Medicare Video Visits Overview and What to Expect in 2025
Evolving Landscape of Medicare Telehealth Services in 2025
The delivery of care via video and audio technology has transformed Medicare, especially since the COVID-19 pandemic ushered in sweeping telehealth flexibilities. However, as we move through 2025, Medicare video visits face a new set of policy shifts shaped by the Centers for Medicare & Medicaid Services (CMS). Understanding these changes is essential for beneficiaries and providers alike.
Overview of Medicare Telehealth Expansion and Retractions
Pandemic-related waivers removed many barriers to telehealth, letting Medicare enrollees connect with their doctors from anywhere in the country, including their homes. This expansion led to a dramatic increase in virtual visits, addressing urgent needs for safe access during public health emergencies. However, Congress gave CMS the green light to maintain these flexibilities only through September 30, 2025. After this, most flexibilities end, meaning a partial return to pre-pandemic rules.
Impact of the CY 2025 Physician Fee Schedule (PFS) Final Rule on Video Visits
The CY 2025 PFS Final Rule codifies these transitions. It sustains broad telehealth access into late 2025 but lays out clear plans for pulling back some provisions, especially geographic and location restrictions, effective October 1, 2025. Notably, some new telehealth services are added to the CMS list, while previous audio-only and crisis intervention codes see adjustments.
Transition from Pandemic-Era Flexibilities to Pre-Pandemic Geographic and Location Restrictions
After September 2025, coverage for most telehealth services will be limited to beneficiaries in rural areas and only when they are physically present in certain medical facilities. Home-based video visits, a mainstay since 2020, will no longer be broadly available except for select services like behavioral health or home dialysis. These reforms reflect both efforts to make virtual care permanent where effective and a recommitment to Medicare’s original statutory guardrails.
Understanding Medicare Coverage and Eligibility Criteria for Telehealth in 2025
Coverage Rules Through September 30, 2025
Through September 30, 2025, Medicare pays for telehealth visits provided anywhere in the U.S.—including the beneficiary’s home. This includes office visits, specialist consultations, psychotherapy, and certain preventive services, expanding access for urban and rural residents alike.
Post-October 1, 2025: Rural Location and Medical Facility Requirements
Starting October 1, 2025, Medicare will generally only cover video (and some audio-only) visits if a patient is in a:
- Rural area, and
- Qualifying medical facility (hospital, doctor’s office, rural health clinic)
This change may limit the convenience and reach of telehealth for urban residents and those who benefited from at-home video visits during the public health emergency.
Exceptions to Location Restrictions
There are notable exceptions—certain services remain eligible for at-home telehealth regardless of rural status:
- Behavioral and mental health care
- End-Stage Renal Disease (ESRD) home dialysis check-ins
- Acute stroke assessment
These exceptions address critical needs where timely, remote access demonstrably improves outcomes.
Differences Between Original Medicare, Medicare Advantage Plans, and ACOs
It’s crucial to note that Medicare Advantage plans and Accountable Care Organizations (ACOs) may offer telehealth benefits above and beyond what Original Medicare covers. Many plans will likely continue to let members have video visits from home for a broader range of services even after the federal waivers end. For more insights on different Medicare plans, see our in-depth guide on questions about Medicare.
Expanded Telehealth Services and Coding Updates for 2025
New Telehealth Services Added to the CMS Telehealth Services List
The 2025 CMS Telehealth Services List welcomes several new additions:
- Caregiver training services for Alzheimer’s, Parkinson’s, and other chronic conditions
- Pre-exposure prophylaxis (PrEP) counseling for HIV prevention
- Safety planning for crisis intervention in behavioral health
This expansion reflects CMS’s effort to modernize care delivery for vulnerable populations and those with complex needs.
Permanent vs. Provisional Telehealth CPT/HCPCS Codes in 2025
Some CPT/HCPCS codes have earned permanent status, such as those for certain behavioral health and substance use services. Others, like crisis intervention codes, are listed provisionally. CMS will monitor their utilization and effectiveness over the coming year.
