Medicare Telehealth Coverage in 2026: What Is and Isn't Covered

Telehealth has transformed the way millions of Medicare beneficiaries receive care. What began as an emergency response to the COVID-19 pandemic has evolved into a permanent feature of the Medicare program, though the rules governing which services are covered, where you can receive them, and how they are billed continue to shift. In 2026, Medicare telehealth sits at a crossroads between temporary congressional extensions and newly permanent policies.

If you are enrolled in Original Medicare or a Medicare Advantage plan, understanding your telehealth benefits can help you access care more conveniently, avoid unnecessary trips, and potentially reduce out-of-pocket costs. This guide explains everything you need to know about Medicare telehealth coverage in 2026 — what is covered, what is not, how behavioral health rules have changed permanently, and how to take advantage of virtual care options.

A Brief History of Medicare Telehealth: From Emergency to Permanence

Before the COVID-19 pandemic, Medicare telehealth was extremely limited. Federal law restricted coverage to beneficiaries located in designated rural areas, and the patient had to travel to an approved originating site — typically a doctor's office, hospital, or clinic — to receive the telehealth service. Home-based telehealth was not covered. Audio-only phone calls were not covered. The result was that very few Medicare beneficiaries actually used telehealth.

The public health emergency (PHE) declared in March 2020 changed everything. CMS used emergency authority to waive geographic restrictions, allow patients to receive telehealth from home, add over 250 services to the telehealth-eligible list, permit audio-only visits, and authorize Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to provide telehealth. Telehealth usage among Medicare beneficiaries surged from roughly 1% of visits pre-pandemic to over 40% at the peak.

When the PHE ended on May 11, 2023, Congress stepped in to prevent a sudden loss of telehealth access. Through a series of appropriations and omnibus bills, lawmakers extended most telehealth flexibilities temporarily. Some provisions have since been made permanent through legislation, while others remain on short-term extensions. Understanding which rules are permanent and which are temporary is essential for beneficiaries planning their care in 2026.

What Changed Permanently: Behavioral Health Telehealth

The most significant permanent telehealth change in Medicare is the expansion of behavioral health services. Under the Consolidated Appropriations Act of 2023 and subsequent CMS rulemaking, the following behavioral health telehealth provisions are now permanent features of Medicare:

• Home as an originating site: Medicare beneficiaries can permanently receive behavioral health telehealth services from their home. There is no requirement to travel to a clinic or approved facility.
• Audio-only telephone visits: Audio-only behavioral health visits via telephone are permanently covered. This is critical for beneficiaries in areas with poor broadband access or those who lack video-capable devices.
• No geographic restrictions: Beneficiaries in urban, suburban, and rural areas are all eligible for behavioral health telehealth. The old requirement that the patient be in a rural Health Professional Shortage Area does not apply to behavioral health.
• Eligible provider types: Psychiatrists, psychologists, clinical social workers, licensed professional counselors, marriage and family therapists, and other qualified behavioral health providers can deliver telehealth services.

These permanent changes are a major step forward for Medicare mental health coverage. Before the pandemic, accessing a psychiatrist or therapist through Medicare often required long drives and weeks-long wait times, particularly in rural areas. Permanent telehealth access removes one of the biggest barriers to behavioral health care for the 65-and-older population.

The In-Person Visit Requirement Waiver (Through 2027)

When CMS made behavioral health telehealth permanent, it included a requirement that patients have an initial in-person visit with their telehealth provider within six months of the first virtual appointment and at least one in-person visit every 12 months afterward. However, Congress recognized that this requirement could undermine the very access that telehealth was designed to improve, especially for homebound individuals or those in provider-shortage areas.

Through subsequent legislation, the in-person visit requirement has been waived through December 31, 2027. This means that throughout all of 2026, you can begin and continue behavioral health telehealth treatment without ever visiting the provider in person. If the waiver is not extended beyond 2027, beneficiaries would need to plan for an in-person visit before the end of that year.

Temporarily Extended Telehealth Flexibilities in 2026

Beyond the permanently established behavioral health provisions, several other important telehealth flexibilities remain in effect through temporary congressional extensions. These apply to the broader set of Medicare telehealth services, not just behavioral health:

• Geographic restriction waiver: All Medicare beneficiaries, regardless of whether they live in a rural or urban area, can access telehealth services. This removes the pre-pandemic requirement that the patient be located in a rural county or Health Professional Shortage Area.
• Home as an originating site for all services: Beneficiaries can receive any telehealth-eligible service from home, not just behavioral health. This covers primary care check-ups, chronic disease management, specialist consultations, and more.
• Audio-only coverage for non-behavioral services: Phone-only visits for certain evaluation and management services outside of behavioral health are covered under the temporary extension, though at potentially lower reimbursement rates than video visits.
• FQHCs and RHCs as distant sites: Federally Qualified Health Centers and Rural Health Clinics can continue to bill Medicare for telehealth services they provide as distant-site practitioners. Before the pandemic, this was not allowed.
• Expanded provider eligibility: Occupational therapists, physical therapists, speech-language pathologists, and audiologists can furnish certain services via telehealth under the temporary extensions.

