. However, not every telehealth visit qualifies for coverage, and the rules changed after the COVID-19 public health emergency ended in May 2023. Some coverage became permanent, but others returned to stricter limits.

The key difference now is location. Medicare covers telehealth visits from your home, a doctor's office, or a hospital — but only if you live in a rural area or meet specific exceptions. If you live in a city or suburb and try to use telehealth from home, Medicare may not pay. You would pay the full cost yourself unless your plan offers additional coverage.

Key Takeaways

  • Medicare Part B covers telehealth visits at the same rate as office visits, but only from certain locations depending on where you live.
  • If you live in a rural area, you can use telehealth from home and Medicare will pay; urban residents usually must visit a clinic, hospital, or doctor's office for coverage.
  • Medicare Advantage plans (Part C) may cover telehealth differently than Original Medicare, so check your plan documents or call the plan directly.
  • Some telehealth visits — like mental health counseling and certain chronic disease management services — have different rules and may be covered even from home in urban areas.
  • You still pay your usual copay or coinsurance for a telehealth visit, just as you would for an office visit.

Where you can have a telehealth visit and still get Medicare coverage

Medicare defines originating sites — the places where you can be during a telehealth visit and have Medicare pay. If you live in a rural county (as defined by Medicare), your home counts as an originating site. If you live in an urban or suburban area, your home does not.

In urban areas, you can have a telehealth visit from a hospital, critical access hospital, federally may have access to health center (FQHC), rural health clinic, hospital outpatient department, or your doctor's office. You cannot use telehealth from home and expect Medicare to pay unless you fall into a specific exception.

The exceptions are narrow. Behavioral health integration services (mental health or substance use counseling provided by your primary care doctor's office) can be delivered to your home in any area. Chronic care management services — ongoing support for conditions like diabetes or heart disease — may also be covered from home. Ask your doctor's office whether the specific service you need qualifies.

How to learn about you live in a rural area for Medicare purposes

Medicare's definition of rural does not always match what feels rural to you. A town of 50,000 people might be classified as rural by Medicare, while a smaller town might not be. The only way to know for certain is to check the official list.

Go to the Centers for Medicare & Medicaid Services (CMS) website and search for "telehealth originating sites." You will find a county-by-county list showing which counties may have access to as rural for telehealth purposes. Enter your county name and state. If your county is listed, you can use telehealth from home and Medicare will pay. If it is not listed, you will need to visit a clinic or office location.

You can also call Medicare at 1-800-MEDICARE (1-800-633-4227) and ask whether your county qualifies. Have your zip code ready.

What Medicare Advantage plans cover for telehealth

Medicare Advantage (Part C) plans set their own telehealth rules within Medicare guidelines. Some plans cover telehealth from home even in urban areas; others follow the same location restrictions as Original Medicare. A few plans offer telehealth as an included benefit with no copay at all.

The only way to know what your plan covers is to read your plan's coverage documents or call the plan's customer service number. The documents are usually available on the plan's website, or you can request them by phone. When you call, ask specifically: "Can I have a telehealth visit from my home, and what will I pay?"

If you are thinking about switching plans during open enrollment, telehealth coverage can be one factor to compare. Plans that offer broader telehealth access may be worth the difference in premium or copay.

What you pay for a telehealth visit

Your out-of-pocket cost for a telehealth visit is the same as for an office visit with the same provider. If your doctor charges a $30 copay for an office visit, you pay $30 for a telehealth visit. If you have not met your deductible, you pay the full cost of the visit until you do. If you have coinsurance (you pay a percentage rather than a flat copay), that percentage applies to telehealth too.

The provider's office will bill Medicare the same way they bill for an office visit. You should receive an Explanation of Benefits (EOB) in the mail showing what Medicare paid and what you owe, just as you would after an office visit.

Types of visits that have different telehealth rules

A few categories of care have their own telehealth coverage rules that may be broader than the standard location restrictions.

Mental health and substance use services: Telehealth visits with psychiatrists, psychologists, licensed clinical social workers, and counselors are covered from your home in any area. You do not have to travel to a clinic. This applies to both diagnosis and ongoing treatment.

Chronic care management: If you have multiple chronic conditions (such as diabetes and heart disease), your doctor's office may offer remote monitoring and check-ins. These services can be delivered to your home even in urban areas, though your doctor's office must have your written consent first.

Behavioral health integration: When your primary care doctor's office provides mental health screening and brief counseling as part of your regular care, this can happen via telehealth from home. This is different from a referral to a separate mental health provider.

Transitional care management: After you leave the hospital, your doctor may check in with you by telehealth within 7 to 14 days. This visit can happen from home.

What to do before your telehealth visit

Before you schedule a telehealth visit, confirm with your doctor's office that the visit will be covered by Medicare. Tell them where you will be during the visit (your home, a clinic, etc.). The office staff should be able to tell you whether Medicare will pay and what you will owe.

Ask what technology you will need. Most telehealth visits use a video call through a find website or app. You will need a device with a camera and microphone (a computer, tablet, or smartphone) and an internet connection. The doctor's office should send you instructions before the visit, including a link to join the video call.

Test your internet connection and camera the day before if possible. Call the office if you have technical problems — they may be able to reschedule or offer an alternative.

Frequently Asked Questions

Can I use telehealth from my home if I live in a city?

Not for most visits covered by Original Medicare. You would need to go to a hospital, clinic, or doctor's office. However, mental health visits, substance use counseling, and some chronic disease management services can be delivered to your home in any location. Ask your provider whether your specific visit qualifies for one of these exceptions.

Does Medicare Advantage cover telehealth differently?

Yes. Each Medicare Advantage plan sets its own telehealth rules. Some cover telehealth from home in urban areas; others do not. Check your plan's coverage documents or call customer service to find out what your plan covers and what you will pay.

What if my internet is not good enough for a video call?

Tell your doctor's office before the visit. Some offices can do a phone visit instead, though you should confirm that Medicare will cover a phone visit with your specific provider. Not all phone visits are covered the same way as video visits.

Do I pay the same copay for telehealth as I do for an office visit?

Yes. Your copay, coinsurance, or deductible applies to telehealth the same way it applies to an office visit. The only difference is location — you do not travel to the office.

How do I know if my county is rural for Medicare telehealth purposes?

Check the CMS website for the county-by-county telehealth originating sites list, or call Medicare at 1-800-MEDICARE. Have your zip code or county name ready. The list changes, so check before each visit if you are unsure.