Telemedicine in Ophthalmology

The Academy wants all patients to have access to care by qualified medical providers. We support the delivery of high-quality ophthalmic telemedicine as a way to improve the quality, availability, and cost of eye care services — particularly for patients in rural and underserved areas who may not otherwise be able to see a provider.

The Academy's position is guided by three principles:

• Review: Physicians — not state legislatures — should determine the appropriateness of a given technology for their patients.
• Payment: Health insurers should cover and provide fair payment for telemedicine services provided by ophthalmologists.
• Regulation: Multi-state physician licensure should be overseen through the Federation of State Medical Boards framework. The Academy supports policies that validate telemedicine technologies and foster their appropriate implementation as a means of extending the physician-patient relationship beyond the exam room.

The Academy actively monitors legislative and regulatory developments affecting telemedicine coverage and payment for ophthalmologists. Key areas of ongoing engagement include:

Medicare telehealth coverage

COVID-19 dramatically expanded Medicare's coverage of telehealth services — waiving geographic restrictions, allowing patients' homes to serve as originating sites, and broadening eligible provider types. These flexibilities, initially enacted under emergency authority, have been repeatedly extended by Congress and are currently authorized through December 31, 2027. The Academy supports efforts to make appropriate telehealth flexibilities permanent so that ophthalmologists and their patients are not subject to ongoing uncertainty. 

Telehealth coding

Beginning January 1, 2025, new synchronous audio-video and audio-only telemedicine E/M service codes (98000–98015) replaced the previous use of standard E/M codes for telemedicine. The Academy has updated its coding guidance to help members navigate these changes.

Ethics in telemedicine

The Academy's Ethics Committee issued an updated information statement in July 2024 affirming that ophthalmologists using telemedicine must place patient welfare above all other interests, provide competent care, respect patient privacy and confidentiality, and take steps to ensure continuity of care.

Stay engaged on telehealth legislation. Congress has repeatedly extended Medicare telehealth flexibilities on a short-term basis, and the ongoing uncertainty affects ophthalmologists' ability to plan for telemedicine services. Learn how to get involved. 

Telemedicine — the use of electronic communications technology to deliver clinical care at a distance — has been part of ophthalmology for decades, with well-established applications including remote screening for diabetic retinopathy and retinopathy of prematurity. The rapid improvement of digital imaging in ophthalmology, combined with advances in health information technology and widespread broadband connectivity, has expanded the range of eye care services that can be delivered remotely.

The COVID-19 pandemic accelerated this transformation. When in-person care was suspended or limited in 2020, ophthalmologists turned to telemedicine at unprecedented scale. In response, federal regulators waived longstanding restrictions on Medicare telehealth coverage — including geographic requirements that had previously limited reimbursement to patients in rural areas visiting approved clinical sites. These changes revealed both the potential and the policy gaps around telemedicine in ophthalmology.

Since 2020, Congress has repeatedly extended the COVID-era Medicare telehealth flexibilities rather than making them permanent — creating ongoing uncertainty for providers and patients alike. The Academy continues to monitor and engage on these developments.

Interstate medical licensure also remains a key issue as telemedicine allows — and sometimes requires — physicians to treat patients across state lines.