Medicare covers telehealth from the patient's home through December 31, 2027, and 23% of fee-for-service Medicare users received a telehealth service in 2025. CMS counted 6,400,135 of 27,524,672 eligible users, down from 25% in 2024.
That gives practices 448 days from October 9, 2026 to plan before the rules change on January 1, 2028. This post lays out the usage numbers, the extension history, and the dates a practice manager needs on the calendar.
What CMS data shows about 2025 telehealth use
CMS publishes a Medicare Telehealth Trends Report built from fee-for-service Part B claims. The September 14, 2026 snapshot covers January 1, 2020 through March 31, 2026, with claims received by August 18, 2026. CMS labels every figure preliminary because claims keep arriving after the service date.
A "telehealth eligible user" is a beneficiary who received a service on the CMS list of covered telehealth services, by telehealth or in person. The share is telehealth users divided by eligible users. CMS rounds the share to a whole percent.
| Year | Eligible users | Telehealth users | Share |
|---|---|---|---|
| 2020 | 30,946,785 | 14,826,919 | 48% |
| 2021 | 29,967,346 | 10,249,756 | 34% |
| 2022 | 28,885,208 | 8,503,157 | 29% |
| 2023 | 27,896,098 | 6,971,495 | 25% |
| 2024 | 27,358,732 | 6,748,365 | 25% |
| 2025 | 27,524,672 | 6,400,135 | 23% |
Source: CMS, Medicare Telehealth Trends Report, snapshot of September 14, 2026. Preliminary data.
Telehealth users fell by 8,426,784 between 2020 and 2025, a drop of 56.8% of the 2020 count. The 2024 to 2025 change was smaller: 348,230 fewer users, or 5.2%. Over the same year the eligible population rose by 165,940 beneficiaries, or 0.6%. Use has settled near one-quarter of the eligible group.
How many visits and clinicians sit behind those users
Brown University School of Public Health researchers Ateev Mehrotra, Andrew Wilcock, and Jared Perkins analyzed fee-for-service claims for the first half of 2025. They found 4,297,532 beneficiaries, or 15% of all fee-for-service beneficiaries with Parts A and B, received a telehealth visit. Those patients had 11,139,779 visits, which is about 2.6 visits per user in six months.
On the clinician side, 469,487 clinicians delivered at least one Medicare telehealth visit. That is 29.6% of clinicians who billed any evaluation and management visit in the period. The Brown brief lists primary care physicians, nurse practitioners, and mental health specialists as common telehealth clinicians. Mental health conditions and chronic conditions such as diabetes and hypertension were the common reasons for visits.
The Brown team also put telehealth in context. In the first months of the pandemic it made up more than 40% of Medicare outpatient visits. It has since settled near 5% of outpatient visits, the brief says, citing 2024 testimony to the House Energy and Commerce health subcommittee.
How common telehealth is across practices
The American Medical Association's 2024 Physician Practice Benchmark Survey, which covered 5,000 physicians, tracks telehealth across all payers. The share of physicians in practices that used telehealth was 25.1% in 2018 and 79.0% in 2020. It was 71.4% in 2024.
The survey also splits video visits by ownership. In 2024, 73.5% of physicians in hospital-owned practices reported videoconferencing with patients, against 58.3% in private practice. That is a 15.2 point gap. A private practice below the hospital-owned rate can check its own video scheduling and platform setup.
How the extension history reached 2027
Congress has set the Medicare telehealth end date several times since the public health emergency ended in May 2023. The Brown brief lists the first three steps. Medical Economics and Foley & Lardner cover the 2026 steps.
| Law or action | Flexibilities run through |
|---|---|
| Consolidated Appropriations Act, 2023 (December 2022) | December 31, 2024 |
| American Relief Act (December 2024) | March 31, 2025 |
| H.R. 1968 (March 2025) | September 30, 2025 |
| Lapse during the shutdown of October 1 to November 12, 2025 | Coverage paused |
| Short-term extension, then lapse on January 31, 2026 | January 30, 2026 |
| H.R. 7148, Consolidated Appropriations Act, 2026 (signed February 3, 2026) | December 31, 2027 |
Sources: Brown University School of Public Health research brief; Medical Economics, February 10, 2026; Foley & Lardner, January 29, 2026, with updates.
The 2026 law is the longest extension in this list, at about 23 months from signing. CMS said telehealth flexibilities apply retroactively to the brief lapse, as if it had not occurred. The American Academy of Sleep Medicine, in a February 6, 2026 summary, adds that the work geographic practice cost index floor runs through January 1, 2027.
What changes on January 1, 2028
Medical Economics, citing the February 2026 CMS telehealth FAQ, reports that nonbehavioral telehealth reverts to prepandemic rules on January 1, 2028 unless Congress or CMS acts. Before the emergency, Medicare limited telehealth to rural or health professional shortage areas, established patients, and certain provider types, according to CMS.
The same date applies to the in-person visit requirement for most mental health telehealth services, which the law delays until January 1, 2028. Federally qualified health centers and rural health clinics can bill most nonbehavioral telehealth encounters with HCPCS code G2025 through December 31, 2026. That is a full year before the general cutoff.
One more date matters to billing staff. On January 1, 2026, CMS allowed virtual presence through real-time audio and video to meet direct supervision for many services.
What a practice can measure now
The national share of Medicare users with a telehealth service was 23% in 2025. The average user had about 2.6 visits in the first half of the year, and 29.6% of billing clinicians delivered at least one visit.
A practice can pull its own Medicare telehealth claims for 2025 and 2026 and compare the share of unique patients, visits per patient, and share of clinicians with the same figures. The result shows how much volume depends on the flexibilities that end after December 31, 2027. CMS data are preliminary, so compare against claims at least 3 months old. CMS reports that 93% of carrier claims arrive within 3 months of the service date.
Sources
- CMS, Medicare Telehealth Trends Report, September 14, 2026
- Brown University School of Public Health, Medicare Telehealth Flexibilities at Risk of Expiration, 2025
- Medical Economics, What changed in Medicare telehealth under the 2026 spending bill, February 10, 2026
- Foley & Lardner, Medicare Telehealth Flexibilities: Countdown to January 30, 2026, January 29, 2026
- American Academy of Sleep Medicine, Congress ends partial government shutdown and extends telehealth flexibilities, February 6, 2026
- AMA, Physician Practice Benchmark Survey, page updated June 24, 2026
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