Medicare telehealth coverage is still available, but the rules have shifted

Medicare has not stopped covering telehealth visits. However, the temporary expansions that began during the COVID-19 pandemic have been narrowed. Starting in January 2024, Medicare reduced the number of conditions you can treat by telehealth and tightened rules about where you can be when you have a virtual visit. If you have been using telehealth regularly, your coverage may have changed, and some visits that were covered before may no longer be.

The key change is that Medicare now requires most telehealth visits to happen from your home, a doctor's office, or a hospital — not from other locations like a car or a retail clinic. Additionally, fewer types of visits may have access to for telehealth payment at all. Understanding what is still covered and what has changed will help you plan your care and know when to expect out-of-pocket costs.

Key Takeaways

  • Medicare still covers telehealth visits for many conditions, but the list is shorter than it was in 2023.
  • You must be in an approved location — your home, a doctor's office, a hospital, or a rural health clinic — for Medicare to pay for most telehealth visits.
  • Mental health visits, diabetes management, and some chronic disease check-ins remain covered by telehealth, but your specific condition may not be on the covered list.
  • Contact your doctor's office or your Medicare plan to confirm whether a telehealth visit for your condition will be covered before you schedule.

Which telehealth visits Medicare still covers

Medicare covers telehealth for a defined list of services. Mental health visits — including therapy and psychiatric appointments — remain covered. Telehealth is also covered for diabetes management, certain chronic disease monitoring visits, and some preventive care screenings. Visits with nurse practitioners, physician assistants, and clinical social workers by telehealth are covered under the same rules as doctor visits.

The exact list changes, and it depends partly on whether you have Original Medicare or a Medicare Advantage plan. Original Medicare follows the federal list set by the Centers for Medicare & Medicaid Services (CMS). Medicare Advantage plans can cover additional services beyond that list, so your plan may cover telehealth for conditions that Original Medicare does not. You can find the current CMS telehealth list on the Medicare website, but the fastest way to know whether your specific visit is covered is to call your doctor's office or your plan directly.

Location rules that affect your coverage

Medicare will only pay for most telehealth visits if you are in one of these locations: your home, your doctor's office, a hospital, a rural health clinic, a federally may have access to health center, or a hospital-based dialysis center. If you are somewhere else — in your car, at work, at a friend's house, or at a retail clinic — Medicare will not cover the telehealth visit, and you will owe the full cost.

The location rule has exceptions for a small number of conditions, mainly mental health and substance use disorder treatment. These visits may be covered from other locations in some cases, but you should confirm with your provider before the appointment. If you travel frequently or do not have a quiet place at home for a video visit, ask your doctor whether you can come to their office instead and have the visit by telehealth from the waiting room — many offices allow this.

What to do if your usual telehealth visit is no longer covered

If you have been having regular telehealth visits and suddenly receive a bill, the first step is to contact your doctor's office and ask why the visit was not covered. Sometimes the visit was coded incorrectly, or your plan has different rules than you expected. The office staff can often resubmit the claim with the correct information.

If the visit truly is not covered under the new rules, you have a few options. You can ask whether your doctor offers in-person visits instead, which may be covered under your regular Medicare benefits. You can also ask whether the doctor's office offers telehealth at a reduced cash price if you pay out of pocket. Some practices have sliding-scale fees or payment plans. If cost is a barrier, mention it to your doctor — they may be able to adjust the visit frequency or suggest lower-cost alternatives.

How to check coverage before you schedule

Before you book a telehealth appointment, call your doctor's office and ask: "Is this visit covered by telehealth under my Medicare plan?" Give them the reason for the visit and your plan type (Original Medicare or the name of your Medicare Advantage plan). They should be able to tell you whether the visit will be covered and what you might owe.

If you have Original Medicare, you can also check the CMS telehealth list yourself on Medicare.gov. Search for "telehealth services" and look for the current list of covered services. If you have a Medicare Advantage plan, log into your plan's website or call the customer service number on your insurance card — they have their own list of covered telehealth services, which may be longer than the Original Medicare list.

When to use telehealth versus in-person visits

Telehealth works well for follow-up visits, medication refills, and discussing test results when your doctor does not need to examine you. Mental health visits, diabetes check-ins, and chronic disease management are common telehealth uses that Medicare covers. However, if your doctor needs to examine you — to listen to your heart, check your blood pressure, or feel your abdomen — an in-person visit is necessary.

Some conditions require a mix of both. For example, you might have an in-person visit once a year for a full physical exam and use telehealth for routine follow-ups in between. Ask your doctor which approach makes sense for your condition. If you are unsure whether a telehealth visit is appropriate for what you need, your doctor can advise you — they are not allowed to push you toward telehealth if an in-person visit is medically necessary.

Questions to ask your doctor about telehealth coverage

Before your next appointment, ask your doctor's office these specific questions: Does this visit may have access to for telehealth under my Medicare plan? What location do I need to be in for the visit to be covered? If the visit is not covered by telehealth, what is the cost if I pay out of pocket? Can I have an in-person visit instead, and would that be covered?

If your doctor recommends telehealth but you are uncomfortable with it or do not have the technology, say so. Your doctor can discuss whether an in-person visit is an option. If you have had telehealth visits before and they were covered, do not assume they will be covered again — coverage rules have changed, and each visit should be confirmed before you schedule.

Frequently Asked Questions

Can I have a telehealth visit from my car or workplace?

Medicare will not cover most telehealth visits from a car, workplace, or any location outside the approved list. You must be at home, a doctor's office, a hospital, or a rural health clinic. The exception is mental health and substance use treatment, which may be covered from other locations in some cases. Always confirm the location rule with your provider before your appointment.

Does Medicare Advantage cover more telehealth than Original Medicare?

Yes, many Medicare Advantage plans cover telehealth for more conditions than Original Medicare does. Each plan sets its own rules, so coverage varies. Call your plan's customer service number to ask what telehealth services are covered under your specific plan.

If I get a bill for a telehealth visit, can I dispute it?

Yes. Contact your doctor's office first and ask why the visit was not covered. If they coded it incorrectly, they can resubmit. If the visit truly is not covered, you can file an appeal with Medicare or your Medicare Advantage plan. Your doctor's office can help you understand the denial and guide you through the appeal process if needed.

Are mental health telehealth visits still covered?

Yes, mental health visits by telehealth remain covered by Medicare. This includes therapy, psychiatric appointments, and counseling. Location rules are more flexible for mental health visits than for other types of care, so ask your provider where you need to be for your specific visit.

What if my doctor says my condition is not on the covered telehealth list?

If your condition is not covered by telehealth, ask whether an in-person visit is an option and whether that would be covered under your Medicare benefits. You can also ask your doctor whether they offer telehealth at a reduced cost if you pay out of pocket. Some practices work with patients on payment options when coverage is not available.