Overview
- Congress missed the Sept. 30 deadline to extend policies, the government shut down on Oct. 1, and Medicare’s pandemic-era telehealth flexibilities lapsed with restrictions resuming the same day.
- CMS told Medicare Administrative Contractors to temporarily hold payments on telehealth claims for roughly up to 10 business days, allowing claims to be submitted but delaying reimbursement.
- Coverage reverts to statutory limits: most patients must be at approved originating sites in rural areas, eligible distant-site providers are narrowed, audio-only visits are largely not reimbursed, and many mental health services now require periodic in‑person visits.
- The Acute Hospital Care at Home waiver expired, and CMS instructed hospitals to discharge or readmit participating patients as of Sept. 30, affecting more than 400 facilities across 39 states.
- Providers are split between continuing virtual visits at financial risk in hopes of retroactive pay and pausing or rescheduling Medicare telehealth, as industry groups press Congress to restore flexibilities and warn of access and private‑payer ripple effects.