Medicare is still paying for telehealth, but the rules have narrowed

Medicare has not stopped covering telehealth visits. However, the temporary expansions that began during the pandemic have largely ended, and coverage now depends on where you live, what type of provider you see, and what condition you are being treated for. If you have been using telehealth regularly, your coverage may have changed without notice, and some visits that were covered before may no longer be.

The key shift happened because Congress allowed the emergency telehealth rules to expire. Starting in 2024, Medicare returned to stricter rules about which telehealth services it will pay for. This means some people lost coverage for routine video visits, while others kept it depending on their circumstances.

Key Takeaways

  • Medicare still covers telehealth for established patients in rural areas and for certain chronic conditions, but the broad pandemic-era coverage has ended.
  • Your location matters: if you live in a rural area or a Health Professional Shortage Area (HPSA), you have more telehealth options than someone in an urban area.
  • Some telehealth visits are covered only if you have seen the provider in person within the past three years, which was not required during the pandemic.
  • Mental health and behavioral health telehealth visits remain covered more broadly than other types of care, even in urban areas.
  • Your specific Medicare plan (Original Medicare, Medicare Advantage, or Medigap) may cover telehealth differently, so you should check your plan documents or call your plan directly.

What Medicare still covers for telehealth

Medicare covers video visits with doctors, nurse practitioners, physician assistants, and mental health counselors if you meet certain conditions. The most reliable coverage is for mental health visits — therapy, psychiatric appointments, and counseling sessions are covered by Original Medicare in most places, regardless of whether you live in a rural or urban area.

If you live in a rural area or a designated Health Professional Shortage Area (HPSA), Medicare covers a broader range of telehealth visits. This includes routine office visits, follow-ups for chronic conditions, and preventive care. You can find out whether your zip code qualifies by searching the HRSA shortage area tool on the Health Resources and Services Administration website.

Established patients — people who have seen the provider in person within the past three years — can have telehealth visits covered more consistently than new patients. This in-person visit requirement is one of the biggest changes from the pandemic rules, when you could start care entirely by video.

What changed when the emergency rules ended

During the COVID-19 pandemic, Medicare temporarily allowed telehealth visits for almost any condition, from anywhere, without requiring an in-person visit first. Patients in cities could see rural providers by video. Providers could offer telehealth to new patients. These rules were meant to be temporary.

Congress extended these rules several times, but allowed them to expire at the end of 2024. Now Medicare has returned to its pre-pandemic telehealth rules, with some narrow exceptions. The biggest loss is that urban patients with routine conditions can no longer use telehealth as easily as they could during the pandemic.

If you have been having regular telehealth visits and your coverage suddenly stopped, the most likely reason is that you do not live in a rural area or HPSA, or your condition does not fall into the categories Medicare still covers by video. You may need to schedule an in-person visit or find a different way to receive care.

How to find out what your specific coverage is

Your coverage depends on three things: where you live, what type of Medicare you have, and what condition you are being treated for. The fastest way to know for certain is to call your plan directly.

If you have Original Medicare, call 1-800-MEDICARE (1-800-633-4227) and ask whether telehealth is covered for your specific condition and location. Have your zip code ready, and be specific about what type of visit you need — for example, "a follow-up visit for diabetes" or "a therapy session."

If you have Medicare Advantage or a Medigap plan, call the plan's customer service number on the back of your card. Plans vary widely in their telehealth coverage, and some cover more than Original Medicare does. Some Medicare Advantage plans still cover telehealth visits in urban areas for established patients, even though Original Medicare does not.

You can also ask your doctor's office whether they offer telehealth and whether it is covered under your plan. Many offices have already adjusted their systems and can tell you when ready whether a video visit is an option.

Rural and HPSA coverage: the most reliable telehealth option

If you live in a rural area or a Health Professional Shortage Area, Medicare's telehealth coverage is much broader. You can have video visits for most conditions, including routine office visits, chronic disease management, and preventive care. You do not need to have seen the provider in person first.

