Does Medicare Cover Virtual Check-Ins and E-Visits?
Medicare covers virtual check-ins and E-visits. You must initiate contact with your doctor or healthcare provider for Medicare to cover these types of telehealth. After you meet your Part B deductible, you will pay 20 percent of the cost for virtual check-in and E-visit services.
Does Medicare Cover Virtual Office Visits?
Virtual office visits with your doctor or healthcare provider are covered under Medicare but with specific requirements based on type.
This first type is a virtual check-in, which is a digital check-up with your doctor that you can initiate to avoid a visit to their office. An E-visit is the second type and is conducted through an online patient portal.
While E-visits and check-ins are useful in many scenarios, telehealth services have become especially prominent since the advent of the COVID-19 pandemic. According to the U.S. Centers for Disease Control and Prevention, about 30.2 percent of 2020 health center visits from June 26th to November 6th were telehealth visits.
Medicare Part B covers 80 percent of the cost for both services.
Medicare Coverage of Virtual Check-Ins
Virtual check-ins – also known as brief communication technology-based services – are covered if you meet several requirements. In addition, you must be the one to initiate contact with your doctor to begin a visit.
Your virtual check-in also cannot be related to a medical visit from the past week for Medicare to cover it. It also will not be covered if it results in a medical visit in the next 24 hours or at the first available appointment.
- Phone call
- Text message
Virtual check-ins take place with a doctor with whom you already have an established relationship. Also, you must verbally consent to the visit – which is a one-time decision that can cover a years’ worth of virtual check-ins.
Medicare Coverage of E-Visits
Medicare covers E-visits and will pay for 80 percent of the cost after you meet your deductible. E-visits allow you to communicate with your doctor through an online patient portal without having to go into a doctor’s office.
- Physician assistants
- Physical therapists
- Clinical psychologists
- Nurse practitioners
Remember: Medicare will only cover the visit if you initiate the appointment first and already have a relationship with the doctor or healthcare provider. After initiation, you’ll need to attend your appointment within seven days.
Medicare Advantage, also known as Medicare Part C, also covers virtual check-ins and E-visits.
Medicare Advantage plans, which private insurers provide, include everything in Original Medicare and some additional benefits.
If you have Medicare Advantage, check with your plan provider to determine how virtual check-ins and E-visits are covered.
Virtual office visits should be available to you almost anywhere in the country.
6 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2020, March 17). Medicare Telemedicine Health Care Provider Fact Sheet. Retrieved from https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
- U.S. Centers for Disease Control and Prevention. (2021, February 19). Trends in Use of Telehealth Among Health Centers During COVID-19 Pandemic – United States, June 26 – November 6, 2020. Retrieved from https://www.cdc.gov/mmwr/volumes/70/wr/mm7007a3.htm
- Harvard Medical School. (n.d.). Telehealth: The advantages and disadvantages. Retrieved from https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages
- U.S. Centers for Medicare & Medicaid Services. (n.d.). E-visits. Retrieved from https://www.medicare.gov/coverage/e-visits
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Telehealth for providers: What you need to know. Retrieved from https://www.cms.gov/files/document/telehealth-toolkit-providers.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Virtual check-ins. Retrieved from https://www.medicare.gov/coverage/virtual-check-ins