Medicare stops Telehealth visits on October 1,2025. Many patients no longer can access virtual visits in the comfort of their homes.
What is Telehealth?
Telehealth or Telemedicine is a service that uses electronic equipment to provide virtual encounters between a doctor and a patient outside of the traditional office setting. This allows for an office visit to be done in the privacy of your own home. It operates like the old fashion “house calls,” but instead of the doctor ringing the bell on your door he or she can now “ping,” you on your smartphone.
Patients and physicians enjoy the flexibility of offering health care services virtually in the home. Patients report a high level of satisfaction with its use. However, some family medicine doctors feel they may not connect as well to their patients using remote devices, but the majority of providers support its use in the right clinical situation. In fact, Telemedicine services allow fast response times in critical situations including the treatment and diagnosis of strokes where every minute counts.
Before the COVID19 pandemic, Telehealth visits were felt cumbersome due to excessive restrictions and high costs. It required expensive equipment, special connectivity rules for doctors and patients, offered mostly to people in rural designated areas, and was not covered by many insurance companies. Even if covered it was paid at lower rates to doctors and higher costs to patients as thought a lower valued service.
In March of 2020, during the peak of the COVID19 pandemic all of this changed. The restrictions set by Medicare (and most insurance companies followed suit) were lifted allowing many doctors and patients the option of Telehealth as a real service.
Telehealth and Telemedicine platforms expanded to include commonly used devices like cellphones, smartphones, and laptops. Coverage was broadened to include patients in all geographic areas and even allowed for Telehealth visits to expand across state lines. This revolutionized how healthcare could be delivered. People were able to connect with their providers through social media platforms including FaceTime, Skype, and Zoom. Even certain co-pays were waived by the insurance companies making this service affordable to more people.
Patients reported feeling satisfied with Telehealth visits, and some even preferred it to the tradition in office face-to-face visits. It reduced wait times to see doctors, could be performed in the home or workplace, decreased travel times, and in some cases was cheaper than traditional in-office visit.
Telehealth also gained popularity in hospitals with reported higher use of Telehealth services in Psychiatry, Cardiology and Radiology nationwide filling the “gap,” for the lack of on-site doctors while maintaining a high quality of care.
What happened to Telehealth on October 1, 2025?
Telehealth as of October 1, 2025, will return to the pre-COVID19 rules unless extended. This means to get Telehealth services you must be located in an office or medical facility (such as a hospital) and physically located in a rural area and have a particular medical condition to qualify.
The EXCEPTION amongst others includes people with kidney failure on dialysis who are on home dialysis, people with mental health concerns, and for certain types of Telehealth services like Tele Neurology to treat strokes especially in rural community hospitals where doctors like Neurologist may not be available in person.
Telemedicine or Telehealth after October 1, 2025, will be restricted to certain patients and providers, limited to encounters using specific equipment and devices, available only in certain geographic areas, and at potentially higher costs to both the provider and the patient.
Any last advice on Telehealth?
Doctor’s offices and patients may be faced with difficult choices if Medicare rolls back to the pre-COVID19 pandemic Telehealth polices. In the meantime, if you have a Medicare Advantage Plan, Medicaid or private insurance Telehealth services may still be a viable option for you but may change in the near future. It’s important to check with your insurance company to see if coverage or costs have changed for Telehealth services before scheduling your next visit.
If you are a doctor, it’s important to offer Telemedicine services if clinically appropriate and financially sustainable. It is also reasonable to honor existing Telehealth appointments with your Medicare patients but consider pausing new appointments except for qualifying reasons including those who live in rurally designated communities or have specific health conditions.
It’s important to see your doctor on a regular basis either virtually by Telehealth (if still an option) or in person until Medicare can sort out its final rule on Telehealth. However, as of October 1, 2025, Telehealth or the virtual visit has stopped except for qualifying reasons leaving many Americans with few options outside of the traditional office visit in getting the medical care they need to stay healthy.
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