Medicare telehealth coverage runs on two separate tracks. Behavioral and mental health telehealth is now a permanent benefit, while the rules that let you get most other care by video from home are temporary and set to expire at the end of 2027. This guide lays out what's permanent, what's temporary, and what you pay under each track in 2026.
The one distinction that changes everything
The single most important thing to know about Medicare telehealth is that it runs on two different rulebooks. Which one applies depends on whether the visit is for behavioral or mental health, or for something else.
Medicare covers many services delivered by telehealth, but the conditions under which you can receive them differ sharply between these two categories. One set of rules is written into permanent law. The other rests on a temporary extension that Congress has to keep renewing.
Behavioral and mental health telehealth: the permanent track
Behavioral and mental health telehealth is the part of the benefit you can count on. The Consolidated Appropriations Act of 2021 permanently removed the geographic and originating-site restrictions for these services, according to the Centers for Medicare and Medicaid Services. That means a beneficiary anywhere in the country, including at home, can get behavioral health care by telehealth.
Two specifics matter here.
First, there is an in-person requirement for at-home behavioral health telehealth. Medicare pays for these home-based visits only if the practitioner furnished an in-person service within the 6 months before the first telehealth visit, with some exceptions. After that initial in-person visit, the telehealth visits can continue.
Second, audio-only counts. When a patient cannot or does not consent to a video connection, Medicare allows behavioral health telehealth by telephone alone. That's a meaningful carve-out for people without reliable internet or a video-capable device, and it does not extend to most other telehealth categories.
General telehealth: the temporary track
For care that isn't behavioral or mental health, the rules are in flux. The flexibilities that let beneficiaries receive telehealth from home, anywhere in the United States, are temporary. They are currently extended through December 31, 2027.
This is the part to watch. If Congress does not extend the flexibilities again, most non-behavioral telehealth would revert to the rules that applied before the pandemic. Under those older rules, the patient generally has to be located in a rural area, at an approved originating site such as a clinic or hospital, not at home. The reversion would not change what services are eligible so much as where you're allowed to be when you receive them.
Because the deadline is a moving target, confirm the current status before you plan a non-behavioral telehealth visit from home. The date has been extended more than once, and it can change again.
| Rule | Behavioral / mental health | General (non-behavioral) |
|---|---|---|
| Status | Permanent | Temporary, through Dec. 31, 2027 |
| Where you can be | Anywhere, including home | Anywhere, including home (until the flexibility expires) |
| If the flexibility lapses | Unaffected | Reverts to rural-area, approved-site rules |
| In-person visit required first | Yes, within 6 months for at-home visits (some exceptions) | No |
| Audio-only allowed | Yes, if patient can't or doesn't consent to video | Generally no |
| Cost | Part B: 20% after the $283 deductible | Part B: 20% after the $283 deductible |
What telehealth costs
Telehealth doesn't carry a separate price. It's billed under Part B, and the cost-sharing matches an in-person visit for the same service.
After you meet the $283 Part B annual deductible for 2026, you generally pay 20% of the Medicare-approved amount for the visit. The Part B standard premium of $202.90 a month still applies as it would for any Part B coverage. CMS confirmed these 2026 figures, which run from January 1 through December 31.
So the telehealth question is rarely about price. For a given service, you pay the same whether you see the provider in their office or on a screen. The question that decides coverage is the one above: which track the visit falls under, and, for general care, whether the temporary flexibility is still in effect.
Telehealth under Medicare Advantage
The rules above describe Original Medicare. If you're enrolled in a Medicare Advantage plan, you get at least the same telehealth coverage Original Medicare provides, and many plans add more.
Medicare Advantage plans may offer additional telehealth benefits beyond what Original Medicare covers, and they set their own cost-sharing, which can differ from the standard 20% coinsurance. They can also apply network and prior-authorization rules to telehealth, just as they do to in-person care. If you have an Advantage plan, check your plan's specific telehealth benefits and any copays, because they vary by plan rather than following a single national rule.
Frequently asked questions
For behavioral and mental health care, yes, permanently. For other care, yes for now, because the flexibility allowing telehealth from home is extended through December 31, 2027. If that extension isn't renewed, most non-behavioral telehealth would again require you to be in a rural area at an approved site rather than at home.
No. Telehealth is covered under Part B at the same cost-sharing as the equivalent in-person service: 20% of the Medicare-approved amount after the $283 deductible in 2026.
For at-home behavioral health telehealth, Medicare requires that the practitioner provided an in-person service within the 6 months before the first telehealth visit, with some exceptions. After that, the telehealth visits can continue.
Yes. Audio-only behavioral health telehealth is allowed when the patient cannot or does not consent to a video connection. This audio-only allowance is specific to behavioral health and doesn't extend to most other telehealth.
Learn More
- What Is Medicare? Parts A, B, C, and D explained
- Medicare mental health coverage
- Original Medicare vs. Medicare Advantage
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