Does Medi-Cal Cover Telehealth? Audio-Only, Dental, and Rx

Yes, Medi-Cal covers telehealth. California’s Medicaid program pays for medically necessary care delivered by video, by phone, or through store-and-forward technology, and it pays at the same rate as an in-person visit. That coverage is permanent, written into state law in 2022, and it reaches most Medi-Cal services, including primary care, specialty care, mental health, substance use treatment, and dental.¹

Under Medi-Cal, you can receive telehealth from home. The old rule that required patients to travel to a clinic to connect with a distant provider is gone. As long as the provider is licensed in California and enrolled in Medi-Cal, the visit can happen wherever you and the clinician both are, provided privacy requirements are met.²

What Medi-Cal Pays For by Telehealth

Medi-Cal recognizes three ways a telehealth visit can happen. A synchronous video visit is a real-time, two-way video call. A synchronous audio-only visit is a real-time phone call with no video. A store-and-forward visit is asynchronous: your clinician captures images, records, or data and sends them to a specialist to review later. Dermatology, radiology, ophthalmology, and electronic specialist consultations commonly use the store-and-forward approach.²

The service categories are broad. Routine primary care visits, specialty consultations, and chronic disease management can all be delivered remotely when clinically appropriate. Reimbursement is at parity with in-person care in both fee-for-service Medi-Cal and in managed care plans, so a provider is paid the same for a telehealth visit as for an identical in-person one.³

Mental Health and Substance Use

Behavioral health is one of the most heavily used telehealth categories in Medi-Cal. Individual and group therapy, medication management, crisis intervention, targeted case management, and day treatment can be delivered through specialty mental health services by video or by phone, at the same rate as in-person care. County Mental Health Plans choose which services they offer remotely, but you keep the right to ask for an in-person appointment.⁴⁵

Substance use disorder treatment under the Drug Medi-Cal Organized Delivery System covers outpatient and intensive outpatient counseling, medications for addiction treatment, residential treatment, and withdrawal management. Individual and group counseling by telehealth is permanent under Drug Medi-Cal.⁶

Dental

Medi-Cal Dental covers teledentistry for diagnostic services and preventive services, both in real-time video form and asynchronously. It cannot be used for procedures that require physical work in the mouth, such as placing or removing crowns, implants, dentures, or orthodontic appliances.⁷⁸

Prescriptions

California providers can prescribe medications during a telehealth visit, including controlled substances, so long as the standard of care is met. The clinical bar is the same as for an in-person visit, and the provider has to use judgment about whether telehealth is adequate for the prescribing decision in front of them. For Schedule II–IV drugs, the provider must check the CURES database before writing a first-time prescription and at least every four months after. Federal pandemic-era flexibilities that let DEA-registered providers prescribe controlled substances by telehealth without an in-person evaluation have been extended through December 31, 2026.⁹¹⁰

Audio-Only Visits: What’s Different

Phone visits are covered and paid at the same rate as in-person care, but they come with limits that video visits don’t. The main one: a provider generally cannot establish a new patient relationship with you over the phone alone. The first visit with a new provider usually has to be video or in person.²

There are important exceptions. A new patient relationship can be established by phone when the visit involves sensitive services — mental health, substance use, sexual and reproductive health, gender-affirming care, or intimate partner violence — when you ask for a phone visit, or when you tell the provider you don’t have access to video.¹

Since January 1, 2024, any provider who offers audio-only visits must also offer the same services by video, and must either offer in-person care or have a referral process to connect you with in-person care without making you find a new provider yourself.³

A few programs restrict audio-only further. California Children’s Services and the Genetically Handicapped Persons’ program do not allow phone visits for initial assessments such as eligibility determinations or care plan development. The Local Educational Agency billing program does not currently allow audio-only telehealth at all.¹¹

What Can’t Be Done by Telehealth

Some care simply has to happen in person. Medi-Cal treats the following as inappropriate for telehealth: anything performed in an operating room, services requiring anesthesia, direct visualization or instrumentation of body structures, tissue sampling, and the insertion or removal of medical devices. In-home environmental assessments for asthma must also be done in person.²

Your Rights as a Patient

Telehealth is voluntary. You are never required to accept a video or phone visit instead of being seen in person, and if you consent to telehealth you can withdraw that consent at any time without losing access to Medi-Cal services.¹²

Before the first telehealth visit, the provider has to get your verbal or written consent and document it. As part of that conversation, you should be told that you have the right to receive care in person, that Medi-Cal covers transportation to in-person visits when other resources have been exhausted, that telehealth is voluntary and your consent can be withdrawn, and that there may be limitations or risks compared with being seen face to face.¹³

If you first consent to video and later want to switch to audio-only, your provider has to get separate consent for the phone format and document that too.¹⁴

Because the visit is billed to Medi-Cal, there is no separate charge for using telehealth instead of coming in. Payment parity means the service costs Medi-Cal the same either way.

How to Schedule a Telehealth Visit

If you are enrolled in a Medi-Cal managed care plan, the fastest route is to call your plan’s member services line or contact your primary care provider’s office and ask to book a video or phone appointment. Many managed care plans contract with telehealth platforms such as Teladoc that offer 24/7 access for non-emergency medical issues and scheduled behavioral health appointments.¹⁵

Before the appointment, charge your device, test the internet connection if you are doing video, pick a quiet space with decent lighting, and have your medication list and a note of your symptoms within reach. If you need an interpreter, ask for one when you book the visit. Medi-Cal plans are required to arrange language assistance for health visits.¹⁶

If your provider offers telehealth but you would rather be seen in person, say so. Your plan can help with transportation to the appointment if you need it.

1
Center for Connected Health Policy. Telehealth in California Legislative History
2
DHCS. Medi-Cal Telehealth Provider Manual
3
DHCS. All Plan Letter 23-007
4
Disability Rights California. Medi-Cal Specialty Mental Health Services Covered by County Mental Health Plans
5
DHCS. BHIN 23-018 Updated Telehealth Guidance for SMHS and SUD Treatment Services in Medi-Cal
6
DHCS. Medi-Cal COVID-19 PHE Unwinding Plan
7
DHCS. APL 23-001 Teledentistry Expansion Policy
8
California Telehealth Resource Center. CTRC Digital Health Payment Guide — Medi-Cal FFS Audio Video Telehealth
9
DHCS. Medi-Cal Telehealth
10
HHS. Prescribing Controlled Substances via Telehealth
11
DHCS. Telehealth Modifier Reference Sheet
12
Anthem Provider News. Updated Telehealth Services Policy
13
DHCS. Patient Consent for Telehealth Services
14
Center for Connected Health Policy. Consent Requirements
15
Health Net. Telehealth
16
San Francisco Health Plan. How to Get Ready for an Online Visit