The Shutdown's Impact on Telehealth

What You Need to Know

Effective today (October 1st), Medicare's telehealth flexibilities have expired as a result of the government shutdown, resulting in the following changes for Traditional Medicare beneficiaries:

• Geographic restrictions return: Telehealth services are now limited to rural areas only.
• Restrictive site requirements reinstated: Traditional Medicare beneficiaries must be physically located in a healthcare facility to receive telehealth services; home-based visits are no longer reimbursable. (Note: a DMEPOS supplier's office is not a "healthcare facility" for the purposes of telehealth services.)
• Audio-only services are no longer covered: Traditional Medicare will not reimburse for telehealth visits conducted by phone.

What This Means for You

Telehealth visits with Traditional Medicare beneficiaries conducted on or after October 1, 2025, are no longer valid for establishing medical necessity unless they meet the geographic and site requirements listed above. Telehealth visits before October 1, 2025 remain valid under the extended telehealth flexibilities that were then in effect. 

Clinics should immediately adjust scheduling protocols for telehealth visits involving Traditional Medicare beneficiaries to avoid claim denials.

However, Medicare Advantage, Medicaid, and commercial health plans are not automatically affected by the shutdown. In general, if one of those payers offered telehealth flexibilities prior to the shutdown, it should still continue to do so while the shutdown continues. Nevertheless, we recommend that you confirm the ongoing validity of telehealth with those payers to prevent surprise denials.