covers certain telehealth services.
Your costs in Original Medicare
After you meet the Part B deductible , you pay 20% of the Medicare-Approved Amount for your doctor or other health care provider's services.
For many telehealth services, you'll pay the same amount that you would if you got the services in person.
Due to the Coronavirus (COVID-19) Public Health Emergency, doctors and other health care providers can use telehealth services to treat COVID-19 (and for other medically reasonable purposes) from offices, hospitals, and places of residence (like homes, nursing homes, and assisted living facilities) as of March 6, 2020. Coinsurance and deductibles apply, though some healthcare providers are reducing or waiving the amount you pay for telehealth visits.
Fraud alert: Watch out for providers you don’t know or haven’t met before contacting you to set up a telehealth appointment. They may offer you perks like cash payments or free prescription drugs to get your personal information, and then start billing Medicare for items and services you didn’t need or you didn’t get, like lab tests, braces or orthotics. If you suspect fraud, call 1-800-MEDICARE.
If you have coverage through Original Medicare or a Medicare Advantage Plan, you won’t have to pay out-of-pocket costs (called cost-sharing) for COVID-19 tests. They may also offer more telehealth services than what was included in their approved 2021 benefits.
To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
What it is
Telehealth includes certain medical or health services that you get from your doctor or other health care provider who's located elsewhere (or in the U.S.) using audio and video communications technology (or audio-only telehealth services in some cases), like your phone or a computer. You can get many of the same services that usually occur in-person as telehealth services, like psychotherapy and office visits.
During the COVID-19 Public Health Emergency and through December 31, 2024, you can get telehealth services at any location in the U.S., including your home. After this period, you must be at an office or medical facility located in a rural area (in the U.S.) for most telehealth services.
You can get certain Medicare telehealth services without being in a rural health care setting, including:
- Monthly End-Stage Renal Disease (ESRD) visits for home dialysis.
- Services for diagnosis, evaluation, or treatment of symptoms of an acute stroke wherever you are, including in a mobile stroke unit.
- Services 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 in your home.
Things to know
Medicare Advantage Plans and providers who are part of certain Medicare Accountable Care Organizations (ACOs) may offer more telehealth benefits than Original Medicare. For example, you may be able to get some services from home, no matter where in the U.S. you live. Check with your plan to see what benefits it offers. If your provider participates in an ACO, check with them to see what telehealth benefits may be available.