What Telehealth Services Are Covered by Medicare?

Telehealth has become a critical component of modern healthcare delivery, and Medicare has significantly expanded its coverage to meet patient needs. Understanding which services are covered can help you access care more conveniently and manage costs effectively. The landscape of Medicare telehealth coverage continues to evolve, particularly following pandemic-related expansions that have largely become permanent.

Whether you’re considering a virtual visit for a chronic condition or seeking mental health support, knowing your coverage options is essential. This guide breaks down Medicare’s telehealth benefits, eligibility requirements, and how costs are handled across different plan types.

Which Specific Medical Services Does Medicare Cover via Telehealth?

Medicare covers a comprehensive list of telehealth services. Virtual office visits with physicians are covered, along with consultations with specialists across nearly all medical fields. Mental health services are particularly well-covered, including psychiatry, psychology, and clinical social work. Nurse practitioner and physician assistant visits are also eligible for telehealth coverage. Additionally, Medicare covers certain diagnostic services like EKGs and remote patient monitoring for chronic conditions. Online doctor visits have become increasingly accessible through this expanded coverage.

Are There Eligibility Requirements or Restrictions for Medicare Telehealth Coverage?

Medicare’s telehealth eligibility rules have become more flexible. For most services, there’s no requirement for a prior in-person visit—you can receive your first consultation via telehealth. However, some specialists may prefer establishing an in-person relationship first. Geographic restrictions have been largely eliminated, meaning you can access telehealth services from anywhere, not just rural areas. Your provider must be Medicare-enrolled and licensed in your state. Healthcare access has improved significantly through these relaxed restrictions.

How Much Does Medicare Pay for Telehealth Visits Compared to In-Person Visits?

Medicare’s reimbursement rates for telehealth are equal to in-person visit rates for most services. This parity ensures that providers have no financial incentive to prefer one format over another. Your out-of-pocket costs—including copays, coinsurance, and deductibles—apply the same way as they would for an in-person visit. Original Medicare covers 80% of approved telehealth services after you’ve met your deductible, and you’re responsible for the remaining 20%.

What Are the Differences Between Medicare Original and Medicare Advantage Telehealth Coverage?

Original Medicare provides standardized telehealth coverage across the country, ensuring consistent benefits regardless of location. Medicare Advantage plans have flexibility to expand coverage beyond Original Medicare’s offerings, and many do—some include virtual visits as a standard benefit with minimal or no copay. However, they may also restrict coverage to in-network providers. It’s crucial to review your specific plan’s telehealth benefits, as they vary significantly between insurers. Digital health options may be more comprehensive under certain Advantage plans.

Which Telehealth Platforms and Providers Are In-Network with Medicare?

Medicare doesn’t maintain a specific list of approved telehealth platforms. Instead, coverage depends on whether your provider is Medicare-enrolled. Major platforms like MDLive and other online doctor services accept Medicare, but you should always confirm before your visit. For Medicare Advantage plans, check your plan’s provider directory to identify in-network telehealth options and avoid unexpected out-of-pocket costs.

Are There Copays or Out-of-Pocket Costs for Medicare Telehealth Services?

Yes, copays and deductibles apply to Medicare telehealth services. Under Original Medicare, you pay 20% coinsurance after meeting your annual deductible ($240 for 2024). Medicare Advantage plans vary—some offer $0 copay telehealth visits as an incentive, while others charge standard copays similar to in-person visits. Mental health services may have different cost structures. Always check your plan documents or call your Medicare plan before scheduling a telehealth visit to understand your exact out-of-pocket responsibility.

How Has Medicare Telehealth Coverage Changed Recently?

Medicare’s telehealth expansion during COVID-19 has largely become permanent. Services that were temporarily covered—like virtual office visits and remote patient monitoring—are now standard benefits. Geographic restrictions that limited telehealth to rural areas have been eliminated. The Centers for Medicare & Medicaid Services (CMS) continues evaluating which additional services should be covered. Recent updates include expanded mental health services and improved online appointment scheduling accessibility. Check the CMS website for the latest coverage updates.

Frequently Asked Questions

Can I use any video platform for Medicare telehealth visits?

Your healthcare provider chooses the telehealth platform, which must comply with HIPAA privacy regulations. Ask your provider which platform they use before your appointment.

Do I need internet or a smartphone for Medicare telehealth?

Most telehealth visits require video, but some providers offer phone-only consultations if you lack video capability. Ensure you have stable internet before scheduling.

Is prescription medication available through Medicare telehealth visits?

Medicare-covered telehealth providers can issue prescriptions, including refills. Controlled substances require specific conditions, including a prior in-person visit in most cases.