Telehealth became a lifeline for millions of Medicare beneficiaries during the COVID-19 pandemic. Virtually overnight, restrictions that had limited virtual care for decades were lifted, allowing people to see their doctors from home via video or phone. But those expanded telehealth flexibilities were always intended to be temporary. As we move through 2026, the landscape of Medicare telehealth is shifting — some pandemic-era rules have been extended, others have expired, and Congress continues to debate what should become permanent. Here is where things stand and what you should expect.
The Pandemic-Era Telehealth Expansion
Before the pandemic, Medicare's telehealth rules were highly restrictive. Virtual visits were generally limited to beneficiaries in rural areas who traveled to an approved originating site (such as a clinic or hospital) to connect with a distant provider. In practice, very few Medicare enrollees used telehealth.
When the public health emergency (PHE) was declared in 2020, CMS used emergency authority to waive most of these restrictions. The changes were dramatic:
- Geographic restrictions were removed: You could receive telehealth services from anywhere, including your home
- Originating site requirements were eliminated: Your living room counted as a valid location for a virtual visit
- Audio-only visits were covered: Phone-only appointments qualified for reimbursement, helping beneficiaries without reliable internet or video capability
- Provider types were expanded: A broader range of healthcare professionals could deliver telehealth services
- New services were added: Many types of visits and evaluations that were previously in-person-only became eligible for telehealth delivery
These changes proved enormously popular. Telehealth usage among Medicare beneficiaries surged, and satisfaction with virtual care was consistently high.
Which Flexibilities Are Still in Place
The public health emergency officially ended in May 2023, but Congress has acted multiple times to extend key telehealth flexibilities beyond the PHE. As of 2026, the following provisions remain in effect through congressional extensions:
- Home as an originating site: You can still receive most telehealth services from your home, without needing to travel to a clinic or hospital. This is the single most important flexibility for most beneficiaries.
- No geographic restrictions: Telehealth is available regardless of whether you live in a rural or urban area. The old rule limiting telehealth to rural-only beneficiaries has not been reinstated.
- Audio-only coverage for behavioral health: Phone-only visits for mental health and substance use disorder services remain covered, provided you have had at least one in-person visit with the provider within a specified period (typically within the prior 12 months).
- Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can continue to serve as distant site providers for telehealth, a change from pre-pandemic rules that excluded them.
These extensions have generally been included in broader spending or healthcare legislation, often on a year-by-year or two-year basis. As a result, their status can change with each legislative cycle.
What Has Expired or Changed
Not all pandemic-era flexibilities have survived. Some notable changes and expirations include:
- Audio-only visits for non-behavioral health: While phone-only visits for mental health remain covered, audio-only coverage for routine medical visits (such as a primary care check-up) has been more restricted. Many non-behavioral health services now require a video component to qualify for telehealth reimbursement.
- Certain provider types: Some temporary expansions that allowed additional provider categories to bill for telehealth have been scaled back. The specific list of eligible providers is narrower than it was at the peak of the PHE.
- In-person visit requirements for behavioral health: To continue receiving telehealth mental health services, you must see your provider in person at least once within a defined timeframe. This requirement was waived during the PHE but has since been reinstated, though CMS has applied it with some flexibility.
- Temporary telehealth-eligible services: During the PHE, CMS added many services to the telehealth-eligible list on a temporary basis. Some of these have been made permanent, but others have reverted to in-person-only status.
Congressional Action and the Path Forward
The future of Medicare telehealth depends heavily on congressional action. Key points of the ongoing debate include:
- Permanent legislation: Several bills have been introduced that would make the most popular telehealth flexibilities permanent — particularly the ability to receive care from home regardless of geographic location. However, as of early 2026, no comprehensive permanent telehealth bill has been enacted.
- Cost concerns: Some policymakers worry that unrestricted telehealth access could increase Medicare spending by encouraging higher utilization of services. Studies on this topic have shown mixed results, with some suggesting that telehealth substitutes for in-person visits rather than creating additional demand.
- Fraud and quality concerns: There have been cases of telehealth-related fraud, where unscrupulous providers used virtual visits to bill for unnecessary services or prescribe unneeded equipment. These incidents have given some lawmakers pause about making all flexibilities permanent without stronger oversight.
- Bipartisan support: Despite these concerns, telehealth expansion enjoys strong bipartisan support. Both parties generally agree that the pre-pandemic rules were too restrictive and that beneficiaries benefit from virtual care access. The disagreement is primarily about how broadly to define the new rules and what guardrails to include.
Congress has typically extended telehealth provisions through short-term extensions attached to must-pass spending bills. While this approach keeps flexibilities alive, it creates uncertainty for beneficiaries and providers who cannot plan long-term around rules that may change every year or two.
What Beneficiaries Should Expect
Given the current landscape, here is practical guidance for Medicare beneficiaries who use or are considering telehealth:
- Telehealth for mental health is secure for now. If you are receiving therapy or counseling via video or phone, these services remain covered. Just be sure to schedule your required in-person visit with your provider as needed.
- Video visits remain broadly available. For most medical services, telehealth via video continues to be covered when you are at home. Confirm with your provider that the specific service qualifies.
- Audio-only visits are more limited. If you rely on phone-only appointments for non-behavioral health care, check whether your specific service is still covered via audio-only. You may need to switch to video or in-person visits.
- Medicare Advantage plans may offer more. Many Medicare Advantage plans provide additional telehealth benefits beyond what Original Medicare covers. Some include access to 24/7 virtual urgent care, expanded specialist consultations, and telehealth platforms with no additional cost-sharing. If telehealth is important to you, compare Advantage plan offerings during Open Enrollment.
- Stay informed about legislative updates. Because telehealth rules are subject to congressional action, the policies in effect today may change. Pay attention to Medicare communications and news coverage about telehealth legislation.
How to Access Telehealth Under Medicare
If you want to use telehealth services, here is how to get started:
- Ask your provider if they offer telehealth visits. Most physicians and specialists now have the infrastructure to conduct video appointments.
- Check your plan for any specific telehealth benefits, platforms, or cost-sharing amounts.
- Ensure you have the right technology. For video visits, you need a smartphone, tablet, or computer with a camera and internet connection. Your provider's office can typically help you set up the necessary app or platform.
- Keep records of your telehealth visits just as you would in-person appointments. Review your Medicare Summary Notice or Explanation of Benefits to confirm that claims are processed correctly.
The Bottom Line
Telehealth has earned its place in Medicare, and most beneficiaries can continue to access virtual care from home in 2026. However, the rules are not yet settled permanently, and the details of what is covered — and how — continue to evolve. Stay proactive about understanding your telehealth options, and advocate for the policies that matter to you by contacting your elected representatives if permanent telehealth legislation is important to your healthcare access.