Medicare's in-person rule for home mental health video starts in 2028
Medicare keeps paying for home mental health video visits. Patients who start them by December 31, 2027 need at least one in-person visit every 12 months.
Head of Growth and Operations, JotPsych
Do you see Medicare patients by video at home? From 2028, each patient who starts home mental health video visits needs an in-person visit in the 6 months before starting, then within 12 months of each video visit.
Section 6209 of H.R. 7148, the Consolidated Appropriations Act, 2026, set the date, and question 5 of the Telehealth FAQ from the Centers for Medicare and Medicaid Services, updated October 8, 2026, gives the rule.
Check when each of your patients started home video visits.
Before the first video visit: no in-person visit
Then: at least one in-person visit every 12 months, from January 1, 2028
Before the first video visit: one in-person visit in the prior 6 months
Then: one in-person visit within 12 months of each video visit
Question 5 of the Telehealth FAQ from the Centers for Medicare and Medicaid Services, updated October 8, 2026, sets both schedules. For a patient who starts home video visits in 2028 or later, book the in-person visit before the first video visit.
Who can do in-person visits
Colleagues of the same specialty and subspecialty in the same group can do in-person visits when you aren't available, per 42 CFR 410.78.
Skipping the 12-month visit
For a given 12-month period, you and your patient can agree that an in-person visit's risks and burdens outweigh its benefits. Write the reason in your patient's record. Then no in-person visit is due for that period, per 42 CFR 410.78(b)(3)(xiv)(B).
Audio-only visits gain conditions in 2028
Medicare patients can have audio-only visits at home through 2027, per H.R. 7148. From January 1, 2028, Medicare covers audio-only visits at home under two conditions, per question 6 of Medicare's Telehealth FAQ. First, you can offer video. Second, your patient can't use video or doesn't consent to it.
Add modifier 93 to each audio-only claim to verify both conditions, per 42 CFR 410.78(a)(3).
The Consolidated Appropriations Act, 2021 permanently removed Medicare's location limits for behavioral health telehealth, per question 11 of the FAQ.
What to do before 2028
- Start home video visits by December 31, 2027 for each Medicare patient you plan to see by video. The patient then counts as established.
- Book each established patient's in-person visit every 12 months.
- Name a colleague of the same specialty and subspecialty in your group who can see your patients in person.
Set your appointment's Session to In-person and its Recurrence to Yearly, and JotPsych repeats the appointment every year.
Book 15 minutes- Centers for Medicare and Medicaid Services, “Telehealth FAQ”, updated October 8, 2026: questions 5, 6, and 11; read October 20, 2026.
- H.R. 7148, the Consolidated Appropriations Act, 2026 (Public Law 119-75), signed February 3, 2026: section 6209.
- 42 CFR 410.78, telehealth services, Electronic Code of Federal Regulations: paragraphs (a)(3) and (b)(3)(xiv)(A) to (C); read October 3, 2026.