As Bradley previously reported, statutory telehealth flexibilities previously passed in response to the COVID-19 pandemic expired on September 30, meaning that, effective October 1, 2025, Medicare telehealth services became subject to pre-pandemic restrictions.
The federal government is once again, funded, and operational. Meaning, effective November 12, 2025, the COVID-19 telehealth flexibilities have been re-implemented, but only through January 30, 2026. In essence, Congress “kicked the can down the road” regarding generally funding the federal government and enacting a more sustainable, long-term solution for telehealth.
Once again, absent further Congressional action, the flexibilities will expire on January 30, and effective February 1, 2026, telehealth claims will only be covered if they comply with pre-pandemic requirements (e.g., place of origin, geographic restrictions, etc.).
In the meantime, CMS recently released telehealth billing guidance (published on November 6) addressing how telehealth providers can retro-bill for certain services provided during the shutdown. However, in light of the fact that the government shutdown has ended, CMS could soon release new guidance that may alter its November 6 instructions concerning retro-billing for telehealth services furnished to Medicare beneficiaries during the shutdown. Providers should keep a close watch on notices and spotlights released on CMS’s website to ensure compliance (and reimbursement) of claims for telehealth services. Bradley will continue to monitor any developments related to these Medicare telehealth billing and coverage guidelines.
