In March 2020, the Centers for Medicare & Medicaid Services (CMS) increased access to Medicare telehealth services with the aim of reducing travel that beneficiaries would have to make in order to get to in-person doctor visits and, therefore, also potentially decreasing exposure to COVID-19. CMS expanded regulatory flexibilities and the range of providers that could be reimbursed for services. A report just released by the Assistant Secretary for Planning and Evaluation (ASPE) shows that the number of Medicare beneficiary telehealth visits increased from 840,000 in 2019 to almost 52.7M in 2020, amounting to a 63 fold increase.
In 2019, before the Medicare telehealth waivers were implemented due to the COVID-19 public health emergency (PHE), there were geographic limitations on telehealth. Only Medicare beneficiaries living in rural areas were eligible for these services. In response to the PHE, Medicare allowed telehealth services to be available nationwide – no matter if the beneficiary lives in a rural or urban environment. The ASPE report shows that the highest rates of telehealth use in 2020 “shifted into more urban states, with the highest rates of telehealth in the Northeast and in the West (particularly) California.” Furthermore, behavioral health visits, such as general psychiatrists, psychologists, and licensed clinical social workers, showed the largest increase, with 38% of all visits these providers delivered occurring through telehealth (up from 1% in 2019).
At the time that the telehealth waivers were implemented by CMS, the Center issued a set of principles – in conjunction with the Medicare Rights Center – providing guidelines on how to proceed with Medicare coverage of telehealth while safeguarding the health and well-being of beneficiaries. One of those principles discussed ensuring “equitable access to telehealth for underserved communities, including Black Americans and people of color, individuals with disabilities, and people with limited English proficiency.”
The ASPE report showed mixed results on racial disparities in accessing telehealth in 2020. There was a lower share of Black beneficiaries that utilized telehealth compared to Whites. The Hispanic and Asian populations, however, had a higher share of telehealth use. The Center will be releasing an in-depth Telehealth report shortly. The report, led by our Chiplin Fellow, Cinnamon St. John, will examine gaps that currently exist in accessibility, along with infrastructure needs that should be addressed by lawmakers to ensure that all Americans have equal access to the advantages and opportunities telehealth provides.
December 9, 2021 – C. St. John
 CMS. Medicare Telemedicine Health Care Provider Fact Sheet. CMS. (March 17, 2020). Available at: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.
 Wong Samson, L., Tarazi, W., Turrini, G., & Sheingold, S. Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location. ASPE. (December 3, 2021). Available at: https://aspe.hhs.gov/reports/medicare-beneficiaries-use-telehealth-2020.
 CMA, & Medicare Rights Center. (2020, July 23). Telehealth – Recognize the Benefits, But Proceed with Caution. Center for Medicare Advocacy. Retrieved December 6, 2021, from https://medicareadvocacy.org/joint-principles-from-center-for-medicare-advocacy-and-medicare-rights-center-medicare-expansion-of-telehealth-helps-beneficiaries-access-care-during-the-pandemic-but-caution-is-needed-bef/.