Update Regarding Medicare Telehealth Coverage

As of October 1, 2025, changes to Original Medicare telehealth coverage are in effect due to Congress not extending pandemic-era telehealth policies. Now, Original Medicare will only cover most telehealth services for beneficiaries located in a rural office or medical facility.

Note: There are exceptions for the following services and they will continue to be covered by Original Medicare: Monthly End Stage Renal Disease (ESRD) visits, services for the diagnosis, evaluation, or treatment of symptoms of an acute stroke; services for the diagnosis, evaluation, or treatment of a mental and/or behavioral health disorder, including a substance use disorder.

How This Affects Highmark D-SNP Plans

While these changes impact Original Medicare, Highmark Medicare D-SNP plans will continue to provide the same telehealth coverage offered throughout 2025. We will continue to provide coverage of expanded telehealth benefits for your D-SNP patients in 2026.

For details on a specific plan's telehealth coverage, please refer to the Evidence of Coverage documents for a given benefit year.