TS Medicare Reimbursement Changes Information Center

Feb. 2: Medicare Telehealth Waivers Extended Through December 31, 2027

Congress has formally extended key Medicare telehealth flexibilities through December 31, 2027, restoring coverage after a brief lapse and providing nearly two years of reimbursement stability for hospital-based telemedicine programs.

This extension preserves the operational and financial continuity previously covered telehealth services, including neurology, and behavioral health services.

For the full February 2 update, please click here.

Jan. 27: Medicare Telehealth Reimbursement Extension Update

The U.S. House has passed legislation extending Medicare telehealth reimbursement flexibilities through December 31, 2027, pending Senate approval. Current flexibilities are set to expire January 31, 2026 without further Congressional action.

The House-passed extension preserves the existing telehealth framework, including removal of geographic and originating site restrictions, expanded provider eligibility, audio-only visits, mental and behavioral health services, hospice telehealth, FQHC/RHC participation, and Hospital-at-Home flexibilities.

Based on prior precedent, brief authorization gaps have been resolved retroactively, with CMS historically indicating low enforcement risk for services delivered in good faith.

For the full January 27 update, please click here.

Nov 14: Medicare Telehealth Flexibilities Reinstated After Government Shutdown:

The recent continuing resolution (CR) will extend payment for telehealth services that expired during the government shutdown.

The legislation retroactively reinstates Medicare telehealth flexibilities from October 1, 2025, through January 30, 2026, and ensures that claims put on hold will be paid.

• Retroactive payments: The CR provides for retroactive payment of telehealth claims that were suspended during the shutdown.
• Reinstated flexibilities: The CR restores Medicare telehealth flexibilities that expired on September 30, 2025, including some geographic limitations and eligibility for certain providers like physical and occupational therapists.
• Future guidance: The Centers for Medicare & Medicaid Services (CMS) is expected to issue guidance on how providers can submit and process these retroactively paid claims.

For more information, please see: Congress Ends Government Shutdown

Oct 15: TeleSpecialists’ Chief Strategy and Growth Officer Molly Reyna releases position paper, titled “Preserving Access to Life-Impacting Care: Why Congress Must Act on Medicare Digital Healthcare Reimbursement.”

Overview: On September 30, 2025, key Medicare telemedicine flexibilities expired, and the following day’s federal shutdown deepened a nationwide care crisis, leaving hospitals, providers, and patients in uncertainty. TeleSpecialists’ position paper outlines the urgent need for Congressional action as Medicare beneficiaries now face new barriers to essential neurology, psychiatry, and specialty consultations—except for stroke care, which remains protected. The analysis reveals that outdated geographic restrictions deny care based on ZIP code rather than medical need, despite evidence showing that digital consultations save $7,500–$12,000 per patient by preventing unnecessary transfers and improving outcomes.

Oct 15: Reimbursement Fact Sheet Released

Oct 6: TeleSpecialists releases Medicare reimbursement guidance and FAQs to its partner hospitals.

Oct 2: TeleSpecialists disseminated news release urging congressional action to preserve patient access to certain emergency neurology and behavioral services nationwide.

Overview: TeleSpecialists urges Congress to:

1. Extend telehealth reimbursement protections beyond rural carve-outs for all hospital-based emergency neurology and psychiatry services.
2. Refine the in-person visit requirement to reduce unnecessary barriers for behavioral health patients receiving care at home.
3. Ensure payment stability by authorizing retroactive reimbursement once the shutdown ends.

Oct 1: Government shuts down

Sept 30: Key pandemic-era Medicare telemedicine flexibilities expired.¹

1: https://www.cms.gov/files/document/mln901705-telehealth-remote-patient-monitoring.pdf