As of the time of this alert, the federal government remains shut down due to a spending impasse in Congress over extending Affordable Care Act subsidies and restoring Medicaid cuts in H.R.1, the reconciliation bill passed in July.
An overlooked casualty of the shutdown is Medicare coverage for telehealth services.
Telehealth became not only popular, but necessary, during the Covid-19 pandemic. Eliminating requirements for in-person office visits became a lifeline for many, but particularly for individuals living in rural areas, without transportation, or with compromised immune systems. Recognizing its value, Congress has since taken steps to extend the Covid-era flexibilities, however in most cases, only temporarily. Those extensions expired September 30, 2025, which means that pre-pandemic restrictions for telehealth services are now in place.
Broadly speaking, this means that most telehealth visits will be limited to certain locations, and patients must be located in a rural health professional shortage area. An in-person visit will also be required for patients receiving diagnosis, evaluation, or treatment for a mental health disorder within six months prior to the initial telehealth visit and every 12 months thereafter.
As a result of the Congressional stalemate, many providers have cancelled or postponed telehealth appointments, or reverted to requiring in-person visits. This is leaving beneficiaries without services, confused, and fearful of nonpayment.
Even when the shutdown ends, it is unclear what the future of Medicare telehealth will look like. Despite bipartisan support, without funding and permanent extensions of the telehealth policies, providers may be wary of resuming telehealth services due to the uncertainty of Medicare payments going forward.
October 9, 2025 – C. Huberty