Before 2020, Medicare covered telehealth only in rural areas and only when patients traveled to an approved medical facility to connect with a remote provider. The pandemic changed everything. Congress temporarily expanded Medicare telehealth extension rules to allow beneficiaries to receive virtual care from home, and those expansions have been renewed repeatedly since. As of 2026, most pandemic-era telehealth flexibilities remain in place through at least the end of the fiscal year, though their long-term future depends on congressional action. For 60 million Americans on Medicare, these rules determine whether a video call with their doctor is covered or whether they must drive to a clinic. For a broader look at how virtual care works across all payers, our telehealth guide covers the fundamentals.
What the Medicare Telehealth Extension Actually Covers
Under the current extension, Medicare Part B covers more than 250 telehealth services that were previously in-person only. The most commonly used include:
- Office visits with primary care physicians and specialists
- Mental health services, including individual therapy, group therapy, and psychiatry
- Chronic care management visits for diabetes, hypertension, COPD, heart failure, and kidney disease
- Annual wellness visits (the “Welcome to Medicare” visit and subsequent yearly wellness exams)
- Substance use disorder treatment and counseling
- Physical therapy, occupational therapy, and speech-language pathology evaluations
- Certain emergency department evaluations (when referred by an ED physician)
- End-stage renal disease (ESRD) related services
- Transitional care management visits following hospital discharge
According to CMS data, telehealth utilization among Medicare beneficiaries reached 45% in 2023, up from under 1% in 2019. The agency considers the telehealth extension critical for maintaining access, particularly for beneficiaries with mobility limitations, chronic conditions requiring frequent follow-ups, and those living in areas with provider shortages.
The breadth of covered services goes far beyond what most beneficiaries realize. Many assume Medicare telehealth is limited to basic urgent care, but the list includes specialty consultations, complex care management, and rehabilitation services. If you can do it in a doctor’s office and it doesn’t require physical contact, it’s likely covered under the extension.
Key Rule Changes Under the Extension
Several pandemic-era flexibilities remain active under the current extension. Understanding them helps you know what’s available and what might change.
Home as an originating site: Before COVID, Medicare required patients to be at an approved healthcare facility (such as a rural health clinic or hospital outpatient department) to receive telehealth. Under the extension, your home qualifies as an “originating site.” This is the single most impactful change, as it eliminated the biggest barrier to telehealth adoption among seniors. Beneficiaries no longer need to drive anywhere to access a virtual visit.
Geographic restrictions suspended: The pre-pandemic rule limiting telehealth to rural areas designated as Health Professional Shortage Areas (HPSAs) is suspended. Beneficiaries in urban, suburban, and rural areas all have equal access to Medicare telehealth services. This matters enormously for the roughly 80% of Medicare beneficiaries who live in urban and suburban areas that were previously excluded.
Audio-only visits permitted: Medicare now covers certain services delivered by phone (audio-only) when a beneficiary doesn’t have access to video technology. This is particularly important for older adults who may lack smartphones, tablets, or reliable broadband internet. According to the Pew Research Center, about 25% of adults over 65 don’t use the internet, making video-based telehealth inaccessible. Audio-only coverage ensures these beneficiaries aren’t left behind.
Expanded provider types: Under the extension, a broader range of providers can deliver telehealth services, including physical therapists, occupational therapists, speech-language pathologists, and clinical psychologists. Pre-pandemic, many of these provider types were not eligible to bill Medicare for telehealth services.
Mental health telehealth: Congress made mental health telehealth coverage permanent in the Consolidated Appropriations Act of 2023. However, there’s a catch: beneficiaries must have an in-person visit with their mental health provider within the first six months of starting telehealth treatment, and at least once every 12 months thereafter. This requirement was designed as a quality safeguard to ensure the provider-patient relationship includes periodic face-to-face contact.
How Much Does Medicare Telehealth Cost?
Medicare covers telehealth visits at the same rate as in-person visits. This is an important point: there’s no discount or penalty for choosing telehealth over an office visit. For beneficiaries on Original Medicare (Parts A and B), this means:
You pay 20% of the Medicare-approved amount after meeting your Part B deductible ($257 in 2026). For a standard office visit billed at $100 to $150, your cost share would be $20 to $30. For a specialist consultation billed at $150 to $250, your share would be $30 to $50. If you have a Medigap (Medicare Supplement) plan, your supplemental insurance may cover part or all of this cost share, potentially reducing your out-of-pocket cost to $0.
Medicare Advantage (Part C) members may have different cost-sharing, often $0 to $20 copays for telehealth visits, depending on their plan. Many MA plans have added enhanced telehealth benefits as a way to attract enrollees, including 24/7 virtual urgent care through platforms like Teladoc or MDLIVE at $0 copay. These supplemental telehealth benefits go beyond what Original Medicare covers and represent a genuine advantage of MA plans for tech-savvy beneficiaries.
For beneficiaries managing multiple chronic conditions who see several specialists, understanding how costs accumulate matters. Our guide to healthcare costs provides context on how Medicare cost-sharing compares to other coverage types and strategies for managing out-of-pocket spending.
How to Access Medicare Telehealth
Through Your Existing Provider
The simplest path is asking your current doctor if they offer telehealth visits. Many primary care physicians, specialists, and therapists adopted video visit technology during the pandemic and continue to offer it. Your provider’s patient portal (often MyChart, Athenahealth, or a similar system) typically includes a telehealth scheduling option. The advantage of this approach is continuity: your doctor already knows your medical history, medications, and treatment plan.
Through Medicare Advantage Plan Platforms
If you’re on a Medicare Advantage plan, check your plan’s app or website for built-in telehealth services. Major MA carriers like UnitedHealthcare, Humana, Aetna, and Cigna offer 24/7 virtual urgent care through their own platforms at $0 copay on many plans. These platforms connect you with on-demand providers for acute issues like respiratory infections, UTIs, and rashes, which is especially valuable for evening and weekend needs.