These temporary provisions are subject to future congressional action. If Congress does not renew them, some telehealth services could revert to pre-pandemic restrictions, including the rural-only geographic requirement and the prohibition on home-based originating sites for non-behavioral-health visits. Beneficiaries and providers alike are strongly advocating for these flexibilities to become permanent.

What Services Are Covered via Medicare Telehealth?

CMS maintains a list of telehealth-eligible services that is updated annually through the Medicare Physician Fee Schedule. In 2026, more than 250 services can be delivered via telehealth. The most commonly used include:

• Office visits for new and established patients (evaluation and management codes)
• Mental health counseling and psychiatric evaluations
• Substance use disorder treatment and counseling
• Chronic care management and principal care management
• Annual Wellness Visits
• Follow-up visits after surgery or hospitalization
• Diabetes self-management training and medical nutrition therapy
• Certain physical therapy, occupational therapy, and speech therapy services
• Remote patient monitoring for chronic conditions like hypertension, diabetes, and COPD
• End-stage renal disease (ESRD) related services

What Is Not Covered via Telehealth

Not all Medicare services can be delivered remotely. Services that require a physical examination, hands-on procedure, or diagnostic imaging must still take place in person. Examples include:

• Surgical procedures and biopsies
• Lab work and blood draws
• X-rays, MRIs, CT scans, and other imaging
• Vaccinations and injections
• Emergency room and urgent physical care
• Durable medical equipment fittings (such as prosthetics or orthotics)

In general, if a service requires the provider to physically touch you, operate equipment, or collect a specimen, it cannot be done via telehealth. However, many follow-up appointments related to these services can be conducted virtually — for example, reviewing lab results, discussing imaging findings, or adjusting a treatment plan after a procedure.

Original Medicare vs. Medicare Advantage Telehealth Benefits

Telehealth coverage differs meaningfully between Original Medicare and Medicare Advantage plans. Understanding these differences can help you choose the right coverage path.

Original Medicare (Parts A and B)

Under Original Medicare, telehealth services are covered under Part B. The same rules that apply to in-person Part B services generally apply to telehealth visits:

1. You must meet the annual Part B deductible before Medicare begins paying its share. For 2026, the Part B deductible is $257.
2. After the deductible, you pay 20% coinsurance for most Part B services, including telehealth. Medicare pays the remaining 80%.
3. The provider must accept Medicare assignment. If your provider does not accept assignment, you could owe more than the standard 20% coinsurance.
4. There is no out-of-pocket maximum under Original Medicare. If you use many services throughout the year, costs can add up. This is why many beneficiaries purchase a Medigap policy.

To understand the full picture of what you may owe, see our complete guide to Medicare costs in 2026.

Medicare Advantage (Part C)

Medicare Advantage plans must cover all telehealth services that Original Medicare covers. However, they frequently offer additional telehealth benefits that go beyond what Original Medicare provides. These supplemental telehealth benefits may include:

• 24/7 virtual urgent care with $0 copay through partnered telehealth platforms like Teladoc, MDLIVE, or Amwell
• Virtual specialist consultations including dermatology, cardiology, endocrinology, and more
• Expanded remote patient monitoring programs with connected health devices shipped to your home
• Virtual behavioral health programs with no copay or reduced cost-sharing
• Telehealth-based chronic disease management programs for conditions like heart failure, diabetes, and COPD

Medicare Advantage plans also have an annual out-of-pocket maximum — capped at $9,350 for in-network services in 2026 — which provides financial protection that Original Medicare alone does not offer. Telehealth copays in Medicare Advantage plans are often lower than in-person copays, making virtual visits an attractive option for routine care. However, network restrictions apply, and you generally must use providers within the plan's telehealth network.

What Does a Medicare Telehealth Visit Cost?

Telehealth visits under Medicare are billed at the same rates as comparable in-person visits. This was an intentional policy decision to ensure providers had no financial disincentive to offer telehealth. For beneficiaries, this means that your out-of-pocket cost for a telehealth visit will generally be similar to what you would pay in person.