To find out whether your area qualifies, use the HRSA shortage area tool at data.hrsa.gov. Enter your zip code or address. If your area is designated as a HPSA or rural area, you can tell your provider that you are in a may have access to area and ask about telehealth options.

Rural patients also have access to telehealth from providers who are not in their area. This means you can see a specialist in a city without traveling, as long as the provider offers telehealth and accepts Medicare.

Mental health and behavioral health telehealth

Mental health coverage is the exception to the stricter rules. Medicare covers telehealth visits with psychiatrists, psychologists, licensed clinical social workers, and counselors in most places, even in urban areas. This includes therapy sessions, psychiatric medication management, and behavioral health consultations.

You do not need to live in a rural area to have mental health telehealth covered. You do need to be an established patient — you should have seen the provider in person at least once — but after that, ongoing visits by video are covered.

If you have been using telehealth for mental health and your coverage stopped, the most likely reason is that you have not had an in-person visit with that provider in the past three years. Scheduling one in-person visit can restore your telehealth coverage for future appointments.

What to do if your telehealth coverage ended

If you were having telehealth visits and they are no longer covered, you have several options. First, confirm that coverage actually ended by calling your plan — sometimes coverage changes are not communicated clearly, and you may still be covered.

If coverage has ended, ask your provider whether they can schedule an in-person visit. After you have seen them in person, telehealth visits may become covered again. Some providers offer hybrid care — an in-person visit every few months and telehealth visits in between.

If you cannot travel for an in-person visit, ask whether your provider offers telehealth at a patient cost. Some doctors charge a cash fee for video visits that Medicare will not cover. This is usually less expensive than an in-person visit, though prices vary.

You can also look for providers in your area who offer in-person visits and ask whether they use telehealth for follow-ups. Many primary care doctors and specialists now offer a mix of both.

Medicare Advantage and Medigap telehealth coverage

Medicare Advantage plans and Medigap plans set their own telehealth rules within Medicare's framework. Some Medicare Advantage plans cover more telehealth than Original Medicare does — for example, some still cover routine video visits in urban areas for established patients.

Check your plan documents or call your plan's customer service to find out what telehealth is covered. The coverage varies significantly from plan to plan, even among plans offered by the same insurance company.

Medigap plans do not set their own telehealth rules — they follow Original Medicare's coverage. However, if you have Original Medicare plus a Medigap plan, your Medigap plan may cover some out-of-pocket costs if you do need to see a provider in person instead of by video.

Frequently Asked Questions

Can I have a telehealth visit if I have never seen this doctor before?

For most conditions, no — Medicare requires an in-person visit within the past three years before covering telehealth. The exception is mental health care, which can sometimes be started by telehealth. If you live in a rural area or HPSA, the rules are more flexible. Call your plan to ask about your specific situation.

Does Medicare Advantage cover more telehealth than Original Medicare?

Some Medicare Advantage plans do cover more telehealth, especially for routine visits in urban areas. Coverage varies by plan and by insurance company. Check your plan documents or call your plan's customer service number to find out what is covered under your specific plan.

If I live in a rural area, can I see any doctor by telehealth?

You can see any Medicare provider who offers telehealth, regardless of where they are located. However, the provider must accept Medicare and must be willing to offer telehealth. Call the provider's office to ask whether they offer video visits and whether they accept your type of Medicare.

What if my doctor says telehealth is not covered but I think it should be?

Call your Medicare plan directly and describe your situation — your location, your condition, and whether you have seen this provider before. Ask the plan representative to confirm whether the visit should be covered. If there is a disagreement, you can file a coverage information request with your plan.

Are there any telehealth services that Medicare covers everywhere, for everyone?

Mental health and behavioral health visits are the most consistently covered telehealth service across all areas and all patient types. Preventive services like annual wellness visits may also be covered by telehealth in some cases. For anything else, coverage depends on your location and whether you are an established patient.