Does Telehealth Accept Medicaid

Does Telehealth Accept Medicaid? What Online Doctor Visits Are Covered

ByAnastasia Mancini

Wondering if Medicaid covers telehealth? Learn what online doctor visits are covered by state programs, audio-only rules, and how to check your specific Medicaid telehealth benefits in 2026.

Medicaid covers telehealth services in all states, including audio-only and video calls, though specific coverage varies by state. Covered services typically include urgent care (colds, allergies), behavioral health, and chronic condition management. Top, affordable options for Medicaid and low-cost care include Teladoc, CVS MinuteClinic, and state-managed Medicaid plans. 

Top Telehealth Options Accepting Medicaid & Affordable Care:

What Telehealth Services Are Covered by Medicaid?

  • Urgent Care: Acute care for fever, cough, flu, rash, and infections (UTIs).
  • Behavioral Health: Therapy and psychiatric evaluations.
  • Specialty Care: Remote consultations for chronic conditions.
  • Preventive Services & Checkups: Virtual check-ins.

Affordable Alternatives Without Insurance (Often < $50):

  • Sesame: CNET Offers, on average, $37–$47 sessions for prescriptions and urgent needs.
  • GoodRx Care: Mira Health Visits start around $19–$49 for common conditions.

Medicaid coverage is expansive, but always verify with your state agency or plan provider to ensure the specific telehealth provider is in-network. 

Does Telehealth Accept Medicaid? What Online Doctor Visits Are Covered

If you or a family member relies on Medicaid for health coverage, you might wonder whether you can use it for online doctor visits. The answer is yes—but with important caveats. Unlike Medicare, which has consistent national rules, Medicaid is administered by individual states, meaning telehealth coverage varies depending on where you live.

This guide explains how Medicaid covers telehealth in 2026, what services are typically included, and how to find out exactly what your state offers. Whether you need urgent care, mental health support, or ongoing chronic condition management, understanding your Medicaid telehealth benefits can save you time and money.

Medicaid and Telehealth: The State-by-State Reality

Medicaid is a joint federal and state program, but states have significant flexibility in designing their own Medicaid programs within federal guidelines. This means telehealth coverage can look very different depending on your location. Some states have embraced telehealth enthusiastically, while others maintain more restrictive policies.

The good news is that all 50 states and the District of Columbia now cover some form of telehealth in their Medicaid programs. The specifics—which services are covered, which providers can bill, what technology is allowed, and reimbursement rates—differ significantly from state to state.

Importantly, recent federal legislation has made it easier for states to streamline enrollment for out-of-state providers, potentially expanding access to telehealth across state lines. The Consolidated Appropriations Act of 2026 requires states to implement a streamlined Medicaid and CHIP enrollment process for eligible out-of-state providers, reducing administrative barriers and improving continuity of care, especially for behavioral health services.

What Telehealth Services Does Medicaid Typically Cover?

While coverage varies by state, most Medicaid programs cover several categories of telehealth services. Understanding these categories helps you know what to look for when researching your state’s specific policies.

Live Video Consultations (Synchronous Telehealth)

Real-time, two-way audio-video communication between you and a provider is the most commonly covered form of telehealth. This includes:

  • Primary care visits for routine and urgent concerns
  • Specialist consultations
  • Mental health and substance use disorder treatment
  • Follow-up appointments for chronic conditions

Wisconsin’s ForwardHealth program, for example, defines telehealth as “the use of telecommunications technology by a Medicaid-enrolled provider to deliver functionally equivalent health care services including assessment, diagnosis, consultation, treatment, or transfer of medically relevant data.” The service must meet the same quality and effectiveness standards as an in-person visit.

Audio-Only (Telephone) Visits

Many states now cover audio-only telehealth visits, recognizing that not all patients have access to video technology or high-speed internet. Coverage varies widely:

  • Vermont: Medicaid provides reimbursement at the same rate for medically necessary, clinically appropriate services delivered by telephone. Claims must include modifier 93 to indicate “service delivered via telephone, i.e., audio-only.”
  • Virginia: Medicaid covers specific audio-only services, with some requiring modifier 93 and others not. Detailed tables list which codes are covered.
  • Wisconsin: ForwardHealth’s expanded definition of telehealth includes “real-time interactive audio-only communication” as an allowable modality.

For behavioral health services, audio-only coverage is particularly common. Many states recognize that telephone consultations can be clinically appropriate for therapy sessions, medication management, and crisis intervention.

Remote Patient Monitoring

Some Medicaid programs cover remote patient monitoring (RPM), which uses devices to track vital signs and other health data at home. This is especially valuable for patients with chronic conditions like diabetes, hypertension, or heart disease. Wisconsin’s permanent telehealth policy, for example, includes coverage for remote physiological monitoring services.

Store-and-Forward Technology

This allows providers to share images and data with specialists for later review—particularly useful in dermatology, ophthalmology, and radiology. Coverage varies by state, with some including it in their telehealth definitions and others treating it separately.

