Telehealth refers to the delivery of health care services using real-time audio and video communication between a patient at one location (the originating site) and a provider at another location (the distant site). Under Medicare, telehealth services are separately billable encounters that largely mirror in-person evaluation and management visits.
Before the COVID-19 public health emergency (PHE), Medicare telehealth was restricted to patients in designated rural areas, originating from approved clinical facilities (not the patient's home), and delivered only by a limited set of provider types. During the PHE, Congress and CMS waived most of these restrictions, allowing patients to receive telehealth from home, removing geographic requirements, expanding the list of eligible providers, and permitting audio-only delivery for certain services.
These flexibilities proved enormously popular and effective, particularly for older adults, patients with mobility limitations, and rural populations. When the PHE ended, Congress enacted a series of extensions. As of 2026, many Medicare telehealth flexibilities have been extended through December 31, 2027, under the Consolidated Appropriations Act, 2026.
The key provisions currently in effect include: patients may receive non-behavioral/mental telehealth services at home through December 2027; geographic restrictions on originating sites are waived through December 2027; all eligible Medicare provider types may furnish telehealth through December 2027; and audio-only delivery is permitted through December 2027 for both behavioral and non-behavioral services.
Certain behavioral/mental telehealth provisions have been made permanent. FQHCs and RHCs can permanently serve as distant-site providers for behavioral/mental telehealth. Patients can permanently receive behavioral/mental telehealth at home with no geographic restrictions.
Telehealth is distinct from RPM, CCM, and other connected care programs. Telehealth replaces an office visit; connected care programs reimburse the work between visits. A practice may use telehealth for an annual wellness visit, then bill CCM and RPM throughout the year for ongoing management. The services are complementary.
Sources:
Social Security Act ยง 1834(m);
Consolidated Appropriations Act, 2026;
Telehealth.HHS.gov policy updates;
CMS CY 2026 PFS Final Rule telehealth provisions.
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