Through Independent Telehealth Platforms
Platforms like Teladoc and MDLIVE accept Medicare for certain services. Verify that the platform and specific provider accept Medicare before scheduling, as not all providers on these platforms are credentialed with Medicare. Some platforms have dedicated Medicare enrollment flows that verify your eligibility and connect you with Medicare-participating providers.
Through Federally Qualified Health Centers (FQHCs)
FQHCs and Rural Health Clinics (RHCs) have expanded telehealth access for Medicare beneficiaries. If you receive care at a community health center, ask about their telehealth offerings. These facilities serve disproportionately underserved populations and have been at the forefront of telehealth adoption.
What Could Change After the Extension Expires
The Medicare telehealth extension is not permanent for most services. If Congress does not act before the current extension expires, several changes would take effect that would dramatically reduce telehealth access for beneficiaries:
The home-as-originating-site flexibility would end, requiring patients to travel to approved healthcare facilities for telehealth. Geographic restrictions would return, limiting telehealth to designated rural areas. Audio-only coverage for most services would end, excluding beneficiaries without video technology. The list of covered telehealth services would shrink from over 250 back to approximately 100. And certain provider types (physical therapists, occupational therapists) would lose the ability to bill Medicare for telehealth services.
The practical impact would be severe. Millions of urban and suburban Medicare beneficiaries who now conduct routine follow-up visits from home would need to travel to doctor’s offices for every appointment. Seniors with mobility limitations, those who rely on caregivers for transportation, and beneficiaries in nursing facilities would face reduced access to specialist care.
Bipartisan support for making these changes permanent is strong, and multiple bills have been introduced in both chambers of Congress. The CONNECT for Health Act and the Telehealth Modernization Act both aim to permanently eliminate geographic and originating-site restrictions. However, budget scoring concerns (CMS estimates that expanded telehealth access increases utilization and therefore costs) and competing legislative priorities have delayed passage. Advocacy organizations including the American Medical Association, AARP, and the American Hospital Association have all urged permanent telehealth access for Medicare.
Medicare Telehealth for Mental Health
Mental health is where Medicare telehealth has arguably had its greatest impact. The National Institute of Mental Health reports that depression affects approximately 7 million adults over 65, yet many lack access to in-person mental health providers. More than 60% of counties in the United States have no practicing psychiatrist, and wait times for a new patient appointment can stretch months in underserved areas. Telehealth has opened access for millions of seniors who previously went without care.
Congress made mental health telehealth a permanent Medicare benefit, which means it won’t disappear even if other telehealth flexibilities expire. The in-person visit requirement (one within the first six months, then annually) is designed to ensure quality of care while preserving virtual access. This compromise reflects the recognition that mental health care delivered via telehealth is both effective and essential.
Medicare covers a wide range of mental health telehealth services: individual psychotherapy, group therapy, psychiatric diagnostic evaluations, medication management, and substance use disorder counseling. The 20% cost share applies after the Part B deductible, though many Medigap and MA plans reduce or eliminate this cost share.
If you’re a Medicare beneficiary experiencing depression, anxiety, grief, or other mental health concerns, telehealth therapy is a covered benefit that you can access from your living room. Don’t let the stigma of mental health treatment or the inconvenience of in-person visits prevent you from getting help.
Frequently Asked Questions
Does Original Medicare cover telehealth in 2026?
Yes. Under the current telehealth extension, Original Medicare (Part B) covers more than 250 telehealth services, including office visits, mental health care, chronic disease management, and wellness visits. You pay 20% of the approved amount after your Part B deductible of $257.
Can I do a Medicare telehealth visit from home?
Yes, under the current extension. Your home is an approved originating site for Medicare telehealth. This flexibility was not available before the pandemic and depends on congressional renewal to continue for most services. Mental health telehealth from home has been made permanent.
Does Medicare cover phone-only doctor visits?
Yes. Medicare currently covers audio-only (phone) visits for certain services, including mental health care and some evaluation and management visits. This is especially important for beneficiaries without video technology or reliable internet access. Audio-only coverage is part of the temporary extension and would require congressional action to become permanent.
Will Medicare telehealth become permanent?
Mental health telehealth is already permanent under legislation passed in 2023. Other telehealth flexibilities, including the home originating site, geographic waivers, and audio-only coverage, require congressional action to become permanent. Multiple bipartisan bills have been introduced but not yet passed as of early 2026. Most healthcare policy experts expect eventual permanent extension, but the timeline remains uncertain.
Does my Medicare Advantage plan have better telehealth benefits?
Many Medicare Advantage plans offer enhanced telehealth benefits beyond what Original Medicare covers, including $0 copay virtual urgent care, 24/7 on-demand access, and partnerships with major telehealth platforms. Check your plan’s Evidence of Coverage document to understand your specific telehealth benefits.
What to Do Next
If you’re a Medicare beneficiary, don’t wait until you’re sick to set up telehealth access. Ask your primary care doctor and specialists whether they offer video visits and help them understand that Medicare covers these services. If you’re on a Medicare Advantage plan, explore your plan’s virtual care platform and verify your copay. Set up any required accounts and test the technology before you need it — making sure your camera and microphone work and that you have a stable internet connection saves frustration during an actual visit.
If your elected representatives haven’t heard from you on the telehealth extension, consider contacting them. Permanent access to home-based telehealth for Medicare beneficiaries is widely supported by both parties and the medical community, but it needs legislative action to become reality. AARP provides easy-to-use tools for contacting Congress on healthcare issues. Your voice matters in ensuring these benefits continue.