Over recent years, telehealth has become an integral part of healthcare delivery for many Medicare beneficiaries, especially seniors managing chronic illnesses or seeking regular health consultations. Since March 6, 2020, under a series of waivers issued by the Centers for Medicare and Medicaid Services (CMS), a wide array of telehealth services could be accessed by Medicare beneficiaries across the United States regardless of their physical location, including from the comfort of their own homes.
This expanded coverage encompassed visits with doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, among others. The flexibility enabled patients to avoid travel and potential exposure to illnesses while maintaining continuity of care.
However, this sweeping coverage is set to change with new regulations becoming effective on January 31, 2026. According to CMS updates, after this date, Medicare will generally require beneficiaries seeking telehealth services to be in a medical facility situated in a rural area. The primary exception to this restriction will apply to behavioral health services, which will remain accessible remotely without geographic limitation.
This change signifies that many Medicare beneficiaries who previously enjoyed the option to consult healthcare providers remotely from their residence or other non-facility settings will face new barriers to telehealth access unless they fulfill specific conditions. To qualify for continued Medicare coverage of telehealth visits, beneficiaries will need to meet one or more of the following criteria:
- Reside in a rural area;
- Be physically located in an office or medical facility during the telehealth session;
- Receive behavioral health treatment remotely;
- Access specialized exceptions such as monthly home dialysis visits for end-stage renal disease (ESRD), rapid stroke care services including evaluations from mobile stroke units, or home-based services aimed at diagnosing, treating, or evaluating behavioral health disorders, including substance use disorders.
These new policies considerably narrow the circumstances under which Medicare will continue to reimburse telehealth services, reversing the broader access granted in the pandemic's early phase. The American Medical Association has reported that telehealth usage was widespread, with more than 70% of physicians utilizing it weekly in their practices, underscoring how embedded this service has become in medical care delivery.
As a result of these regulatory changes, a significant portion of Medicare beneficiaries, particularly those in urban or suburban areas, may lose coverage for telehealth visits conducted outside of medical facilities. Consequently, these individuals might have to pay out-of-pocket for telehealth consultations or seek alternative coverage options, such as specific Medicare Advantage plans that may provide more comprehensive telehealth benefits.
The limitations emerging in 2026 provoke critical considerations about access to care, especially for the senior population that has grown accustomed to the convenience and accessibility of telehealth amid ongoing healthcare challenges and mobility constraints.