Medicare to Roll Back At-Home Telehealth Coverage From January 2026

The policy shift is expected to affect millions of older adults and people with disabilities who have relied on virtual visits for routine and follow-up care.

Medicare will significantly scale back coverage for at-home telehealth services beginning January 31, 2026, as temporary flexibilities introduced during the COVID-19 pandemic come to an end.

The policy shift is expected to affect millions of older adults and people with disabilities who have relied on virtual visits for routine and follow-up care.

During the pandemic, emergency waivers allowed Medicare beneficiaries to access telehealth services from home, removed long-standing geographic restrictions, and expanded the types of providers eligible for reimbursement. These changes enabled widespread use of video and audio visits for chronic disease management, mental health care, medication adjustments, and post-hospital follow-ups.

With the expiration of those waivers, Medicare coverage will largely revert to pre-pandemic rules. Under the revised framework, most telehealth services will only be covered if beneficiaries are physically present at a qualifying originating site located in a rural area. Eligible sites include federally qualified health centers, rural health clinics, and certain medical facilities approved under Medicare guidelines. At-home telehealth visits will generally no longer be reimbursed under traditional Medicare.

The rollback includes several key exceptions. Behavioral and mental health services will continue to be covered when delivered to patients in their homes, regardless of geographic location. Certain specialized and time-sensitive services, such as monthly visits for patients with end-stage renal disease and acute stroke evaluations, will also remain eligible for telehealth reimbursement without site restrictions.

Health policy experts warn that the changes could disproportionately affect seniors living in urban and suburban areas, where rural originating site requirements may not be met. For many beneficiaries, telehealth reduced the need for travel, transportation expenses, and reliance on caregivers. With fewer covered at-home options, patients may face increased out-of-pocket costs or delays in care.

The Centers for Medicare & Medicaid Services has stated that the expanded telehealth coverage was designed as a temporary response to the public health emergency. Policymakers continue to weigh access to care against concerns related to program costs, oversight, and fraud prevention as they consider long-term telehealth policy.

Medicare Advantage plans may provide an alternative for some beneficiaries. Unlike traditional Medicare, these privately administered plans have greater flexibility in offering telehealth benefits, and several insurers have indicated they plan to continue broader virtual care options beyond January 2026. Coverage details, however, vary by plan and region.

Healthcare providers and patient advocates are urging beneficiaries to prepare by discussing care options with physicians, reviewing Medicare Advantage offerings, and assessing potential travel requirements as the policy changes take effect.

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