---
title: "When does Medicare pay for telehealth services? Answer in under 100 words. Cite only eCFR (www.ecfr.gov) sources."
canonical: https://www.m-i-n-d.ai/minds/telehealth/when-medicare-pays-telehealth
jurisdiction: "US Federal"
last_verified: 2026-08-28
license: CC BY 4.0 — https://creativecommons.org/licenses/by/4.0/
attribution: "Source: MIND (m-i-n-d.ai)"
---

# When does Medicare pay for telehealth services? Answer in under 100 words. Cite only eCFR (www.ecfr.gov) sources.

Medicare Part B pays for covered telehealth services on the telehealth list when furnished by an interactive telecommunications system, provided the conditions of 42 CFR § 410.78(b) are met, including distant-site practitioner licensure and eligible originating-site requirements. During the COVID-19 Public Health Emergency, additional services (office/outpatient visits, psychiatric diagnostic interview exams, individual psychotherapy, and ESRD-related monthly capitation services) are also covered via interactive telecommunications under § 410.78(b).

## Details / How it works

Under 42 CFR § 410.78(b), Medicare Part B pays for covered telehealth services when:

- The service is on the Medicare telehealth list and furnished via an interactive telecommunications system.
- The distant-site physician or practitioner is licensed under State law to furnish the service.
- The distant-site practitioner is one of the enumerated provider types (e.g., physician, PA, NP, CNS, nurse-midwife, clinical psychologist, clinical social worker, registered dietitian, CRNA, marriage and family therapist, mental health counselor).
- The beneficiary is located at an eligible originating site, which generally must be in a Health Professional Shortage Area or non-MSA county (geographic requirements waived for certain services).
- The medical examination remains under the control of the distant-site physician or practitioner.

For the duration of the COVID-19 PHE (as defined in § 400.200), Part B also pays for office and other outpatient visits, professional consultation, psychiatric diagnostic interview examination, individual psychotherapy, pharmacologic management, and ESRD-related monthly capitation services via interactive telecommunications when the same conditions are met.

## Numbers & thresholds

| Requirement | Value |
|---|---|
| In-person service prior to initial mental-health telehealth | Within 6 months prior |
| In-person service between subsequent mental-health telehealth | At least once within 12 months |
| Modifier for audio-only telehealth | CPT modifier "93"; "FQ" for RHCs/FQHCs |
| Originating-site geographic test date | December 31 of the preceding calendar year |
| Expanded mental-health originating site (home) | Through Dec 31, 2024 |
| Acute stroke / SUD / home dialysis geographic exemption | On or after January 1, 2019 |
| Rural emergency hospital addition | On or after January 1, 2023 |

## Exceptions & edge cases

Per 42 CFR § 410.78(b)(3)(xiv), when the beneficiary's home is used as an originating site for diagnosis, evaluation, or treatment of a mental health disorder between the day after the end of the PHE and December 31, 2024, Medicare pays only if the distant-site practitioner furnished an in-person service (without telehealth) within 6 months prior to the initial telehealth service and at least once within 12 months of each subsequent telehealth service. The in-person requirement may be met by another physician or practitioner of the same specialty/subspecialty in the same group if the telehealth practitioner is unavailable. Geographic requirements are waived for home dialysis ESRD clinical assessments, acute stroke services (on/after Jan 1, 2019), SUD services (on/after Jul 1, 2019), and mental-health services (on/after Jan 1, 2025). A telepresenter is not required unless medically necessary per the distant-site practitioner.

## Sources

- [1] U.S. Government Publishing Office / Centers for Medicare & Medicaid Services — 42 CFR 410.78 — Medicare telehealth services — conditions for payment · https://www.ecfr.gov/current/title-42/section-410.78 · as of 2026-08-28