Short answer: After spiking during the pandemic, telehealth has settled at a small but durable share of medical claims, well above its pre-pandemic level, with behavioral health now its largest use. Under the One Big Beautiful Bill, HDHPs can permanently cover telehealth before the deductible without breaking HSA eligibility.
Telehealth didn’t disappear after the pandemic, but it didn’t stay at its peak either. It has plateaued at a small but durable share of medical claim lines, well above pre-pandemic levels, and its center of gravity shifted decisively to behavioral health, which now makes up the majority of telehealth visits.
A key benefits rule was settled in 2025: the One Big Beautiful Bill Act made the HDHP telehealth safe harbor permanent (retroactive to plan years beginning on or after January 1, 2025), so a high-deductible health plan may cover telehealth before the deductible is met without jeopardizing employees’ HSA eligibility.