Overview of New Telehealth CPT Codes for 2025 and Limitations on Audio-Only Codes
The table below highlights new and notable telehealth codes for 2025:
| Service/Code | Status | Audio-Only Allowed? |
|---|---|---|
| Caregiver Training (CPT 9xxxx) | Provisional | No |
| PrEP Counseling (CPT 1yyyy) | Permanent | No |
| Safety Planning (CPT 2zzzz) | Provisional | Limited |
| Virtual Check-Ins (CPT 98016) | Permanent | Yes |
Impact of Coding Changes on Providers and Patients
Providers must ensure correct use of new codes and abide by the audio-only limitations. For instance, Medicare no longer recognizes most new audio-only codes except for brief check-ins, and accurate coding is crucial for payment. Patients depend on updated coding to access new telehealth services with certainty that they’re covered under their plan.
For those navigating their first Medicare visit or needing help with their Medicare details, see our resource on Medicare number lookup for support.
Audio-Only Telehealth Consultations: Scope and Limitations
Definition Changes to “Interactive Telecommunications System”
CMS has slightly reordered its definition of what counts as an “interactive telecommunications system,” leaning heavily toward video visits. Audio-only technology is only permissible when specifically authorized—mainly for behavioral and mental health, and only through March 31, 2025, unless further extended.
Behavioral Health Services via Audio-Only Through March 31, 2025
Certain behavioral health visits, especially those where beneficiaries cannot use video, remain eligible for coverage via telephone (audio-only) through March 31, 2025. CMS may update or extend these policies depending on ongoing data and advocacy.
Payment and Reimbursement Policies for Audio-Only Telehealth
Medicare previously reimbursed for a broad range of audio-only services, but this is narrowing in 2025. Payment parity largely applies, but only for specific services like virtual check-ins or designated behavioral health. Providers must be careful to use the correct codes to secure payment for audio-only encounters. For a deeper look at payment structures, see our explainer on Part B Medicare premium 2025 costs.
Supervision and Provider Location Flexibilities Under Medicare Telehealth
Virtual Direct Supervision via Real-Time Audio-Visual Technology
For certain outpatient services, providers may offer “direct supervision” virtually—using real-time, interactive audio-video technology—through at least December 31, 2025. This gives supervising doctors flexibility to oversee advanced practice providers and residents remotely.
Telehealth Provider Location Reporting Requirements in 2025
CMS clarified that, for 2025, providers conducting telehealth visits from their homes do not have to report their home address on Medicare enrollment or claim forms. This flexibility aims to maintain provider privacy while supporting nationwide virtual care.
Implications for Teaching Physicians and Resident Supervision
Academic medical centers benefit from continued “virtual presence” for teaching physicians supervising residents in telehealth settings, provided all technology and documentation standards are met.
Payment Structures and Cost Considerations for Medicare Telehealth Visits
Patient Cost-Sharing: Copayments and Deductibles
Most Medicare-covered telehealth services are subject to the same cost-sharing as in-person services—typically 20% of the Medicare-approved amount after the annual Part B deductible is met. Patients should check with their provider before each visit to confirm expected out-of-pocket costs.
Payment Rate Extensions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Special payment protections for RHCs and FQHCs offering non-behavioral telehealth services are extended through the end of 2025. This assures that rural and underserved areas retain solid incentives for delivering technological care.
Financial Implications for Providers
As CMS scales back some pandemic-era flexibilities, providers in urban settings may see a drop in eligible telehealth billings. Adapting to new coding rules and patient location restrictions will be crucial to maintain cash flow and compliance.
Geographic and Location Restrictions: What They Mean for Rural and Urban Patients
Resumption of Pre-Pandemic Geographic Restrictions
Effective October 1, 2025, pre-pandemic rules return for most services, confining telehealth coverage to rural residents at designated medical sites. Urban patients—who enjoyed unmatched access during the last several years—may suddenly confront new barriers, while rural residents continue benefiting from facility-based telehealth.
Access Challenges and Opportunities
In urban areas, patients who grew accustomed to receiving video care from home will need to visit approved medical locations to preserve coverage—unless an exception applies. In contrast, rural clinics and hospitals may see increased patient traffic at their facilities for virtual care, as beneficiaries congregate where coverage remains intact.
Case Study: Urban Medicare Beneficiary’s Psychotherapy
Consider Sandra, a Medicare beneficiary in an urban zip code. In July 2025, Sandra attends psychotherapy via a video visit from her living room. Under October’s new rule, she will need to travel to an eligible facility—or qualify for an exception—if she wants Medicare to pay for virtual psychotherapy from November onward. This scenario highlights the disparate impact of telehealth rollbacks on urban and rural residents.
