# Telehealth Adoption by State: Where Virtual Healthcare Is Thriving *Our analysis of 3.1 million Medicare providers reveals a 27-point gap in telehealth adoption between the most and least connected states* Source: https://ourhealthnetwork.com/insights/telehealth-adoption-by-state Author: OurHealthNetwork Editorial Team Published: 2026-03-26 Last updated: 2026-03-26 Reading time: 8 minutes ## Summary We analyzed 543,058 telehealth providers across the CMS Doctor and Clinician database to map virtual care adoption by state, specialty, gender, and credential type. ## 543,058 Providers Offer Telehealth. Here Is Where Virtual Care Has Taken Root and Where It Has Not. The pandemic turned telehealth from a niche offering into a lifeline. Four years later, the question is no longer whether virtual care works; it is where it thrives and where it lags behind. We analyzed 3.1 million Medicare-enrolled providers in the CMS Doctor and Clinician database to measure telehealth adoption across all 50 states, every clinical specialty, and both genders. The results reveal a country where geography and specialty type determine whether patients can see a doctor from home. According to the [Doximity State of Telemedicine Report](https://www.doximity.com/articles/doximity-releases-2023-state-of-telemedicine-report), 71.4% of physicians now use telehealth at least once a week. The market itself has grown to $42.5 billion. Yet our data shows that only 17.5% of Medicare-enrolled providers have formally registered telehealth capability with CMS. The gap between usage and formal registration suggests that many providers use ad hoc video calls rather than building telehealth into their permanent practice infrastructure. 543K Telehealth Providers 17.5% National Adoption Rate 29.1% MA (Highest State) 67.4% Sleep Med (Top Specialty) ## State-by-State Telehealth Adoption: A 27-Point Gap Massachusetts leads the nation with 29.1% of its providers offering telehealth, nearly three times the rate of the lowest-ranked states. The District of Columbia follows at 25.9%, then California at 24.4%. The top tier is dominated by northeastern states and technology hubs: Maryland (22.9%), New Hampshire (22.7%), Minnesota (21.8%), and Hawaii (21.5%) all exceed 20%. At the bottom, Puerto Rico sits at just 2.1%, with Guam at 4.5%. Among the 50 states, Mississippi (7.2%) and Alabama (7.4%) have the lowest adoption. These are also states with significant rural populations and fewer broadband options, both of which limit the infrastructure needed for virtual care. 27 points The gap between the highest telehealth adoption rate (Massachusetts, 29.1%) and the lowest (Puerto Rico, 2.1%). Where you live plays a major role in whether your doctor offers virtual visits. Top 15 States by Telehealth Adoption Rate 0% 5% 10% 15% 20% 25% 30% 29.1% MA 25.9% DC 24.4% CA 22.9% MD 22.7% NH 21.8% MN 21.5% HI 20.5% MI 20.4% DE 19.9% WA 19.9% AK 19.5% OR 18.7% FL 18.6% IL 18.5% NY Source: OurHealthNetwork analysis of CMS Doctor and Clinician data (2026) The pattern is clear. States with strong telehealth parity laws, higher broadband penetration, and larger urban populations lead in adoption. Massachusetts passed some of the earliest and most comprehensive telehealth coverage mandates, requiring private insurers to cover telehealth visits at the same rate as in-person care. California's size, tech-forward culture, and large provider workforce drive innovation. The District of Columbia benefits from its entirely urban geography, high concentration of academic medical centers, and proximity to federal health policy. The middle of the pack holds lessons too. States like Michigan (20.5%) and Delaware (20.4%) show that you do not need to be a coastal tech hub to achieve strong telehealth numbers. Michigan's large health systems, including several that invested heavily in virtual care platforms during the pandemic, have maintained those programs. Meanwhile, southern and rural states consistently lag. Mississippi, Alabama, and the U.S. territories face a compound disadvantage: fewer providers per capita, less broadband infrastructure, and state regulations that have been slower to embrace telehealth parity. ## Which Specialties Use Telehealth Most? Telehealth adoption varies far more by specialty than by geography. [Sleep medicine](/sleep-medicine-specialist) leads all specialties at 67.4%, a reflection of how well the field lends itself to virtual consultations. Follow-up visits, CPAP adherence reviews, and symptom assessments can all happen effectively over video. [Endocrinology](/endocrinologist) follows at 63.8%, where ongoing management of diabetes, thyroid conditions, and hormonal disorders fits naturally into telehealth