Telemedicine in primary care has become part of routine practice. Vision care suits video visits too, as our post on virtual eye exams explains. For care teams, the useful question is how to blend them. Which needs suit a screen, and which still belong in the clinic?
Recent research gives a clearer answer than the early pandemic studies did. A national study of nearly 745,000 veterans found that hybrid care kept quality steady on most measures. Medicare has also extended its telehealth flexibilities through the end of 2027. This article reviews the evidence, the current rules, and where remote patient monitoring (RPM) fits between visits.
Why Primary Care Needs More Reach
Access is the starting point for telemedicine in primary care. As of December 31, 2025, HRSA had designated 8,467 primary care Health Professional Shortage Areas. About 92.3 million people live in them. Current staffing meets roughly 48% of the primary care need in those areas, according to HRSA data compiled by KFF. Closing the gap would take an estimated 15,604 more practitioners.
Telemedicine stretches the time of the clinicians already in place. A medication check by video saves the patient a trip and frees an exam room, two simple forms of telehealth savings. Patients who live far from a practice, or who lack reliable transportation, can keep follow-up appointments they might otherwise miss.
Rural patients feel this most. So do patients 65 and up who manage several conditions and see their care team often.
Telemedicine in Primary Care Research and Quality
The largest recent study of telemedicine in primary care comes from the Veterans Health Administration. It was published in JAMA Network Open in February 2026. Researchers followed 744,599 veterans who had three or more primary care visits. They grouped patients by the share of visits held by phone or video.
Veterans with a low share of telehealth visits matched in-person-only patients on every cardiovascular and behavioral health measure. Those measures included hypertension control, statin therapy, and depression screening. The intermediate group was equal or close on most measures. The authors concluded that hybrid models of telehealth and in-person care are viable.
Where Quality Slips
Results changed at the high end. Patients who received half or more of their primary care remotely had lower rates on most measures. Flu vaccination showed the widest gap, at roughly 9 to 10 percentage points below in-person-only patients after adjustment. Statin adherence and depression screening each dipped by about 2 percentage points.
The authors point to a practical cause. Vaccines and some screenings depend on an in-person encounter. They suggested added workflows to bring high telehealth users in for those services. For a wider look at this year’s research, see our review of new telemedicine studies.
Follow-Up and Downstream Care
A 2023 Kaiser Permanente study in Annals of Internal Medicine found more short-term follow-up after video and phone visits than after office visits. Emergency department visits stayed low for all three visit types. Our comparison of telemedicine vs. in-person care covers those numbers in detail.
A 2024 Kaiser Permanente study in the Journal of General Internal Medicine focused on patients with high-risk conditions. Emergency and hospital use after a primary care visit was comparably low for virtual and in-person care.
For scheduling, this points to one habit. Build a check-in into virtual visit workflows. A short message, a call, or a set of home readings can confirm the care plan is working.
Video and Phone Visits Differ
Visit format matters too. A July 2026 study in BMC Primary Care compared 184,308 video and phone consultations on a telemedicine platform in Portugal. Video visits had higher patient-reported helpfulness and fewer short-term return visits. Phone visits offered faster access. The authors cautioned that phone users were older, so the results are likely confounded.
Both formats have a place. Video supports a fuller visual assessment. Audio-only keeps care open for patients without broadband or a video-capable device.
Documentation and Clinician Workload
Virtual visits also change the shape of a clinician’s day. A 2024 study in JAMA Network Open tracked primary care physicians at MedStar Health from December 2021 to June 2023. Days that mixed telemedicine and office visits added about 14.8 minutes of active EHR time. That held when telemedicine made up 26% to 99% of the day’s visits. Fully virtual days did not show the same increase, though the sample was small.
The researchers suggested multitasking as one cause. During a video visit, a physician can chart and talk at the same time. That rarely happens in an exam room. Because fully virtual days did not add EHR time, grouping virtual visits into dedicated sessions may be worth testing.
Some teams also use AI tools to summarize records and flag readings that need review. Our article on AI in RPM explains how this works in monitoring programs.
Medicare Telehealth Rules Through 2027
Federal policy now supports virtual primary care through the end of 2027. The Consolidated Appropriations Act, 2026, signed February 3, 2026, extended Medicare’s telehealth flexibilities through December 31, 2027. The CMS telehealth FAQ, updated in October 2026, explains what that means in practice.
- Patients can receive Medicare telehealth services anywhere in the U.S., including at home, regardless of rural status.
- Audio-only visits remain covered for patients at home through December 31, 2027.
- An expanded range of practitioners, including physical and occupational therapists, can bill for telehealth services.
- Rural health clinics and federally qualified health centers can bill for non-behavioral telehealth visits through at least December 31, 2026.
- Patients who begin mental health telehealth by December 31, 2027, do not need an in-person visit first.
CMS has also proposed changes to remote patient monitoring and remote therapeutic monitoring (RTM) for 2027. The proposals include a separately billed initiating visit before monitoring begins and new staffing requirements. The final rule is expected in early November. Practices should review it before setting 2027 workflows.
Where Remote Patient Monitoring Fits
Video and office visits each capture a single moment. Chronic conditions change between those moments. RPM fills the gap with readings sent from home on a regular schedule.
