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Telehealth Parity Laws in 2025: What Providers Need to Know
Telehealth has shifted from an emergency alternative to a standard method of delivering care — especially in behavioral health. But whether providers can sustainably offer these services often depends on telehealth parity laws.
These laws determine whether virtual care is covered, and in some cases, whether it’s reimbursed at the same rate as in-person care. In 2025, debates over parity aren’t about whether telehealth should exist, but how it should be paid for, regulated, and integrated into long-term healthcare models.
Last Updated: August 06, 2025
What You'll Learn
- What telehealth parity laws mean and how they ensure equal coverage for virtual and in-person care.
- Why these laws became crucial during COVID-19 for maintaining safe access to healthcare services.
- Which states have implemented telehealth parity laws and how coverage requirements vary by location.
- Common objections to telehealth parity including concerns about quality, costs, and patient privacy issues.
Contents
- Understanding What Telehealth Parity Means for Coverage and Payment
- Why Telehealth Parity Laws Matter More Than Ever in 2025
- State-by-State Telehealth Parity and Reimbursement Rules
- How to Tell if a Health Plan Must Follow Parity
- Common Objections to Telehealth Parity (with 2025 Data)
- Implement Secure Telehealth Services With ICANotes
The purpose of telehealth is simple but powerful — to allow physicians, clinicians, therapists, and other healthcare providers to deliver care virtually from almost anywhere. What began as an emerging option years ago has now become a core part of U.S. healthcare delivery, particularly for mental and behavioral health.
Today, millions of Americans rely on telehealth for everything from ongoing therapy sessions to follow-up visits for chronic conditions. According to FAIR Health, telehealth utilization remains more than 20 times higher than pre-2019 levels, and behavioral health continues to dominate virtual visit volume.
One key reason telehealth has been able to expand is the spread of telehealth parity laws. These laws ensure that patients have equal or comparable access to care — and reimbursement for it — whether visits happen in person or online. But parity doesn’t just affect patient access. It directly impacts how providers are paid, how often patients can be seen, and how sustainable telehealth remains as part of a practice’s service model.
What Telehealth Parity Means for Coverage and Payment
Parity in healthcare ensures patients receive equal coverage for comparable services, whether those services are for mental health, substance use, or physical health, and regardless of whether care is delivered in person or via telehealth.
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Coverage parity means insurers must cover telehealth services if they cover the same service in person.
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Payment parity means insurers must pay providers the same rate for a telehealth visit as for an in-person visit.
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 was a landmark law preventing health insurance plans from placing more restrictive limits on mental health or substance use benefits than on medical or surgical care. Later, the Medicare Telehealth Parity Act of 2017 expanded the types of services covered under Medicare, paving the way for broader telehealth use.
Telehealth parity builds on this foundation. If a patient’s plan covers unlimited in-person visits for a condition, true parity means they should have equal access to the same care virtually. In states with both coverage and payment parity laws, insurers must reimburse telehealth visits at the same rate as in-person visits, a critical point for provider sustainability.
However, parity does not guarantee generous coverage. Plans can still limit the number of covered visits or restrict which telehealth services qualify for reimbursement.
Why Telehealth Parity Laws Matter More Than Ever in 2025
Telehealth is no longer an emergency stopgap — it’s a permanent fixture in care delivery. In behavioral health especially, virtual care has removed barriers for rural patients, individuals with mobility challenges, and those who face stigma when seeking in-person therapy.
In 2025, parity laws remain essential because they:
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Protect Access: Without reimbursement parity, many practices could scale back or discontinue telehealth services due to low or inconsistent payments.
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Support Equity: Telehealth can bridge care gaps for rural, underserved, and mobility-limited populations, but only if coverage is on par with in-person care.
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Encourage Provider Adoption: Fair payment incentivizes clinicians to integrate telehealth into their workflows without financial loss.
Policy debates now focus less on whether telehealth should be covered and more on how it should be paid for, regulated, and integrated with value-based care models.
State-by-State Telehealth Parity and Reimbursement Rules
Telehealth parity is regulated at the state level, and the specifics vary widely.
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Coverage Parity: Most states require commercial insurers to cover telehealth services if they cover the same service in person.
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Payment Parity: Fewer states mandate equal reimbursement rates for telehealth and in-person visits, though the number has grown steadily since 2020.
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Medicaid: All 50 states and D.C. reimburse for some telehealth services under Medicaid, but the scope of coverage differs.
As of April 2025, the Center for Connected Health Policy reports that 44 states, the District of Columbia, Puerto Rico, and the Virgin Islands have private payer laws addressing telehealth reimbursement, with 23 states having explicit payment parity laws. Many of these laws include exceptions or limitations in their implementation.
How to Tell if a Health Plan Must Follow Parity
While the MHPAEA provides certain protections on coverage, a federal parity law may only cover a patient's plan depending on the health plan they have and the limits within it. Here are health plans that must follow federal parity laws:
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Group health plans for employers with 51+ employees
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Medicaid Managed Care Plans (MCOs)
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The Federal Employees Health Benefits Program
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State Children’s Health Insurance Programs (S-CHIP)
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Most group and individual plans purchased through the ACA marketplace
Small-group plans, self-insured employer plans, and certain government plans may be exempt or have different rules.
