US Healthcare · Getting Care
Telehealth
What telehealth covers in the US, state licensing requirements, Medicare telehealth rules, when in-person care is required, and how to access remote visits.
Anyone in the US who wants to understand what types of care can be accessed by video or phone, how telehealth billing works, and the limitations of remote care.
Telehealth — the delivery of healthcare services using telecommunications technology — expanded dramatically during the COVID-19 pandemic and remains a significant part of the US healthcare landscape. Video visits, telephone consultations, remote patient monitoring, and asynchronous messaging with providers are now available through most major health systems, insurers, and standalone telehealth platforms. Understanding what telehealth can and cannot do, how it is covered by insurance, and how to access it helps you use this option effectively.
What telehealth can handle
Telehealth is most effective for care that does not require a physical examination, laboratory test, or in-person procedure. Services commonly delivered via telehealth include:
Mental health and behavioral health. Therapy, psychiatry, medication management for stable psychiatric conditions, and counseling are among the most widely available and effective telehealth services. Mental health telehealth expanded significantly during the pandemic and many providers continue to offer it as a primary modality.
Primary care follow-up. Checking in on stable chronic conditions — hypertension, diabetes, thyroid conditions, asthma — reviewing lab results, or adjusting medications that do not require physical findings are well-suited for telehealth.
Minor acute conditions. Many common infections (urinary tract infections, sinus infections, pink eye, certain skin conditions) can be diagnosed and treated remotely based on reported symptoms, particularly when a prescriber has access to your prior medical history.
Prescription management. Refill requests, medication questions, and dose adjustments for stable regimens can often be handled by telehealth, though controlled substances require specific conditions to be prescribed by video.
Specialist consultations. Dermatology (asynchronous photo review), endocrinology, neurology follow-up, and second opinions are increasingly available by telehealth.
When telehealth is not appropriate
Telehealth cannot replace care that requires physical presence. Situations requiring in-person evaluation include:
- Acute chest pain, shortness of breath, or suspected cardiac emergencies
- Physical examination findings (masses, tenderness, neurological signs)
- Wounds requiring cleaning, closure, or debridement
- Procedures — injections, biopsies, imaging
- Lab work and point-of-care testing
- Initial evaluation of complex conditions where a physical exam is essential to diagnosis
If you describe symptoms during a telehealth call that suggest a condition requiring in-person evaluation, the provider should direct you to appropriate in-person care, including the emergency room if urgency warrants it.
How telehealth coverage works under private insurance
Most ACA-compliant individual, family, and employer plans now cover telehealth services, though the scope and cost-sharing vary. Your plan’s Summary of Benefits and Coverage (SBC) should include telehealth coverage details — what services are covered, which platforms are in-network, and what your copay or coinsurance is.
Many insurers contract with third-party telehealth platforms (such as Teladoc, MDLive, or AmWell) as in-network services. Others work primarily through primary care and specialist networks where individual providers offer telehealth visits. Telehealth through your own in-network doctor is typically covered the same way as an in-person office visit — same copay, same network rules.
Prior authorization requirements for telehealth visits follow the same general rules as in-person visits. A telehealth visit with a specialist does not bypass HMO referral requirements, for example.
Telehealth under Medicare
Medicare Part B covers certain telehealth services when specific conditions are met. The list of covered telehealth services, originating site rules (where the patient must be located), and requirements for the type of technology used are defined by CMS and have been modified by legislation since the pandemic. The current scope of Medicare telehealth coverage — including which services are available by audio-only versus video — is available on medicare.gov.
For Medicare Advantage (Part C) plans, telehealth coverage may be broader than Original Medicare, as advantage plans can offer supplemental benefits. Review your specific Medicare Advantage plan’s coverage documents.
State licensure and cross-state care
Telehealth adds complexity to state medical licensing requirements. A physician must generally be licensed in the state where the patient is physically located at the time of the telehealth visit. For patients who live in one state and travel to another, or who live near a state border, confirming the provider’s licensure in the patient’s current state matters.
Several interstate licensure compacts — such as the Interstate Medical Licensure Compact (IMLC) — allow physicians to more easily obtain licenses in multiple states. The practical effect is that more providers now hold multistate licenses, making cross-state telehealth more accessible. Check with your provider or telehealth platform about where they are licensed to practice.
Key terms
| Term | Plain meaning | Glossary |
|---|---|---|
| Telehealth | Healthcare services delivered remotely via video, phone, or digital communication | → |
| PCP | Primary care physician — the main doctor you see for general health concerns and referrals | → |
| Specialist | A physician with advanced training in a specific field, such as cardiology or psychiatry | → |
| Medicare Part B | The Medicare component that covers outpatient services, including telehealth | → |
| Network | The set of providers your insurance plan has contracted with | → |
Common questions
- Is a telehealth visit the same price as an in-person visit?
- Cost depends on your plan. Many plans apply the same copay or coinsurance to telehealth visits as in-person visits for the same service type. Some plans have lower telehealth copays to encourage use. Check your Summary of Benefits or call member services for your plan's telehealth cost-sharing.
- Can I use my plan's telehealth with any doctor?
- Usually only in-network providers in your plan's telehealth program. Many insurers have contracted with telehealth platforms (such as Teladoc, MDLive, or AmWell) as in-network services. You may also be able to have telehealth visits with your own primary care provider or specialist if they offer the option and are in your network.
- What conditions cannot be treated by telehealth?
- Telehealth cannot substitute for physical examination, hands-on procedures, point-of-care testing, imaging, or in-person interventions. Conditions requiring physical assessment — suspected fractures, acute abdominal pain, chest pain, wound care — generally require in-person evaluation. Mental health care, medication management, and follow-up for stable chronic conditions are among the most common telehealth use cases.
- Can I see a doctor in another state by telehealth?
- Physicians are licensed by state, and many states require that a provider be licensed in the patient's state to provide care. Rules vary by state and by the type of license held. Cross-state telehealth licensure compacts have expanded the ability of some clinicians to practice across state lines, but confirm your provider's licensure before booking a cross-state telehealth appointment.
- How did the COVID-19 pandemic change telehealth rules?
- During the COVID-19 public health emergency, the federal government relaxed many telehealth restrictions — particularly for Medicare. Some of these expanded policies were made permanent or extended by subsequent legislation. Others reverted to prior restrictions when the emergency ended. For Medicare specifically, check medicare.gov for the current scope of covered telehealth services.
Sources
Last reviewed: September 2026