The Mississippi Telehealth Association has been closely watching Congress’ actions regarding the Medicare COVID-era telehealth extensions that were set to, and did, expire on September 30, 2025.
Despite our advocacy for extension along with peers from across the country, the partisan fight over the budget has caused a stalemate in Congress.
When the pandemic began, Congress authorized broad waivers that temporarily removed restrictions on where patients could be located, which types of clinicians could provide telehealth, and even permitted acute hospital care at home. These waivers provided Medicare patients and providers with unprecedented access to virtual care, but they were tied to government funding bills.
With Congress failing to pass new legislation before the September 30 deadline, those extensions expired, and Medicare has reverted to its pre-COVID telehealth coverage rules. This will remain the case until Congress passes a Continuing Resolution (CR) or separate bills with such language included.
What Has Changed for Providers
Providers now face a much narrower landscape of telehealth options for Medicare beneficiaries. The most significant loss is the ability to treat patients in their homes through telehealth, regardless of geographic location. In addition, some clinicians who were temporarily allowed to deliver and bill for telehealth services are no longer eligible. Acute hospital care at home programs, which gained momentum under the waiver period, are also discontinued until legislative action occurs. These sudden shifts have created confusion and financial concern for practices that had integrated these services into their care delivery models.
Continuing Medicare Reimbursement
While Medicare remains authorized to reimburse for certain telehealth services, payments may experience delays because of reduced staffing during the shutdown. The covered services are restricted to those allowed under long-standing rules, including visits that originate in approved sites such as rural health clinics, hospitals, and other designated facilities. Eligible clinician types also return to the narrower list recognized before COVID-19. This means that while telehealth is not completely gone, its use is far more limited than it has been over the past several years.
What Providers Should Do Now
Every practice is encouraged to evaluate its patient population and financial outlook in light of these changes. For some, suspending telehealth services to Medicare patients altogether may be the most prudent approach until Congress reinstates the waivers. Others may continue offering telehealth but limit it to patients who meet pre-COVID eligibility rules. A third option is to provide telehealth on an out-of-pocket basis, charging patients directly for services not covered by Medicare. The right strategy will depend on the practice’s mix of patients, its cash flow, and its long-term planning goals.
Medicare Codes Still Reimbursed
Under the current rules, Medicare will continue to pay for telehealth services furnished in approved originating sites. Physicians, nurse practitioners, physician assistants, and certain specialists remain authorized providers of these services. Codes tied to office visits, behavioral health, and other long-standing telehealth categories remain eligible for reimbursement. These services continue to offer a pathway for providers to deliver care virtually, albeit under more restrictive conditions than during the waiver period.
Medicare Codes No Longer Reimbursed
Medicare will no longer reimburse for telehealth visits conducted in a patient’s home unless the home is in an approved rural or clinical site area. Services delivered by provider types added under the COVID-era waivers, including physical therapists, occupational therapists, speech-language pathologists, and audiologists, are no longer reimbursed. Acute hospital care at home, a program that expanded significantly during the pandemic, has also lost reimbursement authority. Until Congress passes a new funding measure that reauthorizes these waivers, providers will need to adjust operations and carefully manage patient expectations.