Here is what you can expect to pay for common telehealth visits in 2026:

• Primary care telehealth visit (Original Medicare): After the $257 Part B deductible, you owe 20% coinsurance. A typical 15-to-25-minute visit billed at $130 to $200 means your share is roughly $26 to $40.
• Behavioral health telehealth visit (Original Medicare): After the deductible, you owe 20% coinsurance. A 45-to-60-minute therapy session billed at $150 to $250 means your share is approximately $30 to $50.
• Medicare Advantage telehealth visit: Costs vary by plan. Many plans charge $0 to $20 for primary care telehealth and $0 to $40 for specialist telehealth visits. Virtual urgent care is often $0.
• With Medigap (Medicare Supplement): If you have a Medigap plan like Plan G, your supplement covers the 20% coinsurance after the Part B deductible. Your out-of-pocket cost may be $0 after you meet the deductible.

Keep in mind that while the Medicare-approved amount for telehealth is the same as in-person, you save on indirect costs. There is no transportation expense, no parking fee, no time spent in a waiting room, and no need to arrange for someone to drive you. For beneficiaries with mobility challenges or those living far from their provider, these savings can be substantial.

Rural vs. Urban Telehealth Coverage Differences

One of the most important telehealth policy questions is whether geographic restrictions will return. Under pre-pandemic rules, most Medicare telehealth services were restricted to beneficiaries living in rural counties or Health Professional Shortage Areas. The patient also had to be physically present at an approved originating site — typically a hospital, physician's office, or clinic — rather than at home.

In 2026, those geographic and originating-site restrictions remain waived through congressional extensions for all Medicare telehealth services. This means urban, suburban, and rural beneficiaries have equal telehealth access. However, there are some practical differences:

• Broadband access: Rural beneficiaries are more likely to lack high-speed internet, which can limit video telehealth. The permanent coverage of audio-only behavioral health visits partially addresses this gap, but broadband limitations remain a barrier for video-based services.
• FQHC and RHC availability: FQHCs and RHCs are disproportionately located in rural and underserved areas. The continued authorization for these facilities to provide telehealth directly benefits rural populations who may have limited access to other providers.
• Medicare Advantage availability: In some rural counties, fewer Medicare Advantage plans are available, which means fewer supplemental telehealth benefits. Beneficiaries in these areas may rely more heavily on Original Medicare telehealth coverage.
• Provider shortages: Telehealth can connect rural patients to specialists hundreds of miles away, helping to overcome the provider shortage that affects many rural communities. This is especially valuable for behavioral health, where rural provider shortages are acute.

If the temporary geographic waivers expire without being renewed, rural beneficiaries in designated shortage areas would still retain some telehealth access under pre-pandemic rules, while urban and suburban beneficiaries could lose access entirely for non-behavioral-health services. This creates a strong policy incentive for Congress to make the geographic waiver permanent.

FQHCs and RHCs as Telehealth Providers

Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) serve as a healthcare safety net for millions of Americans, including many Medicare beneficiaries. These facilities are often the only source of primary care in underserved communities. Before the pandemic, FQHCs and RHCs were not permitted to serve as distant-site telehealth providers under Medicare — meaning they could not bill Medicare for telehealth services they delivered remotely.

The pandemic changed this. CMS authorized FQHCs and RHCs to bill for telehealth services at a rate comparable to similar in-person visits. Congress has since extended this authority through temporary legislation. In 2026, FQHCs and RHCs can continue to provide and bill for telehealth services, including behavioral health, primary care, and chronic disease management. This is especially important because:

1. FQHCs serve over 30 million patients nationally, many of whom are on Medicare or Medicaid.
2. RHCs are specifically located in rural, underserved areas where other providers are scarce.
3. Both types of facilities offer care on a sliding fee scale, making them affordable for low-income Medicare beneficiaries.
4. Telehealth allows these facilities to extend their reach beyond their immediate geographic area, connecting patients who may live far from the physical clinic.

If you receive care at an FQHC or RHC, ask your provider whether telehealth is available for your upcoming appointments. Many of these facilities have invested in telehealth infrastructure and can offer video and, in some cases, audio-only visits.

