Telehealth visit cost: the office rate, from home, through 2027

The rule that sets the price

Medicare does not have a separate, cheaper price list for telehealth visits. The clinician bills the same visit codes used in the office, and the claim carries a place of service code that says where the patient was. The CMS Telehealth FAQ, updated October 8, 2026, names the two codes: place of service 02 for telehealth provided other than in the patient's home, and place of service 10 for telehealth provided in the patient's home. It then states the payment rule: starting January 1, 2024, claims for Medicare telehealth services provided to patients in their homes are paid at the non-facility payment rate.

The non-facility rate is the rate a physician office is paid, the one that carries the practice's own overhead. So a visit from home is priced as if it happened in the office. Medicare.gov says the same thing from the patient's side: for most telehealth services, you pay the same amount you would if you got the services in person, and after the Part B deductible you pay 20 percent of the Medicare-approved amount.

That is the whole answer for a typical Medicare telehealth visit, and it is why vendor price ranges for "a telehealth visit" do not help a Medicare patient much. The useful questions are which visit code will be billed, and whether any second line, such as a test or a facility fee, will come with it.

CY2026 anchors by visit level

The tables below are the CY2026 Medicare Physician Fee Schedule non-facility amounts for Michigan Locality 01, computed by MyCarePrice from the CMS RVU26D relative value file (October 2026 release), the CY2026 geographic indices and the $33.4009 conversion factor. Under the place of service 10 rule, each figure is both the office anchor and the telehealth-from-home anchor for that code.

Source: CMS PFS RVU26D and GPCI2026, Michigan Locality 01, CY2026, computed and checked October 30, 2026; place of service 10 rule from the CMS Telehealth FAQ updated October 8, 2026. Coinsurance column assumes the 2026 Part B deductible of $283.00 is already met. Medicare anchors, not your bill; other localities differ.

Read the coinsurance column as the shape of the arithmetic, not a promise. For a person with Original Medicare whose deductible is already met, a 99213 telehealth visit produces a 20 percent share of $19.11 and a 99214 produces $27.30, exactly what the same visits would produce in the office. Supplemental coverage, a Medicare Advantage plan's own copays, or Medicaid can change the patient share. The level of the visit, not the medium, moves the price: the step from 99213 to 99214 is larger than any difference between video and office, because there is no such difference under the home rule.

Supplemental coverage changes only the patient's share, not the anchor. A Medigap policy may pay some or all of the 20 percent coinsurance, depending on the plan letter, and a Medicare Advantage plan replaces the 20 percent with its own telehealth copay or coinsurance, which its Evidence of Coverage lists. Either way, the visit level on the claim still determines the approved amount the share is calculated from.

A deductible illustration

Early in the year the deductible changes the picture. As an illustration with stated inputs: suppose a person with Original Medicare has four 99213 telehealth visits in January and has not yet met any of the 2026 Part B deductible. The approved amounts total 4 x $95.55, which is $382.20. The first $283.00 of that goes to the deductible and is paid by the patient. The remaining $99.20 is shared, and 20 percent of it is $19.84, so the patient's total for the four visits is $302.84. The same four visits in the office would produce the same figures. The deductible and out-of-pocket guide explains the order in which a plan applies each layer.

A year of telehealth visits, worked

One visit is easy to price; a year is where the deductible and the visit levels interact. As an illustration with a stated mix of visits, chosen for the arithmetic and not as a typical year: a person with Original Medicare has six telehealth visits from home in 2026, three billed as 99213, two as 99214 and one as 99215, and has not met any of the Part B deductible when the first visit happens.

Two points stand out. The patient total is the same as it would be for six office visits at the same levels, because the home rule pays the office rate. And most of the patient's cost in this year is the deductible, which is met once a year across all Part B services, not just telehealth. If other Part B care, such as lab work or an imaging study, had already met the deductible, the patient total for these six visits would be the coinsurance alone, 20 percent of $753.60.

The telehealth facility fee: only when you are at a site

One telehealth charge has no office equivalent. When a patient goes to a clinic, hospital or other eligible site and is connected to a distant clinician by video, the site where the patient sits can bill an originating site facility fee, HCPCS Q3014. CMS's summary of the CY2026 Physician Fee Schedule final rule (MLN Matters MM14315) gives the amount: the payment for Q3014 is 80 percent of the lesser of the actual charge or $31.85, and the patient is responsible for any unmet deductible amount and Medicare coinsurance.

