On February 3, President Trump signed the Consolidated Appropriations Act, 2026 (H.R.7418), which extends certain Medicare telehealth flexibilities through December 31, 2027. These flexibilities were initially enacted by Congress in response to the COVID-19 pandemic and rising need for telehealth services.
The most important aspect of these flexibilities was that they permitted Medicare beneficiaries to receive Medicare-covered telehealth services anywhere in the U.S. and from any practitioner eligible to bill Medicare for covered services. Prior to this, Medicare beneficiaries were generally limited to receiving Medicare-covered services in a medical facility and telehealth services were limited to only rural areas. Although seen as temporary, emergency accommodations during the pandemic, these flexibilities were extended twice in recent months, with the most recent extension expiring on January 31 amidst the government shutdown.
During this new two-year extension, the Medicare telehealth flexibilities that have been extended include:
- Removing the geographic restrictions on where a patient or eligible provider is physically located within the U.S. during the telehealth services, including allowing patients to continue receiving telehealth services from their homes.
- Expanding the list of distant site practitioners to include all practitioners who are eligible to bill Medicare for covered services, including physical therapists, occupational therapists, speech language pathologists, and audiologists.
- Maintaining eligibility for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to serve as distant sites for non-behavioral health telehealth services.
- Allowing providers to continue to use audio-only technology for reimbursable telehealth visits.
- Extending the waiver of the requirement for practitioners who provide behavioral and mental health via telehealth to provide in-person visits within six months of the first telehealth visit and annually thereafter.
- Allowing the use of telehealth to conduct the face-to-face encounter required for recertification of eligibility for hospice care.
Although this extension is beneficial for Medicare beneficiaries who have come to rely on telehealth services, it continues to provide only a temporary solution. The long-term outlook remains unclear; however, Congress is currently considering legislation that could make these current telehealth flexibilities permanent. Specifically, the CONNECT for Health Act of 2025, introduced in early 2025, is being considered by the House of Representatives (H.R. 4206) and the Senate (S.1261).
Telehealth service providers should keep in mind that the extension of these flexibilities applies only to Medicare, and telehealth reimbursement policies may differ under commercial payor programs and state Medicaid programs. Furthermore, these flexibilities do not modify any state licensure requirements or other state laws governing the provision of telehealth services.
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