Medicare Telehealth Flexibilities Have Expired - What You Need to Know

Current Medicare telehealth flexibilities that were extended by Congress through September 30, 2025 have expired effective today, October 1.

The lapse will continue until Congress passes legislation to extend those flexibilities. A continuing resolution to avoid a government shutdown was the best opportunity to also preserve telehealth flexibilities that have been in place since the COVID-19 public health emergency. Yesterday, senators rejected dueling spending stopgap bills, including a failed 55-45 vote on a House-passed continuing resolution.  

Congress has enacted multiple, short-term extensions for Medicare telehealth flexibilities, with the most recent extension passing as part of a continuing resolution in March 2025, extending the flexibilities through Sept. 30, 2025.

• Effective today, October 1: 
  Telehealth services will be limited to rural areas;
  Medicare patients will not be able to receive telehealth services in their homes; 
  Physicians will be prohibited from providing audio-only services; and
  The Acute Hospital Care at Home waiver authority, which relies heavily on telehealth, has expired.

Even with the lapse in telehealth flexibilities, there is the possibility Congress will act at a later time and make telehealth policies and payment retroactive to October 1.

Additionally, Medicare Administrative Contractors (MACs) have been instructed by the Centers for Medicare and Medicaid Services to implement a temporary hold of all claims for 10 business days. The hold should have a minimal impact on providers due to the 14-day payment floor. This ensures Medicare payments are accurate and consistent with statutory requirements. The hold prevents the need for reprocessing large volumes of claims should Congress act. Providers may continue to submit claims during this period, but payment will not be released until the hold is lifted.

ACOI members can take steps now to minimize potential practice disruptions by adjusting patient schedules to accommodate telehealth services and proactively communicating with the patients who will be affected.

ACOI is closely monitoring the situation and will share updates as they become available.