Telehealth Access Faces Major Rollback as Key COVID-19 Flexibilities Expire
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Medicare beneficiaries could soon see significant limitations to telehealth access as several key flexibilities enacted during the COVID-19 public health emergency (PHE) expired on October 1st, despite bipartisan support for extending them. The lapse occurred as legislative efforts to renew these provisions failed, leaving healthcare providers and patients facing a rapidly changing regulatory landscape.
The end of an Era for Expanded Telehealth Services
During the PHE, the Centers for Medicare & Medicaid Services (CMS) issued numerous waivers to expand telehealth access, recognizing its crucial role in maintaining continuity of care during the pandemic. Many of these were extended through September 30,2025,by the Full-Year Continuing Appropriations Act,2025 (CAA). However, the expiration of these flexibilities, coupled with the failure of recent legislative attempts to reinstate them, marks a significant shift in telehealth policy.
What Flexibilities Have Expired?
The CAA extensions that recently ended encompassed a wide range of telehealth provisions. These included:
- “Originating Site” Definition: Previously, the CAA allowed telehealth services to be delivered from any location within the U.S., including a patient’s home. this broadened access substantially, especially for individuals in rural areas or with mobility limitations.
- “Practitioner” Definition: The expanded definition included qualified occupational, physical, speech-language, and audiologists, extending telehealth services beyond traditional physician-led
On October 1, 2025, CMS issued an N Connects Bulletin instructing Medicare Administrative Contractors (MACs) to implement a temporary claims hold – typically lasting up to ten business days – to avoid potential reprocessing of claims if Congress were to act.However,this bulletin was later removed from the CMS website without explanation.
“The hold would be intended to avoid the need to reprocess a large volume of claims if Congress acts after the expiration date,” a senior official stated. Providers were able to submit claims during the hold, but payments would not be released until it was lifted.
Looming Restrictions and Potential impact
If Congress fails to act, many pre-PHE restrictions will be reinstated, potentially prohibiting telehealth services delivered to beneficiaries in their homes or outside designated rural areas. In-person hospice recertifications will likely be required once more. These changes could even impact beneficiaries’ eligibility for other Medicare benefits in certain instances.
Practitioners are now advised to consider issuing an advance Beneficiary Notice of Noncoverage for telehealth services that may no longer be covered by medicare. It is indeed also recommended that they closely monitor Congressional developments and potentially hold claims for services that may become non-payable. Furthermore, some practitioners may become ineligible for Medicare payment for telehealth services.
uncertain Future and Call for Vigilance
While there is bipartisan recognition of the value of telehealth, the timing and potential retroactivity of any future extensions remain unclear. CMS’s own approach to the expirations appears fluid, as demonstrated by the removal of its initial guidance. In the meantime, healthcare providers offering telehealth services must proactively evaluate their practices to ensure compliance with the evolving post-PHE regulatory habitat.
[i] CMS, MLN006764 – Evaluation and Management Services (Sept. 2025), available at: https://www.cms.gov/files/document/mln006764-evaluation-management-services.pdf.
[ii] Palmetto GBA, MLN Connects for Wednesday, October 1, 2025 (Oct. 1, 2025), available at: https://www.dmepdac.com/palmetto/jmhhh.nsf/DID/CQ6HASGLIW.
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