Medicare Telehealth Flexibilities Expire Following Missed Congressional Deadline
Despite broad bipartisan support in Congress and strong public approval, lawmakers failed to pass legislation on critical Medicare telehealth payment waivers before the September 30, 2025 deadline and have likewise failed to extend current rules via the government budget process. As a result, key flexibilities that had expanded access to care since 2020 have now expired, leaving clinicians and patients facing significant disruptions. Key impacts:
- Medicare will no longer reimburse clinicians for telehealth visits delivered to beneficiaries in their homes, reinstating restrictive pre-pandemic policies.
- Similarly, Medicare will no longer reimburse for telehealth visits in non-rural geographic areas, even for patients in approved locations such as hospitals or ambulatory care facilities.
- The Acute Hospital Care at Home waiver has also expired, ending Medicare payment for hospital-at-home initiatives.
- Because Medicare Advantage (MA) plans are required to cover existing Medicare benefits, the termination of telehealth and hospital-at-home coverage in traditional Medicare puts MA coverage at risk, creating uncertainty for enrollees and clinicians.
- While the DEA has extended prescribing flexibilities for controlled substances via telehealth through December 2025, lack of reimbursement may still undermine clinicians’ ability to sustain telehealth-based care; further, no information is available regarding DEA controlled substance prescribing requirements in the new year.
CAPC supports telehealth flexibilities as a critical extender of care to people living with serious illness and their caregivers and has participated in multiple Congressional outreach efforts through the Alliance for Connected Care, ATA Action, and other efforts to continue these flexibilities. We urge Congress to take swift action to restore these flexibilities, including retroactive reimbursement for telehealth services delivered after September 30.