Healthcare services in Australia have been using telehealth to reach remote areas for many years prior to the Covid-19 pandemic. It is estimated that 10% of the Australian population have no access to primary healthcare within a 60-minute drive. This study explored changes in how service users accessed speech and language therapy during the pandemic. Patient data was compared across two time periods, 2018–2019 (pre-Covid-19 period) and 2020–2021 (Covid-19 period). Geographic locations of occasions of service use were aggregated to spatially map where service users were who accessed telehealth services during these time periods. Occasions of services were statistically analysed based on characteristics such as age, sex and indigenous status. Results demonstrated that the overall number of episodes of care increased by 7.7% over the two time periods, with the largest increase in telehealth use among children’s services. The authors flag a disparity in uptake based on age, geography and economic factors. They suggest future development of such services requires the involvement of consumers in the design and training to enhance the user experience.