The progress of technology in the medical field has been great for many people. Both for healthcare providers and patients. One of the most hot trends in the medical field today is telehealth. It has quickly grown in popularity due to the COVID-19 pandemic.

This leads to a question more and more people have, “does Medicare cover telemedicine?” In this article, we answer that question in clear, plain English. You will also find the average costs of a telemedicine appointment and other helpful info.

Does Medicare Cover Telemedicine?

The short answer is yes; Medicare will cover the cost of telemedicine appointments. 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 telemedicine appointment. 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 telemedicine appointments. Coverage for telehealth appointments falls under Medicare Part B. 

Medicare Part B considers telemedicine appointments as similar to in-person outpatient appointments. For that reason, Medicare Part B provides coverage for telemedicine appointments.

There are a variety of services that you may receive in a telehealth consultation. Some of them may include: 

  • Physician visits
  • Consultations
  • Psychotherapy

Certain healthcare providers can provide a telemedicine appointment. Among the providers that can conduct these telehealth visits are:

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

You can receive a telehealth service in two ways. You can either receive it in your home without ever going out or you can go to a healthcare facility and have it there.

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

Part C Coverage for Telemedicine

Medicare Advantage plans (Medicare Part C) also provide coverage for telemedicine appointments. Part C plans must cover everything Original Medicare covers. However, the also offer some additional benefits. Exactly what those benefits are and how much you have to pay out of pocket for them will vary from plan to plan.

In 2020, Medicare Part C made some changes to its coverage policies for telemedicine appointments. Additional benefits were added which include telehealth access from home. All Medicare Part C plans include this benefit. Some Part C plans have other additional benefits aside from that one.

How Much Does A Telehealth Service Cost?

When you compare it to outpatient in-person visits, a telehealth visit is less expensive. The exact cost of a telehealth service will differ depending on what type of service you will need.

Other factors that may affect the overall cost of your telehealth visit may include the type of healthcare provider you need as well as the condition that needs to be treated/checked.

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.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover viscosupplementation injections?

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