On the full $31.85, Medicare's 80 percent is $25.48 and the patient's 20 percent is $6.37, once the deductible is met. That line is paid to the site, not to the distant clinician, who bills the visit code on a separate claim. A patient connecting from home does not produce a Q3014 line, because a private residence is not a facility. If you see Q3014 on a statement, it should match a date you were physically at a site for a telehealth visit.

In the CMS relative value file, Q3014 carries status X and no relative values, so its amount does not come from the fee schedule formula. CMS publishes the figure each year, and the same MLN article states it next to the 2.7 percent Medicare Economic Index increase for 2026.

What changes on January 1, 2028

Most of the home telehealth rules are temporary extensions, now running through December 31, 2027. The CMS Telehealth FAQ lays out the change point. The table summarizes it; each row is from the FAQ updated October 8, 2026.

Source: CMS, Telehealth FAQ, updated 10/8/26, questions 1 to 6 and 11. Checked October 30, 2026. Congress can change these dates again.

The cost consequence for 2028 is not a different price for the same visit; it is whether Medicare pays for a home visit at all. A visit Medicare does not cover is a visit the patient pays for on whatever terms the practice sets, so anyone who relies on home telehealth for routine visits should ask the practice in late 2027 how it will bill those visits from January. Behavioral health is the exception: its home telehealth is permanent, subject to the in-person visit rules, which the therapy session cost guide covers with the psychotherapy code anchors.

Two administrative details from the same FAQ show up on claims rather than prices. When the flexibilities lapsed during the government shutdown that began October 1, 2025, CMS said it would pay telehealth claims as if there had been no lapse. And from January 1, 2027, claims must carry new telehealth modifiers BB and BC in certain arrangements, which CMS says have no payment implications.

Questions to ask your practice before 2028

The January 2028 change is a coverage question first and a price question second, and it is easier to settle in 2027 than after the first bill. These questions put the practice's plan in writing.

• "Which of my regular visits are billed as telehealth from home today, and will Medicare still cover them from January 1, 2028?"
• "If a home video visit is no longer covered, will you offer it at a cash price, and what is that price by visit level?"
• "For behavioral health visits, when will I need an in-person visit, and how will that visit be billed?"
• "If you plan to use a clinic site as an originating site, which site, and will it bill the facility fee?"
• "Does my Medicare Advantage plan, if I have one, cover home telehealth beyond what Original Medicare covers, and at what copay?"

Write the answers down with the date and the name of the person who gave them, and check them again in late 2027, because Congress has extended these rules before and may do so again.

Codes that are not Medicare telehealth visits

Several shorter services happen through technology but are not telehealth visits in Medicare's sense. The CMS FAQ explains that services that do not substitute for an in-person encounter, such as chronic care management or remote monitoring, are not subject to the telehealth restrictions at all. For patients, the two that matter most are patient portal messages, billed as online digital evaluation and management (e-visits), and brief virtual check-ins. Both have their own, much smaller fee schedule amounts, and both carry the usual Part B cost sharing. Our guide to patient portal message charges prints the 2026 anchors for each of those codes and the seven-day rule that decides when a message becomes a billable e-visit.

A second group of codes causes confusion on commercial bills. CPT includes a set of codes for synchronous audio-video and audio-only visits, 98000 through 98015. In the CMS RVU26D file for 2026 those codes carry status I, which means Medicare does not recognize them for payment; Medicare telehealth visits are billed with the ordinary office visit codes instead. A commercial plan or a cash-pay practice may use the 98000 series, so if one appears on a bill, ask the plan how it pays that code and whether its rate differs from the office visit code for the same level.

High deductible plans and telehealth before the deductible

For people with a high deductible health plan, telehealth has a tax-code wrinkle that changes the patient's price. Normally a plan must apply its deductible before paying for most care to qualify as a high deductible health plan for health savings account purposes. IRS Publication 969, the edition for 2025 returns, says a plan will not fail to be treated as a high deductible health plan because it has no deductible for telehealth. Public Law 119-21 made that treatment permanent for plan years beginning after December 31, 2024, as our HSA and FSA guide describes.

Permission is not a requirement. Each plan decides whether to cover telehealth before the deductible, so the same visit might cost nothing under one high deductible plan and the full allowed amount under another, until the deductible is met. Ask the plan, or read the Summary of Benefits and Coverage, for the telehealth line specifically. The HDHP cost math guide shows how that one plan feature enters a full-year comparison.

