Section: UPA News
Medicare Telehealth Coverage On Pause at Home
Oct 7, 2025
Click to view October 2025 RCM News
Medicare Telehealth Coverage: On Pause at Home
As of October 1, 2025, while experiencing a government shutdown, many of the statutory limitations that were in place for Medicare telehealth services, prior to the COVID-19 Public Health Emergency, will take effect. CMS directs all Medicare Administrative Contractors (MACs) to implement temporary claim processing hold up to 10 business days to ensure that Medicare payments are accurate and consistent with statutory requirements. Providers may continue to submit claims during this period but payment will not be released until the hold is lifted.
Medicare will not reimburse telehealth services that are not payable by Medicare in the absence of Congressional action, including many services provided to beneficiaries in their homes, excluding rural areas and hospice recertifications that require a face-to-face encounter.
The AMA states “As a reminder, physicians who provide telehealth services to Medicare patients should be aware that the Medicare telehealth flexibilities lapsed for care to all patients except those being treated for mental health or substance use disorders. This means that telehealth services are limited to rural areas as they were before the COVID public health emergency and that patients cannot receive telehealth services in their homes.”
Healthcare administrators and practitioners should monitor Congressional action for the latest updates on the impact of telehealth coverage for Medicare beneficiaries.
Additional information & links to articles referenced can be found here:
Oct. 3, 2025: Advocacy Update spotlight on the government shutdown | American Medical Association