2026 Telehealth Payable Services - Medicare
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Lists Medicare telehealth-payable CPT/HCPCS codes and indicates whether telehealth delivery and audio-only delivery are permitted for each service; intended for providers and billing staff submitting claims to Magellan Healthcare.
No material clinical or coverage changes in this revision.
Telehealth Coverage Criteria & Notes
Coverage criteria and notes
Coverage stance by service line and code-level permissions:
CPT / HCPCS Codes and CMS Telehealth Status
| 90785 | Interactive complexity (audio-only permitted) |
| 90791 | Psychiatric diagnostic evaluation - no medical services (audio-only permitted) |
| 90792 | Psychiatric diagnostic evaluation - with medical services (audio-only permitted) |
| 90832 | Psychotherapy 30 minutes (audio-only permitted) |
| 90834 | Psychotherapy 45 minutes (audio-only permitted) |
| 90837 | Psychotherapy 60 minutes (audio-only permitted) |
| 90839 | Psychotherapy for crisis, initial 60 minutes (audio-only permitted) |
| 90840 | Psychotherapy for crisis, additional 30 minutes (audio-only permitted) |
Billing, Claims & Provider Responsibilities
Billing/claims check — verify code-level telehealth and audio-only permissions
Review the Magellan list of CPT/HCPCS codes before submitting Medicare telehealth claims to ensure telehealth and audio-only delivery permissions are met and follow Magellan claims submission rules for Medicare telehealth payable services.
- Verify per-code CMS telehealth permissibility (2026 CMS Telehealth column) before billing (see per-code entries such as +G0318, G0406–G0408, G0425–G0427, G0459).
- Confirm audio-only permissibility using the Audio-only column (e.g., many listed codes are marked 'No' for audio-only; submit only when audio-only is permitted).
- Use Magellan claims submission rules for Medicare telehealth payable services when submitting the claim.
Definitions and Delivery Mode Notes
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.