Mental Health and Substance Use Disorder Services

Behavioral health services are among the most consistently covered telehealth benefits across state Medicaid programs. Many states explicitly include:

  • Individual and group therapy
  • Psychiatric evaluations and medication management
  • Substance use disorder counseling and treatment
  • Crisis intervention services

Virginia’s Medicaid manual, for example, details that peer recovery specialists may deliver services in-person or through telehealth or audio-only. The state also specifies requirements for after-hours crisis intervention via telephone for intensive community-based services.

State Examples: How Medicaid Telehealth Policies Differ

To illustrate the variation across states, here are specific examples of how different Medicaid programs approach telehealth:

Wisconsin: Comprehensive Expansion

Wisconsin’s ForwardHealth program has significantly expanded telehealth coverage in permanent policy. Key features include:

  • Coverage for “functionally equivalent” services delivered via telehealth, meaning the quality and effectiveness must match in-person care
  • Inclusion of real-time interactive audio-only communication
  • Remote physiological monitoring coverage
  • Clear billing guidelines with place of service code 02 and GT modifier for synchronous telehealth
  • Transition from temporary pandemic policies to permanent expanded coverage

Vermont: Audio-Only Parity

Vermont Medicaid takes a notably progressive approach to audio-only care:

  • Reimbursement at the same rate for medically necessary services delivered by telephone as for in-person or video visits
  • Requires modifier 93 for audio-only claims
  • Publishes a complete list of audio-only covered codes
  • Clarifies that place of service code 10 is for telehealth provided in patient’s home, while code 02 is for other locations

Importantly, Vermont explicitly notes that “Medicare telehealth changes do not impact Medicaid”—a reminder that federal Medicare policy shifts don’t automatically affect state Medicaid programs.

Virginia: Detailed Service Specifications

Virginia’s Medicaid program provides extensive detail on what’s covered:

  • Tables listing virtual check-in services, audio-only covered services, and those requiring specific modifiers
  • Requirements that telemedicine include at minimum audio and video equipment (distinct from audio-only)
  • Standards of care: services must be provided with the same quality as in-person visits
  • Guidance that if a telehealth visit becomes clinically inappropriate, providers must arrange timely alternatives
  • Specific provisions for peer services, case management, intensive community-based services, and opioid treatment programs

For example, Virginia requires that crisis intervention be available 24/7 via telephone and face-to-face for certain programs, and after-hours crisis intervention by a qualified ACT team member through audio-only may be included in billing if clinically appropriate.

Medicare vs. Medicaid: Why the Distinction Matters

One of the most common sources of confusion is the difference between Medicare and Medicaid telehealth rules. They are separate programs with different funding structures and policies.

Medicare is federal: Changes to Medicare telehealth policy, such as those in the CY 2026 Physician Fee Schedule, apply uniformly across the country. For example, Medicare now permanently allows the patient’s home as an originating site and has eliminated frequency limits for subsequent inpatient and nursing facility visits.

Medicaid is state-based: As Vermont’s Medicaid agency explicitly states: “Starting January 30, 2026, Medicare telehealth coverage is changing because of federal law that only applies to Medicare. These changes do not impact Medicaid. Vermont Medicaid coverage of telehealth services is not changing.”

This distinction is crucial for dual-eligible individuals (those enrolled in both Medicare and Medicaid). Vermont explains: “Medicaid members who are dually enrolled in Medicare and Medicaid must continue to get covered services from Medicare participating providers at a Medicare covered place of service. Services cannot be billed to Medicaid because of changes to Medicare telehealth coverage.”

Recent Federal Legislation Affecting Medicaid Telehealth

The Consolidated Appropriations Act of 2026, signed into law on February 3, 2026, includes several provisions relevant to Medicaid telehealth:

Streamlined out-of-state provider enrollment: Section 6101 requires states to implement a streamlined Medicaid and CHIP enrollment process for eligible out-of-state providers. States may only require minimum necessary information such as name and National Provider Identifier (NPI). Providers enrolled under this process remain enrolled for five years unless terminated or excluded. This change may reduce administrative barriers in cross-state Medicaid telehealth arrangements and improve continuity of psychiatric and behavioral health services.

Mental health funding: The Act appropriates approximately $2.79 billion for SAMHSA mental health programs, including $991.5 million for the Mental Health Block Grant and $385.5 million for Certified Community Behavioral Health Clinic (CCBHC) grants. These funds support expansion of outpatient psychiatric-mental health services and integrated care teams, many of which rely on telehealth delivery models.

How to Find Out What Your State Medicaid Covers

Since Medicaid telehealth policies are state-specific, you’ll need to research your state’s program. Here’s how:

Step 1: Visit your state Medicaid website. Search for “telehealth” or “telemedicine” in the site’s search function. Look for provider manuals, member handbooks, or specific telehealth policy pages.

Step 2: Check for telehealth supplements. Many states publish separate telehealth documents. Virginia, for example, has a “Telehealth Services Supplement” to its provider manual that details covered services, billing requirements, and modifiers.