workflows. [Hematology](/hematologist) (58.1%), medical [oncology](/oncologist) (56.9%), and [rheumatology](/rheumatologist) (55.1%) round out the top five. These specialties share a common thread: patients with chronic conditions who need regular check-ins but do not always need physical examinations at every visit. A [neurologist](/neurologist) (54.1%) reviewing medication response for multiple sclerosis or a [psychiatrist](/psychiatrist) (49.0%) conducting a therapy session can deliver the same quality of care through a screen as in an office. Rank Specialty Telehealth Rate 1 Sleep Medicine 67.4% 2 Endocrinology 63.8% 3 Hematology 58.1% 4 Medical Oncology 56.9% 5 Rheumatology 55.1% 6 Neurology 54.1% 7 Hematology/Oncology 52.2% 8 Psychiatry 49.0% 9 Clinical Psychologist 41.8% 10 Infectious Disease 39.5% At the other end of the spectrum, hands-on specialties have almost no telehealth presence. Chiropractic and anesthesiology assistants sit at 0.0%. CRNAs and audiologists register at just 0.1%. Pathology (0.2%) and optometry (0.4%) also remain almost entirely in-person. The dividing line is physical: if a specialty requires touching, positioning, or imaging a patient, telehealth adds little clinical value. This specialty-level variation matters for patients. If you are looking for a [dermatologist](/dermatologist) or [cardiologist](/cardiologist), your chances of finding a telehealth option fall somewhere in the middle. If you need a [pulmonologist](/pulmonologist) or [urologist](/urologist), the odds are lower but growing. Understanding which specialties have embraced virtual care helps patients set realistic expectations before searching for providers. ## Mental Health Dominates Virtual Care The single most important story in telehealth is mental health. According to [CDC National Center for Health Statistics data](https://www.cdc.gov/nchs/products/databriefs/db445.htm), 58% of all telehealth visits are for mental and behavioral health services. This is not a temporary surge from the pandemic; it reflects a permanent shift in how mental healthcare is delivered. 58% of all telehealth visits are for mental and behavioral health Source: CDC/NCHS Data Brief No. 445 Our data confirms this pattern from the provider side. Psychiatry has a 49.0% telehealth adoption rate, and clinical psychologists sit at 41.8%. Combined, mental health professionals make up the largest single bloc of telehealth-registered providers. The fit is natural: therapy and medication management rely on conversation, not physical examination. Patients benefit from reduced stigma (joining from home rather than walking into a mental health clinic), eliminated travel time, and greater flexibility in scheduling. The [American Hospital Association](https://www.aha.org/factsheet/telehealth) reports that 78.6% of hospitals now have some form of telehealth program. For mental health services specifically, telehealth has helped address provider shortages in areas where psychiatrists are scarce. Rural patients who once drove two hours for a 30-minute psychiatry appointment can now connect in minutes. ## The Gender Gap in Telehealth Women providers adopt telehealth at slightly higher rates than men: 18.6% versus 16.3%, a gap of 2.3 percentage points. While the difference is modest, it is consistent across most specialties and may reflect the types of medicine women practice at higher rates. Women are overrepresented in primary care, [internal medicine](/internist), [OB/GYN](/obgyn), and psychiatry, all fields with above-average telehealth adoption. Men are more concentrated in surgical subspecialties and procedural fields where telehealth is less applicable. The gender gap also reflects workforce flexibility. Research suggests that telehealth appeals to providers seeking schedule control, and women physicians are more likely to cite flexibility as a factor in career decisions. This does not mean women prefer telehealth because they work less; rather, telehealth allows a wider range of practice models that do not require full-time office presence. ## Medicare and Telehealth: Near-Total Overlap Of the 543,058 providers who offer telehealth, 96.7% also accept Medicare. This near-total overlap reflects Medicare's role as the primary payer driving telehealth policy. When CMS expanded telehealth coverage during the pandemic through emergency waivers, providers who registered for telehealth were by definition doing so within the Medicare system. The CMS Doctor and Clinician database captures this relationship directly. This also means that Medicare beneficiaries have strong access to telehealth. Seniors, who often face mobility challenges and transportation barriers, are well-positioned to benefit from virtual visits. For patients managing chronic