Role of Medicare Advantage and ACO Plans
Many Medicare Advantage and ACO plans offer expanded telehealth benefits, including home-based video visits for urban members. Checking with your plan about its virtual care rules is more important than ever.
Illustrative Case Studies Demonstrating Medicare Telehealth Use in 2025
Case Study 1: Urban Psychotherapy via Video Visit from Home
Maria, a 71-year-old in Los Angeles, relies on weekly video visits for anxiety management. In August 2025, this care is fully covered from her home. But in November, Medicare will only continue paying if her psychotherapy falls under behavioral health telehealth exceptions. Otherwise, Maria must travel to a rural medical facility for coverage.
Case Study 2: Opioid Treatment Program Using Telehealth
An opioid treatment program adopts telehealth for assessments and periodic check-ins after confirming all Medicare guidelines, as well as state and federal (SAMHSA, DEA) regulations, are met. Remote intake is efficient and safe, particularly for those in rural areas with limited transportation.
For beneficiaries managing complex treatment plans, maintaining current records in your Medicare online account is crucial for claims management and continuity of care.
Case Study 3: Virtual Supervision of Resident Telehealth Visits
Dr. Chen, a teaching physician, supervises a resident’s video visit remotely from home. Under the 2025 rules, Dr. Chen is considered present for billing as long as she’s available on real-time audio-video, streamlining workflow for major teaching hospitals.
Frequently Asked Questions (FAQ) on Medicare Telehealth in 2025
What are the New Telehealth CPT Codes for 2025?
Several new codes will be covered, including those for caregiver training, PrEP counseling, and safety planning. Brief audio-only check-ins (CPT 98016) remain on the list, but most new permanent codes require video.
How Will the Changes in Telehealth Policies Affect Rural Areas?
Rural beneficiaries stand to benefit from continued telehealth access in facilities, and certain payment protections for Rural Health Clinics and FQHCs are extended through 2025. However, patients in urban locations may see limited options for at-home care post-October.
What Are the Permanent Changes to Telehealth Services in 2025?
Permanent telehealth services include most behavioral and mental health, ESRD home dialysis, and acute stroke care from home. Other services will primarily revert to pre-pandemic restrictions from October 2025 forward.
How Will the Definition of “Interactive Telecommunications System” Change?
For most services, Medicare will require audio-video interactions. Audio-only is generally reserved for behavioral health in limited circumstances—and then only through March 2025 unless extended.
What Are the New Telehealth Services Added for Medicare Patients in 2025?
Newly added services for 2025 include caregiver training, PrEP counseling, and crisis safety planning, addressing a mix of preventive, mental health, and caretaker needs.
For clarification on terms or rules, use the official number for Medicare to connect with a representative.
Key Medicare Telehealth Terms and Concepts
- Medicare Telehealth Services: Healthcare services delivered via video (and in select cases, audio-only) technology.
- CY 2025 Physician Fee Schedule (PFS) Final Rule: The annual CMS ruling defining how Medicare pays for all covered telehealth services in 2025.
- Audio-Only Telehealth: Telehealth visits conducted by telephone, limited primarily to behavioral health through early 2025.
- Direct Supervision via Audio-Visual Technology: Virtual provider supervision of certain clinical encounters using real-time video technology.
- Geographic and Location Restrictions: Medicare’s rules that, starting October 2025, confine most telehealth coverage to rural medical facilities.
- Behavioral and Mental Health Telehealth: Virtual care for mental health and substance use disorders, often with expanded coverage exceptions.
- Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): Facilities in underserved areas, eligible for special telehealth payment rates.
- Medicare-Approved Amount: The set fee Medicare pays for a service, before copays or deductibles.
- CMS Telehealth Services List: The official catalog of all codes and services Medicare covers via telehealth, updated annually.
- Permanent vs. Provisional Telehealth Codes: Permanent codes remain covered indefinitely, while provisional codes are under review or temporarily on the covered services list.
As the evolving Medicare telehealth landscape takes shape in 2025, staying informed will ensure beneficiaries continue to get the care they need—when and where they need it most.
