Medicare telehealth visits jumped from under 1% to near half

The signal

Effective 6 March 2020, the Centers for Medicare & Medicaid Services used its Section 1135 waiver authority, under the Coronavirus Preparedness and Response Supplemental Appropriations Act, to expand Medicare telehealth in the health sector nationwide. CMS's fact sheet, published 17 March 2020, describes the prior rule as paying for telehealth “on a limited basis: when the person receiving the service is in a designated rural area and when they leave their home” for a clinic or facility; the waiver instead let Medicare “make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home,” paid at the same rate as an in-person visit, and expanded which provider types could bill for it.

The evidence

The effect on actual visit patterns is measured by a separate agency. The Department of Health and Human Services' ASPE report, published 27 July 2020, using data through early June 2020, found that in February 2020, before the waiver, “less than one percent” of Medicare primary care visits were delivered by telehealth; by April 2020, “nearly half of Medicare primary care visits were provided via telehealth.” That is a share of visit type, not a raw count, and the report separately notes telehealth adoption was lower among rural than urban Medicare beneficiaries over the same period. The jump followed the regulatory change closely in time, which supports reading the waiver as the proximate cause rather than a coincidental shift in patient behaviour.

Timeframe and confidence

Confidence in the February-to-April 2020 share figures is high, since they come from a dedicated federal analysis of claims data. An editorial distinction matters here: a share rising under a temporary emergency waiver is a policy-enabled ceiling, not automatically a new permanent baseline, since the legal authority behind it was time-limited by design. CMS's own CY 2025 Physician Fee Schedule fact sheet, published 1 November 2024, confirms this directly: “Absent Congressional action, beginning January 1, 2025, the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 PHE will retake effect for most telehealth services,” including the geographic and site-of-service restrictions the 2020 waiver had lifted.

What would change the reading

Whether Congress acted before 1 January 2025 to extend the flexibilities is the fact that would settle this. This piece, prepared 16 September 2026, has not opened a document confirming what happened after that date, so the reversion described in the November 2024 fact sheet should be read as CMS's stated legal position at that time, not a confirmed outcome.

• Did Congress extend the telehealth flexibilities before the 1 January 2025 reversion date, and on what terms?
• Has the rural-urban adoption gap ASPE identified in 2020 narrowed or widened since?
• Would Medicare telehealth's share of primary care visits return toward its pre-2020 level if the statutory limits fully retook effect?

A policy-driven jump this large is only half the story without its expiry date attached: the same CMS that reported the near-fifty-percent share in 2020 stated in 2024 that the legal basis for it was due to lapse without further action.

Source trail

1. Medicare Telemedicine Health Care Provider Fact Sheetwww.cms.gov · Source publication: 2020-03-17 · Retrieved 2026-09-16

   Describes the Section 1135 waiver's original telehealth terms, effective 6 March 2020: originating sites, eligible providers and payment parity.

2. Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemicaspe.hhs.gov · Source publication: 2020-07-27 · Retrieved 2026-09-16

   Measures the share of Medicare primary care visits delivered by telehealth, from under 1% in February 2020 to nearly half in April 2020.

3. Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule (fact sheet)www.cms.gov · Source publication: 2024-11-01 · Retrieved 2026-09-16

   States that absent Congressional action, pre-pandemic statutory telehealth limits retake effect from 1 January 2025.

Read across the evidence

• FDA authorised the first mRNA vaccine in December 2020
• WHO's pandemic statement became a cross-sector reference date
• US work-from-home share roughly tripled between 2019 and 2021

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