What Is Telehealth? Current Medicare Rules and Deadlines

Medically reviewed by Krystie Linares, MD. Last reviewed July 2026.

Telehealth is health care delivered remotely, by video, telephone, or secure messaging, rather than in person. The rules governing it in the US have changed repeatedly since 2020 and remain temporary, so the most useful thing to know is the current status. Medicare’s general telehealth flexibilities run through 31 December 2027. Mental health telehealth is separately permanent. And the DEA rules allowing controlled substances to be prescribed without an in-person visit expire earlier, on 31 December 2026. Those two dates are different and are constantly confused. Here is what applies now.

What Telehealth Covers

Live video visits with a clinician, the closest equivalent to an office appointment. Telephone visits, which matter more than they sound, since they are the only option for many people without reliable broadband. Store and forward, where images or test results are sent for a specialist to review later, common in dermatology and radiology. And remote patient monitoring, where devices send blood pressure, glucose, or heart data to a care team.

Medicare: The Current Rules

This is where most outdated information circulates, partly because coverage actually lapsed twice while Congress worked on extensions, once from 1 October to 12 November 2025 and again from late January to 3 February 2026. Any article written before February 2026 is likely wrong.

On telephone visits, there is a permanent provision worth knowing. For any telehealth service delivered to a patient at home, audio-only is permanently allowed if the clinician is capable of video but the patient is not able to use it or does not consent to it. So if video is genuinely not workable for you, telephone remains an option regardless of the 2027 date.

Note what “through 31 December 2027” means. These are extensions, not permanent law, and they have been extended repeatedly at the last minute. If telehealth is central to your care, it is worth knowing your in-person options.

Prescribing Controlled Substances: The Nearer Deadline

This deadline arrives sooner and affects more people than most realise.

Normally, federal law requires an in-person examination before a controlled substance can be prescribed. That requirement has been waived since 2020, and the waiver currently runs through 31 December 2026.

This matters for ADHD medication, buprenorphine for opioid use disorder, testosterone, and certain anxiety and sleep medications. If you receive any of these through a telehealth service, it is reasonable to ask your prescriber now what happens after that date, rather than in December.

Medicaid and Private Insurance

Medicaid telehealth coverage is set state by state and varies considerably in which services are covered, which clinicians can bill, and whether audio-only counts. Check with your state Medicaid agency.

Private insurance is governed by state parity laws, and there are two different kinds that are easy to confuse.

Coverage parity means an insurer must cover a service by telehealth if it would cover it in person. Payment parity means the insurer must pay the same rate for it. Around 44 states plus DC have private-payer telehealth laws, with coverage parity in most of them. Payment parity exists in roughly 33 to 35 states, though counts differ depending on how partial and behavioural-health-only laws are counted.

What this means for you: coverage parity does not guarantee your cost is the same. Check your copay for a telehealth visit specifically.

Seeing a Clinician in Another State

Generally, a clinician must be licensed in the state where you are physically located at the time of the visit, not where they are. This catches people out when they travel or move.

Several interstate compacts make cross-state practice easier. The Interstate Medical Licensure Compact streamlines licensing for physicians. PSYPACT allows psychologists to practise across member jurisdictions and now covers 42 of them. The Nurse Licensure Compact covers 43 jurisdictions, though several are enacted but not yet operating. The Counseling Compact has 40 member states but is currently issuing privileges in only six, so enacted does not mean usable.

One practical warning: the Interstate Medical Licensure Compact’s official website is imlcc.com. The .org address is no longer the commission’s and now serves unrelated commercial content.

If you are moving or travelling for an extended period, ask your clinician before you go whether they can continue treating you in that state.

When Telehealth Is Not the Right Choice

Telehealth suits a great deal of routine care. It does not suit everything.

Use in-person care or emergency services for: anything requiring physical examination, vital signs, labs, or imaging. Chest pain, difficulty breathing, stroke symptoms, severe bleeding, or any suspected emergency, which need 911 rather than a video appointment. New or undiagnosed problems where an examination is likely to change the answer. And situations where you cannot find a private, safe place to talk.

Telehealth works well for follow-up of stable chronic conditions, medication reviews, discussing test results, many mental health appointments, minor conditions where examination adds little, and specialist second opinions where records do the work.

Access and Cost

The Affordable Connectivity Program, which subsidised broadband for around 23 million households, ended on 1 June 2024, and no federal replacement has been enacted. If you were relying on it, the alternatives are the FCC’s Lifeline programme, which is smaller at $9.25 a month with narrower eligibility, and carrier low-income plans such as Comcast Internet Essentials, AT&T Access, and Spectrum Internet Assist, all around $10 to $18 a month. New York has a state law requiring a $15 plan, and similar bills are pending elsewhere.

This is the main reason audio-only telehealth matters. For households without adequate broadband, telephone access is not a lesser convenience, it is the difference between care and no care.

Free and low-cost options: federally qualified health centres offer telehealth on income-based sliding scales, findable at findahealthcenter.hrsa.gov. Community health centres and county clinics often do the same. The 988 Suicide and Crisis Lifeline is free and available by call or text at any hour.

A Privacy Point Worth Knowing

Care delivered by a clinician or health system is protected by federal health privacy law. Some consumer health apps and platforms are not covered in the same way, and enforcement action has been taken over health data shared with advertisers. Before entering health information into any app, check what it says about sharing data with third parties. Our page on telehealth therapy covers this in more detail, including a significant regulatory settlement involving a major platform.

Telehealth FAQs

Does Medicare cover telehealth in 2026?

Yes. General telehealth flexibilities, including receiving care at home without geographic restrictions, run through 31 December 2027. Mental health telehealth coverage is permanent and not tied to that date.

Can I still get ADHD medication through telehealth?

For now. The waiver of the in-person requirement for prescribing controlled substances runs through 31 December 2026. Ask your prescriber what their plan is after that date.

Can my doctor treat me if I travel to another state?

Usually they must be licensed where you are physically located during the visit. Compacts exist for physicians, psychologists, nurses, and counsellors, but coverage varies and some compacts are not yet operating. Ask before you travel.

Are telephone-only visits covered?

For mental health, permanently. For other services, through 31 December 2027, plus a permanent provision allowing audio-only at home when the patient cannot use or does not consent to video.

Will a telehealth visit cost the same as an office visit?

Not necessarily. Most states require insurers to cover telehealth if they cover the in-person equivalent, but only some require the same payment rate. Check your specific copay.

When should I not use telehealth?

For emergencies, anything needing a physical examination or tests, and new undiagnosed problems where an examination is likely to matter. Chest pain, breathing difficulty, or stroke symptoms need 911, not a video visit.

References

HHS, telehealth policy updates: telehealth.hhs.gov

CMS, telehealth frequently asked questions: cms.gov

Center for Connected Health Policy, telehealth parity by state: cchpca.org

PSYPACT participating states: psypact.gov

FCC, Affordable Connectivity Program wind-down: fcc.gov

HRSA, find a health centre: findahealthcenter.hrsa.gov

Telehealth rules are temporary and have been extended repeatedly at short notice, and coverage has briefly lapsed more than once. Confirm current Medicare rules at telehealth.hhs.gov and check your own plan before scheduling.