Original Medicare (Parts A & B): Telehealth, Virtual Check-Ins, and E-Visits

Medicare covers certain telehealth services.

Telehealth is a broad term that encompasses a variety of telecommunications technologies and tactics to provide health services from a distance. Telehealth involves everything from simple telephone calls to the complex transmission of diagnostic imaging over smart devices, though its fundamental element is the virtual visit (face-to-face communication between provider and patient over the internet).

It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and even remote admissions. Telehealth has become so sophisticated as to be able to replace many in-office visits, which is very beneficial for you or your loved one who may have mobility problems and difficulty traveling, transportation issues, or merely scheduling conflicts and lack of time.

Examples of services that can be delivered via telehealth include:

• Office visits

• Psychotherapy

• Consultations

• Certain other medical or health services

Acceptable telehealth settings

Through December 31, 2024, your loved one can get telehealth services at any location in the U.S., including their home. After this period, however, they must be in an office or medical facility located in a rural area for most telehealth services.

In other words, your loved one cannot be in a setting with easy access to healthcare facilities, offices, and services (such as urban and suburban settings) and receive coverage for telehealth services. Visits are then expected to be in person.

Exceptions to rural rule

Your loved one can get these Medicare telehealth services in any setting, including urban and suburban:

• Monthly end-stage renal disease (ESRD) visits for home dialysis.

• Services for diagnosis, evaluation, and treatment of symptoms of an acute stroke wherever they are, including a mobile stroke unit.

• Service to treat a substance use disorder or a co-occurring mental health disorder (sometimes called a "dual disorder") or for the diagnosis, evaluation, or treatment of a mental health disorder, including in their home.

• Behavioral health services, including in their home.

For most of these services, your loved one will pay the same amount as they would if they got the services in person.

Virtual check-ins

Medicare covers virtual check-ins (or brief communication technology-based services) with providers using a phone, computer, or smart device, without going to the provider's office. The provider can also conduct remote assessments using photo or video images sent for review to determine whether your loved one needs to be seen in person.

The provider can respond by phone, virtual delivery, secure text message, email, or patient portal.

Virtual check-ins are available if your loved one has met these conditions:

• They have spoken with their provider about starting these types of visits.

• The virtual check-in doesn't relate to a medical visit they had within the past 7 days and doesn't lead to a medical visit within the next 24 hours (or the soonest next available appointment).

• They verbally consent to the virtual check-in and the provider documents that consent in the medical record (consent can be given for up to 1 year).

E-visits

Medicare covers e-visits to allow your loved one to talk to their provider using an online portal without going to the provider's office. Providers who can furnish these services include:

• physicians

• nurse practitioners and physician assistants

• physical, occupational, and speech therapists

• licensed clinical social workers (in specific circumstances)

• clinical psychologists (in specific circumstances)

To get an E-visit, your loved one must request one with their provider(s).