Tag: Patient co-pays and co-insurance under Part B

How Does Medicare Cover Telemedicine?

By Danielle K. Roberts, a Medicare insurance expert and co-founder, Boomer Benefits.

Danielle Kunkle Roberts

The telehealth revolution gives health providers the opportunity to assist patients in remote or rural areas; the same kind of care that they give to patients in person. It saves money on travel and improves efficiency in healthcare as well.

While telehealth options in healthcare are helpful to individuals at any stage in life, they can be particularly helpful in treating older adults with chronic illnesses. The Centers for Medicare and Medicaid Services have recognized this and have put together guidelines for primary care physicians who treat patients in geographical areas where it may be difficult for those beneficiaries to otherwise gain access to certain specialists and medical experts.

Telehealth services are made available to these Medicare beneficiaries who have signed up for Medicare Part B. Here’s how Medicare covers telemedicine for these people.

Medicare outpatient coverage for telemedicine

Medicare has two original parts: Part A hospital coverage and Part B outpatient coverage. Telehealth services fall under Part B. Medicare Part B will cover a telehealth consultation whenever a consultation is medically necessary, and your Medicare doctor follows the guidelines in arranging the consultation.

The specialist must conduct your teleconsultation using two-way interactive communication that must include both live audio and video feeds. Fortunately, with the prevalence of digital technologies and telehealth platforms, this has become common practice for most healthcare organizations.

The Medicare beneficiary needs to live within designated rural areas, and the video conferencing call must be held at a designated originating site. Approved originating sites include your physician’s office or rural health clinic. Calls can also be conducted from within a federally qualified health center, a skilled nursing facility, inpatient hospital, critical access hospital or community mental health facility.

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