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Medicare Now Covers Telehealth, Thanks to This Pandemic

Many private health insurers have offered telehealth for several years, but Medicare lagged behind covering the service.

In March 2020, Washington gave telehealth a shot in the arm by bending long-standing Medicare reimbursement rules for physicians and other health care professionals who use technology to remotely examine and treat Medicare patients at home.

The Trump administration now allows Medicare to reimburse doctors for telehealth at the same rate as office visits. The idea is to motivate doctors to use telehealth to care for patients and not invite them into medical offices and hospitals that may be brimming with those suffering from the highly contagious coronavirus.

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Telehealth was already an option allowed by many private Medicare Advantage plans, which are alternatives to traditional Medicare. The five biggest insurers selling Medicare Advantage plans, which serve about one-third of Medicare’s more than 60 million beneficiaries, have offered telehealth for several years.

Traditional Medicare, on the other hand, set strict limits for where and when telehealth would be covered. Until 2019, Medicare paid for telehealth services only if they included both audio and video interactions between patient and provider. Even then, the coverage was often limited to rural areas, and the patient had to already be in a Medicare-approved facility, not at home.

After Congress eased some of the restrictions, patients can now be at home to consult with doctors and other medical specialists using telehealth.

However, Medicare beneficiaries aren't afforded any price breaks for virtual visits, for which they currently pay 20% of the doctor’s fee on top of a deductible. “For most telehealth services,” the agency said on its web page for fees, “you’ll pay the same amount that you would if you got the services in person.”

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