Community health centers and rural health clinics

If your video visit comes from a federally qualified health center or a rural health clinic, the claim follows different rules from the ones above. The CMS Telehealth FAQ updated October 8, 2026 says behavioral health services these clinics furnish by telecommunications are paid under the clinics' own payment systems, the all-inclusive rate for rural health clinics and the prospective payment system for health centers, rather than under the Physician Fee Schedule amounts in the tables above. For other services, the clinics may keep billing telehealth through December 31, 2027. Through September 30, 2026 they reported those visits with a single code, G2025; from October 1, 2026 they bill the individual CPT or HCPCS code for the visit with a telehealth modifier. That change is why a health center statement for a video visit this fall can show a familiar visit code where an earlier statement showed G2025. The same FAQ says the home, and any geographic location, can serve as the patient's site for these clinics' telecommunications services. Because the clinic's payment system sets the amount, ask the clinic how it prices the visit instead of comparing its bill with the 99213 anchor.

Commercial plans and cash-pay telehealth

Outside Medicare there is no single telehealth price rule. A commercial plan's contract with each practice sets the allowed amount for each code, and the plan's benefit design sets your share: some plans apply the office visit copay to telehealth, some apply a separate telehealth copay, and some can route telehealth through a contracted virtual vendor with its own cost sharing. The plan documents are the only reliable source, and the question to ask is narrow: "What is my cost share for a telehealth visit with an in-network clinician, and is it different from an office visit?"

Cash-pay telehealth companies post flat visit prices, and those prices are set by the company, not by any fee schedule. The Medicare anchors above are a yardstick for comparing a posted price with what the same visit level is paid elsewhere, not a statement of what any platform should charge. Ask which visit level a flat price corresponds to, because the same flat price compares differently against a short 99212 visit than against a 99214. Before paying, ask what the price includes: one visit only, or follow-up messages too; whether prescriptions, lab orders or a referral letter are billed separately; and whether a second visit within a short window is charged again.

A self-pay patient also has federal estimate rights for telehealth. The Good Faith Estimate rules apply to scheduled items and services generally, and a provider must give an estimate when care is scheduled at least three business days ahead or when the patient asks. On-demand visits booked minutes ahead fall outside the scheduling trigger, but the right to ask still applies. Our Good Faith Estimate guide explains what the estimate must list and the $400 dispute threshold.

A checklist for telehealth charges

Telehealth bills are usually simple, which makes errors easy to spot. A site fee on a home visit, a level that does not match a short call, or a visit charge on a date with no appointment is each a precise question for the billing office. The itemized-bill check gives the general procedure.

Second lines that come with a video visit

A telehealth visit rarely produces a second line on its own, but what is ordered during it can. A lab order produces a lab bill from whichever lab performs the test, priced under the Clinical Laboratory Fee Schedule, as the lab fee schedule guide explains. A prescription produces a pharmacy charge, governed by your drug coverage. A hospital-based practice can sometimes bill a facility fee for in-person visits, and the facility fee guide explains how that split works, but a patient at home generates no originating site fee under the Medicare rule above. When a statement shows more than one line for a telehealth date, match each line to what was ordered.

Common questions about paying for a video visit

Where the 2027 and 2028 dates come from

• CMS, Telehealth FAQ, updated 10/8/26: dates through December 31, 2027, the January 1, 2028 changes, place of service 02 and 10, the non-facility rate for home, rural health clinic and health center billing (G2025 through September 30, 2026), shutdown claims, modifiers BB and BC, and non-face-to-face services. Checked October 30, 2026.
• Medicare.gov, Telehealth: cost sharing and coverage through December 31, 2027. Checked October 30, 2026.
• CMS, MLN Matters MM14315, CY2026 Physician Fee Schedule final rule summary: Q3014 at 80 percent of the lesser of the actual charge or $31.85, MEI 2.7 percent. Checked October 30, 2026.
• CMS, Physician Fee Schedule relative value file RVU26D (October 2026 release) and CY2026 GPCIs, Michigan Locality 01, $33.4009 conversion factor: visit anchors, and status indicators for Q3014 and 98000 to 98015. Computed October 30, 2026.
• Medicare.gov, Medicare costs: 2026 Part B deductible of $283. Checked October 30, 2026.
• Internal Revenue Service, Publication 969 (for 2025 returns): telehealth and the high deductible plan rule. Checked October 30, 2026.

General billing information, not medical, legal or insurance advice. Medicare anchors are not your bill. Confirm your price in writing before service.