Does Medicare Cover Phone Consultations?

Telehealth is a technology that allows healthcare providers and patients to communicate with each other without ever meeting in person. This new way of practicing medicine became quite common during the COVID-19 pandemic.

So a common question many people have is, “does Medicare cover phone consultations?” In this article, we answer that question in clear, plain English. You will also find the average costs of phone consultations and other helpful info.

Does Medicare Cover Phone Consultations?

The short answer is yes; Medicare will cover the cost of telehealth consultations. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your phone consultations. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for telehealth consultations. Coverage for phone consultations is provided by Medicare Part B. Medicare Part B considers phone consultations as similar to an in-person outpatient visit. For that reason, Medicare Part B provides coverage for this service.

There are a variety of services that you may receive in a telehealth consultation which may include doctor’s office visits, consultations, and even psychotherapy.

You can also receive your telehealth service from certain healthcare professionals. These certain healthcare professionals may include the following:

Doctors
Physician assistants
Nurse practitioners
Clinical social workers
Nurse anesthetists
Licensed nutritionists
Licensed dieticians

You can either receive your phone consultation in your home or by going to a healthcare facility and having it there.

Medicare Part B covers 80 percent of the costs of your phone consultation. You will pay for the remaining 20 percent.

Part C Coverage for Phone Consultations

Medicare Advantage plans (Medicare Part C) also provide coverage for phone consultations. They cover everything Original Medicare covers, and usually offer some additional benefits as well. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.

In 2020, Medicare Advantage plans made some alterations to their telehealth visit coverage. They decided to include additional benefits. All Medicare Part C plans may cover telehealth visits from home. Other benefits added vary depending on the Medicare Part C plan.

How Much Does A Telehealth Service Cost?

Most of the time, online phone consultations cost less when compared to in-person hospital visits. Just like with in-person consultations, the exact cost of your telehealth service will differ depending on what type of service you will receive.

Other factors that may affect the overall cost of your telehealth service includes the condition that needs to be treated and the healthcare provider themselves.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.