Step 3: Look for provider alerts and updates. States frequently communicate policy changes through alerts. Wisconsin’s ForwardHealth portal, for instance, maintains a comprehensive list of telehealth-related updates and alerts dating back several years.

Step 4: Call member services. The phone number on your Medicaid card can connect you with representatives who can explain your telehealth benefits and help you find participating providers.

Step 5: Contact your managed care plan. If you’re enrolled in a Medicaid managed care plan, your plan may have its own telehealth policies and preferred platforms. Reach out to member services for plan-specific information.

Questions to Ask When Checking Your Coverage

When researching your state’s Medicaid telehealth benefits, ask these specific questions:

  • Does Medicaid in my state cover live video doctor visits?
  • Are telephone (audio-only) visits covered? If so, for which services?
  • What is my cost-sharing amount for telehealth visits (copay, if any)?
  • Do I need to use specific telehealth platforms or apps?
  • Can I see any provider who accepts Medicaid, or must they be enrolled in a specific way?
  • Are mental health and substance use disorder services covered via telehealth?
  • Can I receive telehealth services from providers outside my state?
  • How do I find Medicaid providers who offer telehealth appointments?

What to Expect During a Medicaid Telehealth Visit

The actual experience of a telehealth visit with Medicaid is similar to what privately insured patients experience:

Finding a provider: Use your state Medicaid website, managed care plan directory, or call member services to find providers offering telehealth. Many states now have online provider directories with telehealth filters.

Scheduling: When you call to schedule, explicitly ask if they offer telehealth visits and whether they accept your Medicaid coverage. Confirm any technology requirements.

Preparing for the visit: Find a quiet, private space with good lighting. If using video, ensure your camera and microphone work. Have your medications and a list of questions ready.

During the visit: The provider will verify your identity, discuss your concerns, provide assessment and treatment recommendations, and if appropriate, send prescriptions to your pharmacy. The same standard of care applies as for in-person visits.

Follow-up: After the visit, you’ll receive documentation and instructions. Your provider should coordinate any needed follow-up with your regular care team.

Frequently Asked Questions

Does Medicaid cover telehealth in all states?
Yes, all 50 states and D.C. now cover some form of telehealth in their Medicaid programs. However, coverage details—which services are covered, which providers can bill, what technology is allowed—vary significantly by state. You must check your specific state’s policies.

Are audio-only (telephone) visits covered by Medicaid?
It depends on your state. Vermont Medicaid covers audio-only visits at the same rate as in-person care with modifier 93. Wisconsin includes audio-only in its expanded telehealth definition. Virginia has detailed tables specifying which audio-only services are covered and whether they require modifiers. Many states cover audio-only for behavioral health services even if not for all medical services. Check your state’s policies.

Do Medicare telehealth changes affect Medicaid?
Generally, no. As Vermont Medicaid explicitly states: “Medicare telehealth changes do not impact Medicaid.” Medicare and Medicaid are separate programs with different funding structures and rules. Changes to Medicare policy, such as those in the CY 2026 Physician Fee Schedule, do not automatically apply to Medicaid. Each state determines its own Medicaid telehealth policies.

What if I’m dual-eligible for Medicare and Medicaid?
If you have both Medicare and Medicaid, you must follow Medicare’s rules for telehealth coverage. Vermont explains: “Medicaid members who are dually enrolled in Medicare and Medicaid must continue to get covered services from Medicare participating providers at a Medicare covered place of service. Services cannot be billed to Medicaid because of changes to Medicare telehealth coverage.” Medicare is the primary payer.

Can I see a provider in another state via telehealth with Medicaid?
Traditionally, Medicaid has been limited to in-state providers due to licensing and enrollment requirements. However, the Consolidated Appropriations Act of 2026 requires states to implement a streamlined enrollment process for eligible out-of-state providers, potentially expanding cross-state telehealth options. This is especially relevant for behavioral health services. Check with your state Medicaid program for current policies.

Are mental health services covered via telehealth by Medicaid?
Yes, mental health and substance use disorder services are among the most consistently covered telehealth benefits across state Medicaid programs. Coverage typically includes individual and group therapy, psychiatric evaluations, medication management, and crisis intervention. Many states have detailed provisions for behavioral health telehealth in their Medicaid manuals.

How do I find a Medicaid provider who offers telehealth?
Start with your state Medicaid website’s provider directory—many now include telehealth filters. If you’re in a managed care plan, contact member services for a list of in-network providers offering virtual visits. You can also call providers directly and ask if they offer telehealth and accept your Medicaid coverage.

Medical Disclaimer: The information in this article is for general informational and educational purposes only and does not constitute medical advice. Medicaid policies vary significantly by state and are subject to change. Always verify your specific coverage and benefits with your state Medicaid program or managed care plan before receiving care. Never disregard professional medical advice or delay in seeking it because of something you have read here. If you are experiencing a medical emergency, call your local emergency services immediately.

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