Telehealth and Virtual Visits: What Patients Should Know

What telehealth is

Medicare.gov's telehealth coverage page describes telehealth as medical or health services you get from a provider located somewhere else in the U.S., using audio and video technology, or audio-only communication in some cases, such as through your phone or a computer.

The same page lists several ways to communicate with a provider remotely:

• Telehealth visits: real-time video or phone visits that replace an office visit, psychotherapy session or consultation.
• E-visits: non-face-to-face communications, usually through an online patient portal.
• Virtual check-ins: brief, real-time communications that usually last 10 minutes or less.

Telehealth is not suitable for everything. A provider may still need to examine you in person, order lab work or imaging, or refer you to an office. For an emergency, call 911 rather than booking a video visit.

Medicare telehealth coverage

Through December 31, 2027

According to Medicare.gov, through December 31, 2027 Medicare covers telehealth services that you can get from anywhere in the U.S., including your home. Examples listed by Medicare include advance care planning, cognitive assessments, depression screenings, diabetes self-management training, medical nutrition therapy and outpatient psychotherapy, and Medicare may cover more.

The CMS Medicare telehealth FAQ adds that through the same date an extended range of practitioners may bill for telehealth, and patients may continue to receive audio-only telehealth services in their homes.

What you pay

Medicare.gov says that after you meet the Part B deductible, you pay 20% of the Medicare-approved amount for your provider's services, and that for most telehealth services you pay the same amount as for an in-person visit. Whether the provider accepts assignment still matters; see our Medicare assignment guide.

From January 1, 2028

Under current law, the CMS FAQ explains that starting January 1, 2028, except for behavioral health services, beneficiaries will generally need to be in a medical facility and in a rural area to receive Medicare telehealth services. From the same date, physical therapists, occupational therapists, speech-language pathologists and audiologists can no longer furnish Medicare telehealth services.

These dates are set by law and have changed before, so check the Medicare.gov page before relying on one.

Behavioral and mental health care

The CMS FAQ states that the Consolidated Appropriations Act, 2021 permanently removed geographic and place of service restrictions for behavioral health telehealth, so patients in rural and urban areas can receive it at home. It also notes that the law requires an in-person, non-telehealth visit within 6 months before the first mental health telehealth service, a requirement that takes effect after December 31, 2027.

Medicare Advantage and other plans

Medicare.gov notes that Medicare Advantage plans and some providers in Original Medicare may offer more telehealth benefits than basic Original Medicare coverage. Employer, Marketplace and Medicaid plans set their own telehealth rules and copays, so check your plan documents.

Licensing across state lines

HHS explains on telehealth.hhs.gov that health professionals must meet the licensure requirements of the state where they are located and be licensed or legally permitted to practice in the state where the patient is located. In practice, this means the state you are in during the visit matters, not only the state where the clinician's office is.

If you travel or live part of the year in another state, ask whether the clinician can see you there. The Interstate Medical Licensure Compact makes it faster for qualified physicians to get licenses in member states, but each state still issues its own license.

Privacy and security

During the COVID-19 public health emergency, the HHS Office for Civil Rights temporarily relaxed enforcement of some HIPAA rules for telehealth. Its notice of expiration states that those notifications of enforcement discretion expired on May 11, 2023, followed by a transition period that ended on August 9, 2023. Since then, providers covered by HIPAA must follow the HIPAA Rules when they provide telehealth.

OCR's page on HIPAA and telehealth also offers privacy and security tips for patients. Simple steps help too:

• Join the visit from a private place and use a link or app the office gave you.
• Use your own device and a secure internet connection rather than public Wi-Fi if you can.
• Be wary of unexpected messages asking for your insurance or payment details.

Prescriptions after a video visit

Many medications can be prescribed after a telehealth visit, as they would be after an office visit. Controlled substances follow separate federal rules. The Drug Enforcement Administration and HHS have extended the COVID-19 era telemedicine flexibilities for prescribing controlled medications several times; the most recent fourth temporary extension is effective from January 1, 2026 through December 31, 2026. Rules after that date depend on further federal action, so ask the prescriber how it affects you.

Preparing for a telehealth visit

• Test the app or link, camera, microphone and connection before the appointment.
• Have your medication list, recent readings (for example blood pressure or blood sugar, if you track them) and questions ready.
• Know the address where you are, in case the clinician needs to send help.
• Ask what happens if the connection drops and how to reach the office afterwards.
• Confirm the cost before the visit, especially if you have a plan other than Original Medicare.

The telehealth indicator on T-MedInfo profiles

Some clinician profiles show "Telehealth (some services)". This comes from the CMS Doctors and Clinicians file. Its data dictionary defines the telehealth indicator as "Y" when Medicare fee-for-service claims indicate that the clinician offers telehealth services over video and/or audio.

The CMS telehealth indicator fact sheet explains how the indicator is built: CMS looks for paid Medicare claims billed as telehealth (telehealth place of service codes 02 and 10, or modifier 95), uses a 6-month lookback period and refreshes the indicator "bimonthly, as technically feasible", on the same schedule as other clinician directory information. On Medicare's compare tool the indicator comes with a statement that the clinician provides some, not all, services through telehealth, and the label on T-MedInfo profiles follows the same wording. The data dictionary describes a 12-month claims lookback for the file as a whole; the 6-month period is the one CMS gives for the telehealth indicator.

That means:

• The indicator is based on what the clinician billed to Original Medicare, not on a statement by the clinician or a booking system.
• A clinician without the indicator may still offer telehealth, for example to patients with other insurance.
• Profiles show the value from the copy of the CMS file we loaded most recently, so it can differ from what Medicare.gov shows today.
• The indicator does not say which services are available by video, which states the clinician can see patients in, or whether they are taking new patients.

Specialty benchmark sections on profiles may also show the share of clinicians in the same specialty and area that have the indicator, calculated from the same CMS data. Always confirm with the office whether a telehealth visit is possible for your situation.