Does Medicare Cover Telehealth Services?

Telehealth is the delivery of health services remotely through digital communications or telecommunications. This includes live video conferencing over smartphones, tablets and computers through mobile health apps.

It is part of a much larger field called telemedicine that applies to wide-ranging virtual health and medical services.

Telehealth applies to a relatively narrow list of virtual services, including long-distance clinical health care, health-related education for both patients and medical professionals, and public health efforts.

Not all telehealth services are covered by Medicare. Those that are will be covered by Part B. They are also covered by Medicare Advantage plans, but the list of services and costs may vary.

Part B Coverage

Telehealth services are typically covered under Part B. This is because while the medium is different, the actual services are often the same that you would receive from an in-person doctor’s visit or consultation.

For Medicare to cover them, telehealth services must be provided by an eligible health care provider using an interactive two-way communications system — typically real-time audio and video.

Medicare Advantage Coverage

Medicare Advantage plans are provided through private insurers and are available regionally, so coverage differs from plan to plan. Medicare Advantage plans must at minimum include everything that is covered under Original Medicare, so telehealth services are covered.

These plans often include expanded benefits and coverage beyond what is available in Original Medicare, and that can include expanded or enhanced telehealth coverage. But you do typically have to remain within a network if you have Medicare Advantage.

Examples of Medicare-Covered Telehealth Services

Medicare covers office visits, consultations, psychotherapy and certain other services. Since telehealth is a relatively new field of medicine, Medicare may adjust the services covered as new ones emerge. Just recently, according to AARP, coverage was expanded to increase the availability of mental health services available via telehealth.

There are some disparities in telehealth coverage that may need to be eventually addressed as well. A recent study found that telehealth users were more likely to live in urban areas than rural areas.

This is an interesting development since telehealth seemingly could be most beneficial for those who don’t live in an area where in-person medical services are readily available.

Telehealth Costs Under Medicare

As with other Part B-covered services, Medicare will handle 80% of the cost of telehealth. This leaves you to pay 20% of the cost after you have met your Part B deductible.

If you have a Medicare Advantage plan, your costs may vary since each plan is unique. The cost of a telehealth visit is not necessarily less than the cost of an in-person doctor’s visit.

The U.S. Centers for Medicare & Medicaid Services (CMS), which administers Medicare, expanded telehealth coverage early in the COVID-19 pandemic. CMS added 135 new services it would cover — effectively doubling the number of covered telehealth services.

Even as the pandemic has lessened in 2021 and 2022, telehealth expansion has not, with mental health services available via telehealth recently expanding. Telehealth coverage options available through Medicare may continue to grow as these services become more common.

Prior to the pandemic, telehealth services were typically limited to people in rural areas who could not easily travel to the appropriate health care professionals’ offices.

But according to the U.S. Department of Health and Human Services, the total number of telehealth visits in the United States jumped from 840,000 in 2019 to more than 52 million in 2020.

The pandemic-related expansions of Medicare-covered telehealth services were originally meant to be temporary when they were first approved, lasting only until the health emergency is over. But as telehealth continues to expand and grow in importance, it is unclear if that will remain the case as the pandemic continues to move toward a conclusion.