conditions like diabetes, heart failure, or COPD, the ability to check in with a [geriatrician](/geriatrician) or specialist without arranging transportation removes a significant barrier to consistent care. The policy question is whether these expanded telehealth permissions, many of which were temporary pandemic waivers, will become permanent. As of 2026, most have been extended, but the long-term legislative framework remains uncertain. Congress has repeatedly passed short-term extensions rather than codifying telehealth coverage into permanent Medicare policy, leaving both providers and patients in a cycle of year-to-year uncertainty. ## Credential Breakdown: Who Offers Telehealth? The credential mix of telehealth providers reflects which provider types are most engaged with virtual care. Nurse practitioners have the highest telehealth rate at 21.8%, consistent with their role in [primary care](/family-medicine-physician) and chronic disease management. MDs follow at 21.1%, DOs at 18.1%, and physician assistants at 15.4%. Clinical psychologists, at 41.8%, are measured as a specialty rather than a credential category, but their high rate underscores mental health's dominance in telehealth. The relatively even distribution among MDs, DOs, and NPs suggests that telehealth is not concentrated in any single provider type. This is a mature technology that has spread across the healthcare workforce rather than being adopted by only one segment. The slightly higher NP rate may reflect the profession's emphasis on primary care and chronic disease management, two areas where telehealth has proven most effective. Physician assistants, at 15.4%, may trail due to their higher concentration in surgical and emergency settings where virtual visits are less common. "Telehealth is no longer a pandemic workaround. With 543,000 providers registered and 71% of physicians using it weekly, virtual care has become a permanent feature of American healthcare delivery." OurHealthNetwork Editorial Team ## What the Data Tells Us About the Future of Telehealth The $42.5 billion telehealth market is not distributed evenly. It clusters in states with favorable regulations, among specialties built on conversation rather than procedures, and around chronic disease management rather than acute care. The 27-point gap between Massachusetts and Puerto Rico is a policy gap as much as a technology gap. Three trends will shape what comes next. First, the specialties with the highest adoption, such as sleep medicine, endocrinology, and psychiatry, will likely push past 70% as younger providers enter these fields with telehealth as a default expectation. Second, states at the bottom of the rankings face a choice: invest in broadband and pass parity laws, or watch their providers and patients migrate to states that have. Third, the mental health dominance of telehealth (58% of all visits) signals that virtual care's biggest impact may be in expanding access to services that have historically faced the worst shortages. For patients, the practical takeaway is straightforward. If you live in Massachusetts, California, or the D.C. metro area, nearly one in four providers offers virtual visits. If you need a sleep medicine specialist, endocrinologist, or psychiatrist, your odds of finding a telehealth option exceed 50%. And if you are a Medicare beneficiary, 96.7% of telehealth providers accept your coverage. The infrastructure exists. The question is whether the rest of the country will catch up. ## Methodology This analysis uses data from the CMS Doctor and Clinician database, which contains 3,107,274 Medicare-enrolled providers. Telehealth capability is determined by the telehealth indicator field in CMS records, which flags providers who have registered to deliver services via telehealth. State assignments are based on the provider's primary practice location. Specialty classifications follow CMS taxonomy codes. Gender data is self-reported through the Medicare enrollment process. All data was accessed in March 2026. ## Tags telehealth, virtual care, telemedicine, healthcare data, telehealth by state ## Related articles on OurHealthNetwork - https://ourhealthnetwork.com/insights/gender-gap-medicine-specialties - https://ourhealthnetwork.com/insights/insurance-network-comparison-by-state - https://ourhealthnetwork.com/insights/medical-school-rankings-active-practitioners ## About this article This article is part of OurHealthNetwork's insights collection. We are an independent healthcare data platform aggregating federal datasets (CMS, FDA, CDC) to inform patients and caregivers. See https://ourhealthnetwork.com/methodology for our editorial approach and https://ourhealthnetwork.com/data-sources for source datasets.