covers certain telehealth services.
You pay 20% of theMedicare-Approved Amount
for your doctor or other health care provider’s services, and the Part Bdeductible [glossary]
applies. For most 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:
Medicare telehealth services include office visits, psychotherapy, consultations, and certain other medical or health services that are provided by a doctor or other health care provider who’s located elsewhere using interactive 2-way real-time audio and video technology.
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 in your home.
Starting in 2020, Medicare Advantage Plans may offer more telehealth benefits than Original Medicare. These benefits can be available in a variety of places, and you can use them at home instead of going to a health care facility. Check with your plan to see what additional telehealth benefits it may offer.
Medicare made these changes to telehealth in 2020:
- You can get Medicare telehealth services at renal dialysis facilities and at home.
- You can get Medicare telehealth services for certain emergency department visits at home.
- You can get certain physical and occupational therapy services at home.
- Medicare covers some services delivered via audio only devices.
- Medicare also covers virtual check-ins and E-visits.