Medicare payment policies
Read the latest on the Centers for Medicare & Medicaid Services (CMS) coverage for telehealth.
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Recent legislation authorized an extension of many of the Medicare telehealth flexibilities that were in place during the COVID-19 public health emergency through March 31, 2025.
Telehealth policy updates
The Federal government took a range of steps to expedite the adoption and awareness of telehealth. Telehealth policies allow:
- Location. Medicare patients can receive telehealth services for non-behavioral/mental health care in their home through March 31, 2025. There are no geographic restrictions for originating site for Medicare non-behavioral/mental telehealth services through March 31, 2025.
- Providers. Telehealth services can be provided by all eligible Medicare providers through March 31, 2025. Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can serve as Medicare distant site providers for non-behavioral/mental telehealth services through March 31, 2025. For an encounter furnished using interactive, real-time, audio and video telecommunications technology or for certain audio-only interactions in cases where the patient is not capable of, or does not consent to, the use of video technology services, payment to RHCs and FQHCs are subject to the national average payment rates for comparable services under the physician fee schedule (PFS) through December 31, 2025.
- Modality. Non-behavioral/mental telehealth services in Medicare can be delivered using audio-only communication platforms through March 31, 2025. Interactive telecommunications system may also permanently include two-way, real-time audio-only communication technology for any telehealth service furnished to a patient in their home if the distant site physician or practitioner is technically capable of using an interactive telecommunications system, but the patient is not capable of, or does not consent to, the use of video technology.
- In-person behavioral health visit requirement. An in-person visit within six months of an initial Medicare behavioral/mental telehealth service, and annually thereafter, is not required through March 31, 2025. For FQHCs and RHCs, the in-person visit requirement for mental health services furnished via communication technology to beneficiaries in their homes is not required until January 1, 2026.
- Supervision. Supervising practitioners may directly supervise through real-time audio and visual interactive telecommunications, including presence and “immediate availability”, through December 31, 2025.
- Practitioner home address. Distant site practitioners may use their currently enrolled practice location instead of their home address when providing telehealth services from their home through December 31, 2025.
- Frequency Limitations. Telehealth frequency limits are suspended on subsequent inpatient visits, subsequent nursing facility visits, and critical care consultations through December 31, 2025.
Tip: To learn about recent Federal legislation and policies related to telehealth, visit Telehealth policy updates.
Permanent telehealth policy
Telehealth can increase access to health care. To support access to care, telehealth policies allow:
- Eligible services. There are currently more than 250 codes on the Medicare telehealth services list. Additions and deletions of codes on the Medicare telehealth services list generally occurs on an annual basis. For the latest information, view the list of telehealth services.
- Modality. Interactive telecommunications system means multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner. Interactive telecommunications system may also include two-way, real-time audio-only communication technology for any telehealth service furnished to a patient in their home if the distant site physician or practitioner is technically capable of using an interactive telecommunications system as defined in the previous sentence, but the patient is not capable of, or does not consent to, the use of video technology.
- Providers. Physicians, physician assistants, nurse practitioners, clinical nurse specialists, nurse-midwives, clinical psychologists, clinical social workers, registered dietitians or nutrition professionals, certified registered nurse anesthetists, marriage and family therapists, and mental health counselors can permanently serve as Medicare distant site providers. FQHCs and RHCs can permanently serve as a Medicare distant site provider for behavioral/mental telehealth services.
- Location. Originating sites must be located in a health professional shortage area, located in a county that is not included in a Metropolitan Statistical Area, an entity participating in a Federal telemedicine demonstration project, or in certain exemptions. Originating sites must be in the office of a physician or practitioner, a critical access hospital, a rural health clinic, a federally qualified health center, a hospital, a hospital-based or critical access hospital-based renal dialysis center, a skilled nursing facility, a community mental health center, a renal dialysis facility, the home of an individual (for certain purposes related to end-stage renal disease, substance use disorder, and mental health), a mobile stroke until (for certain purposes), or a rural emergency hospital. Medicare patients can permanently receive telehealth services for behavioral/mental health care in their home. There are no geographic restrictions for originating site for Medicare behavioral/mental telehealth services on a permanent basis.
More information:
Billing and coding Medicare Fee-for-Service claims — Health Resources and Services Administration
Billing Medicare as a safety-net provider — Health Resources and Services Administration
Telehealth policy updates — Health Resources and Services Administration
List of telehealth services — Centers for Medicare & Medicaid Services
Calendar Year 2025 Medicare Physician Fee Schedule — Centers for Medicare & Medicaid Services