Hypertension shows why this matters. The 2025 AHA/ACC high blood pressure guideline encourages home blood pressure monitoring with validated, cuff-based devices. It pairs that monitoring with team-based care and standard treatment protocols. A clinician reviewing a month of home readings has more context than one office reading provides. Our guide to RPM for hypertension covers how programs put this into practice.
The same approach applies to other common primary care conditions:
- Diabetes. Glucose readings show patterns across the day and week.
- Heart failure. Daily weights can flag fluid gain before symptoms worsen.
- COPD. Pulse oximetry and peak flow readings support earlier follow-up.
- Post-discharge care. Readings in the first weeks home help teams act on early warning signs.
Device design affects whether patients keep sending readings. Tenovi cellular devices transmit on their own, with no apps, no syncing, and no Wi-Fi. Bluetooth devices connect through the Tenovi Gateway, so one patient can use a blood pressure monitor, scale, and pulse oximeter together. That keeps setup simple for patients who are less comfortable with technology.
How to Build a Hybrid Primary Care Model
The evidence favors a blend of visit types. These six steps can help a practice put that blend into place.
- Set visit-type guidelines. Decide which needs suit video, phone, or the clinic, and share the rules with schedulers.
- Track in-person services. Flag patients whose visits are mostly virtual so vaccines and screenings stay on schedule.
- Keep audio-only as an option. Some patients lack broadband or a camera-ready device. Medicare covers audio-only visits at home through 2027.
- Plan a check-in after virtual visits. A message or call can confirm that the care plan is on track.
- Add home data for chronic conditions. Pair telemedicine visits with RPM readings so each visit starts with current numbers.
- Watch clinician time. Track EHR time as virtual volume grows, and consider dedicated virtual sessions.
Frequently Asked Questions About Telemedicine in Primary Care
This section answers common questions about telemedicine in primary care. It covers quality, Medicare coverage, visit formats, and how remote monitoring supports virtual visits.
1) What is telemedicine in primary care?
Telemedicine in primary care is the use of video, phone, and connected devices to deliver primary care at a distance. It covers follow-up visits, medication checks, results reviews, behavioral health, and chronic disease management. Many practices combine it with office visits in a hybrid model.
2) Does telemedicine change the quality of primary care?
At low and moderate levels, quality stays close to in-person care. A 2026 study followed 744,599 veterans. Those with a small share of telehealth visits matched in-person-only patients on cardiovascular and behavioral health measures. Quality dipped when half or more of a patient’s visits were virtual, mostly for vaccines and screenings.
3) Does Medicare cover primary care telehealth visits at home?
Yes, through December 31, 2027. The Consolidated Appropriations Act, 2026 extended Medicare’s telehealth flexibilities, so patients can receive covered telehealth services at home anywhere in the U.S. Audio-only visits from home are also covered through that date.
4) Which primary care services still need an in-person visit?
Vaccinations, physical exams, procedures, and most diagnostic tests need the patient in the clinic. New or unclear symptoms and urgent concerns also call for in-person evaluation. Recent VHA research found that patients with mostly virtual care were less likely to receive flu vaccines.
5) When should a practice use phone visits instead of video?
Phone visits work well when speed matters or when a patient lacks broadband or a video-capable device. Video supports a fuller visual assessment. A 2026 study of more than 184,000 primary care consultations found faster access with phone visits and higher patient-reported helpfulness with video.
6) How does remote patient monitoring support telemedicine in primary care?
RPM sends readings such as blood pressure, weight, glucose, and oxygen levels from home to the care team. Clinicians can review trends before a video or phone visit. The visit can then focus on decisions, backed by current data.
Understanding Telemedicine in Primary Care
Telemedicine in primary care works best as part of a blended model. The 2026 VHA research shows that low and moderate telehealth use keeps quality close to in-person care on most measures. Higher shares of virtual care call for extra attention to vaccines and screenings. Medicare’s telehealth flexibilities now run through December 31, 2027, which gives practices time to plan. Remote patient monitoring adds the home data that makes each virtual visit better informed. Together, these tools help primary care teams reach more patients and keep care moving between visits.
Tenovi provides cellular-connected remote monitoring infrastructure for RPM and RTM programs. We work with RPM software companies, chronic care management companies, telehealth platforms, health systems, payers, government programs, and pharmacies. Our 60+ devices send readings with no apps, no syncing, and no Wi-Fi, and we handle fulfillment, provisioning, and support. Contact us for a free demo and consultation.
This material is provided for general informational and educational purposes only and does not constitute legal, compliance, billing, coding, or reimbursement advice. CPT® codes, descriptions, and Medicare payment rates referenced here are drawn from publicly available sources, are subject to change, and may vary by payer, locality, and patient circumstances. Tenovi makes no representation or guarantee regarding coverage, payment, or the appropriateness of any code for a particular patient or service, and any presented are illustrative only. Providers are solely responsible for independently determining medical necessity and applicable coding, coverage, documentation, and billing requirements and for submitting accurate claims. Consult applicable payer guidance and qualified billing, coding, compliance, or legal professionals before making billing decisions. CPT® is a registered trademark of the American Medical Association.