How to Access Telehealth Through Medicare

Getting started with Medicare telehealth is straightforward. Follow these steps to schedule and prepare for a telehealth visit:

1. Contact your provider's office. Call your doctor, therapist, or specialist and ask if they offer telehealth visits. Most Medicare-participating providers now offer at least some services via telehealth.
2. Confirm the visit type. Ask whether the visit will be conducted by video, audio-only phone call, or through a patient portal. Confirm that Medicare covers the specific service via telehealth.
3. Check your technology. For video visits, ensure you have a device with a camera and microphone and a reliable internet connection. Download any required apps in advance. For audio-only visits, a standard telephone is all you need.
4. Prepare for the visit. Have your Medicare card ready, along with a list of current medications, symptoms, and questions for your provider. Find a quiet, private space for the visit.
5. Understand your costs. Ask the provider's billing department what your expected cost-sharing will be. If you have Original Medicare, expect 20% coinsurance after the deductible. If you have Medicare Advantage, check your plan's copay schedule for telehealth.
6. Follow up as needed. After the visit, follow your provider's instructions for prescriptions, referrals, or scheduling an in-person follow-up if necessary.

If you are enrolled in a Medicare Advantage plan, check your plan's website or member portal for a dedicated telehealth section. Many plans offer a built-in virtual care platform with online scheduling and direct access to providers.

Remote Patient Monitoring Under Medicare

Remote patient monitoring (RPM) is a related but distinct telehealth service that Medicare covers under Part B. RPM involves the use of connected medical devices — such as blood pressure monitors, glucose meters, pulse oximeters, and weight scales — that transmit health data from your home to your provider's office in real time or at regular intervals.

Medicare covers RPM for beneficiaries with chronic conditions that require ongoing monitoring. Common conditions managed through RPM include:

• Hypertension (high blood pressure)
• Type 2 diabetes
• Chronic obstructive pulmonary disease (COPD)
• Congestive heart failure
• Chronic kidney disease

RPM allows your care team to detect concerning trends early — such as rising blood pressure or blood sugar spikes — and intervene before a problem requires an emergency room visit or hospitalization. Under Original Medicare, RPM is covered with the standard 20% coinsurance after the Part B deductible. Many Medicare Advantage plans include RPM as part of their chronic disease management programs, sometimes at reduced or no additional cost to the beneficiary.

Tips for Getting the Most Out of Medicare Telehealth

To make your Medicare telehealth experience as productive as possible, consider the following practical tips:

• Test your technology before the appointment. Log into the telehealth platform 10 to 15 minutes early to ensure your camera, microphone, and internet connection are working properly.
• Have your medical information ready. Keep a written list of your medications, dosages, allergies, recent symptoms, and questions. This helps you make the most of your time with the provider.
• Choose a quiet, well-lit location. Minimize background noise and sit in a well-lit area so your provider can see you clearly during video visits.
• Ask about follow-up care. Before ending the visit, clarify next steps including prescriptions, referrals, lab orders, and whether a follow-up appointment is needed in person or via telehealth.
• Review your Medicare Summary Notice. After your telehealth visit, check your Medicare Summary Notice or Explanation of Benefits to confirm the service was billed correctly and that you were charged the right amount.
• Ask about RPM if you have chronic conditions. If you manage a chronic disease like diabetes, COPD, or heart failure, ask your provider whether remote patient monitoring is available and covered under your Medicare plan.

The Future of Medicare Telehealth

Telehealth has proven its value to both beneficiaries and the healthcare system. Studies have shown that telehealth reduces no-show rates, improves access for underserved populations, supports chronic disease management, and can lower overall healthcare costs by catching problems before they escalate. There is strong bipartisan support in Congress for making more telehealth flexibilities permanent.

Key areas where permanent action is still needed include:

• Removing geographic restrictions permanently for all telehealth services, not just behavioral health
• Allowing the patient's home to be a permanent originating site for all telehealth services
• Making FQHC and RHC distant-site authorization permanent
• Extending audio-only coverage permanently for non-behavioral-health services
• Expanding the telehealth-eligible services list to include new types of care

Until permanent legislation passes, the best strategy for beneficiaries is to stay informed. Review your plan documents each year during the Annual Enrollment Period, check with your providers about telehealth availability, and monitor CMS announcements for any changes to telehealth policy.

Bottom Line: Medicare Telehealth in 2026

Medicare telehealth has come a long way from the limited, rural-only program it was before 2020. In 2026, behavioral health telehealth from home — including audio-only phone visits — is a permanent Medicare benefit. The in-person visit requirement for behavioral health telehealth is waived through 2027. Broader telehealth flexibilities, including home-based care for all services, removal of geographic restrictions, and FQHC/RHC billing authority, continue under temporary congressional extensions.

Whether you have Original Medicare or a Medicare Advantage plan, telehealth gives you a convenient, cost-effective way to see your doctor, manage chronic conditions, and access behavioral health care without leaving your home. Talk to your provider about which of your upcoming appointments can be done virtually, and take advantage of one of the most significant expansions in Medicare's history.