Common Objections to Telehealth Parity (with 2025 Data)
Health insurance plans are not created equal, even with the help of parity laws, when it comes to mental health and substance abuse treatment. With the rise of telehealth and telemedicine, some specific challenges raise objections among healthcare workers — especially when it comes to reimbursement.
Reliability and Quality Concerns in Virtual Care
Critics argue telehealth can’t match in-person care quality, but many services — especially in behavioral health — are equally effective virtually.
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A 2023 study of over 1.5 million primary care visits found telehealth visits (both video and phone) resulted in fewer prescriptions, lab tests, and imaging compared to in-office visits. For example, video visits resulted in lab orders for 27.4% of visits versus 41.4% for in-person visits—and they led to higher rates of follow-up than in-person visits (6.2% for video vs. only 1.3% for in-office).
This suggests telehealth may require additional follow-up to reach equivalent clinical outcomes, highlighting the importance of thoughtful use and reimbursement strategies. Quality gaps can often be addressed with hybrid models and clear triage protocols.
Does Telehealth Parity Lead to Overuse or Fraud?
Another concern about telehealth parity laws is that they will lead to overuse, abuse or fraud.
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Concerns around telehealth fraud appear largely unsupported by data. A 2025 OIG report found that only 0.2% of telehealth providers were considered “potentially high-risk” for fraud, waste, and abuse—meaning 99.8% were operating compliantly American Hospital Association (2025).
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Broader healthcare fraud actions in 2025 targeted schemes totaling over $14.6 billion, but telehealth was not disproportionately implicated.
These figures indicate telehealth’s overall fraud risk remains low, and equitable parity should not be hindered by fear of abuse. Even with telehealth use 20 times higher than in 2019, data shows it primarily replaces in-person visits rather than adding unnecessary volume.
Cost-Savings vs. Reimbursement Challenges
In addition to the perceived low quality of care, some argue that telehealth costs less to deliver than in-person care. While it might cost less up-front to use telehealth compared to in-person care, telehealth reaches a wide range of patients who may have otherwise not been able to access medical or mental health care, which could increase a practice's patient base.
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Telehealth can increase access but may also raise overall costs. Analysis of Medicare trends showed a 2.2% increase in telehealth visits per patient per year, and of those, 83% replaced in-person visits. Still, this led to a per-patient cost increase of about $248, or a 1.6% rise in total healthcare spending. A separate study published in JAMA estimated the increased cost at $164.99 per beneficiary.
These data suggest that parity is financially viable, but cost management and utilization optimization remain critical. While some costs are lower for telehealth delivery, reimbursement rates factor in provider time, malpractice insurance, and practice expenses, which remain comparable to in-person care.
Patient Privacy and Digital Access Gaps
Some patients and physicians who are new to telehealth are concerned about patient privacy as medical records and information become digitized. This concern relies on the idea that digital records are more vulnerable to hacking or inappropriate use, which only presents a risk when a practice uses a system or platform that is not secure. With HIPAA-compliant platforms, telehealth can be as secure as in-person care, provided providers use vetted, encrypted systems.
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Telehealth requires strong digital infrastructure and literacy. A Wikipedia overview notes that telemental health greatly benefits those in remote or underserved areas by reducing travel burdens and stigma—but also raises concerns around digital exclusion, privacy, and suitability for certain mental health conditions like paranoia or anxiety.
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Moreover, data on healthcare breaches is sobering: in 2024, breaches affected 276 million individuals, an average of 758,000 exposed records per day The HIPAA Journal.
These figures underscore the necessity for HIPAA-compliant platforms, robust cybersecurity, and ongoing training to ensure telehealth delivers safe, equitable care.
Key Telehealth Parity Objections and Evidence
| Reliability & Quality | Fewer orders/follow-ups needed suggests gaps in equivalency—but manageable with strategy |
| Overuse/Fraud | Only 0.2% flagged as high-risk; telehealth not a major contributor to health fraud |
| Cost-Savings Arguments | Most telehealth replaces in-person care, but still leads to modest spending increases |
| Privacy & Access Challenges | Massive data breaches and digital divides highlight need for secure, inclusive platforms |
The Future of Telehealth Parity and Provider Sustainability
In 2025, parity laws remain the cornerstone of equitable telehealth access. As states refine their regulations and federal policymakers consider permanent flexibilities, providers who invest in secure, HIPAA-compliant, and workflow-integrated telehealth platforms will be best positioned to serve patients and maintain revenue.
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Dr. October Boyles
DNP, MSN, BSN, RN
Dr. October Boyles is a behavioral health expert and clinical leader with extensive expertise in nursing, compliance, and healthcare operations. With a Doctor of Nursing Practice (DNP) from Aspen University and advanced degrees in nursing, she specializes in evidence-based practices, EHR optimization, and improving outcomes in behavioral health settings. Dr. Boyles is passionate about empowering clinicians with the tools and strategies needed to deliver high-quality, patient-centered care.