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  • Jan 31, 2026

    Update on Extension of Telehealth Medicare Waivers

    Center for Connected Health Policy
    Last Thursday, the House passed HR 7148 – The Consolidated Appropriations Act, 2026 which includes the FY 2026 Appropriations package for Labor, Health and Human Services (LHHS), Education and Related Agencies.  This bill includes an extension for the Medicare telehealth waivers through December 31, 2027.

    The following telehealth related items would be extended under the bill:
     
    TELEHEALTH WAIVER NEW EXPIRATION DATE
    Waiving the location requirements (geographic and type of site)
         		 December 31, 2027
    Expanded list of eligible telehealth providers
         		 December 31, 2027
    Allowing federally qualified health centers (FQHCs) and rural health clinics (RHCs) to be eligible telehealth providers
         		 December 31, 2027
    Delaying the prior in-person visit for mental health when certain permanent telehealth policy requirements are not met
         		 December 31, 2027
    Delaying the prior in-person visit for mental health provided via telecommunications technology for FQHCs and RHCs
         		 December 31, 2027
    Allowing of audio-only for telehealth services
         		 December 31, 2027
    Extending the use of telehealth to conduct a face-to-face encounter for recertification of eligibility for hospice care
         		 December 31, 2027
    Extending the Acute Hospital Care at Home Initiative
         		 September 30, 2030

    The next step is for the Senate to vote on the bill; however, its timing and prospects are now uncertain, as the telehealth provisions are part of a broader appropriations bill that has become entangled with Department of Homeland Security (DHS) funding debates that emerged over the weekend. Without the extension, the waivers will expire on January 31, 2026 and policy would revert back to permanent Medicare telehealth policies as was experienced last fall, October – November 2025, and things would likely unfold in a similar manner. Providers would need to decide whether they will reschedule to a later date the telehealth appointments that do not qualify under permanent policies, have those services completed in-person instead of virtually, or simply continue to hold scheduled telehealth appointments in the hopes that any future policy solution would apply retroactively to services provided during this expired waiver period (like it did during the previous expiration period). 

    Unlike the previous three telehealth Medicare waiver extensions, this current proposal is for a longer period of time – almost two years. This more extensive waiver period should provide more stability and comfort to providers and patients, and will also allow additional time for more thoughtful discussion around potentially finding a more permanent solution to these telehealth policies.

    Other items to note in this bill include:
    • Allocation of $45.5 million to the Office for the Advancement of Telehealth.
    • The Centers for Medicare and Medicaid Services (CMS) will be required to have billing modifiers by 2027 to identify telehealth services delivered through third party virtual platforms with whom a clinician contracts or has a payment arrangement, and when telehealth is billed “incident to” another professional service.
    • Through CY 2027, allows for hospitals to furnish and bill Medicare for cardiopulmonary rehabilitation services delivered to hospital outpatients in their homes via live video.
    • Health and Human Services must issue guidance within one year of this bill’s enactment on best practices for delivering telehealth services to patients with limited English proficiency.
    • Requires CMS to educate Medicare clinicians by January 1, 2028 on screening for medication-induced movement disorders in at-risk patients, including best practices for telehealth screening and how such services should be reflected in billing.
    • Requires Medicare Advantage plans to include certain information in provider directories, including telehealth capabilities.
    • $1,000,000 is allocated to the purchase and implementation of telehealth services and other efforts to improve health care coordination for rural veterans between rural providers and the Department of Veterans Affairs.
    For all the details, read the full text of the bill, and stay tuned to CCHP newsletters for updates as the legislation moves through Congress.

    CMS Updates Telehealth Fact Sheet
     
    At the end of 2025, CMS updated their Medicare Learning Network (MLN) Fact Sheet on Telehealth and Remote Patient Monitoring (RPM). Some readers may be familiar with the MLN telehealth fact sheet, as it contains information on the latest telehealth Medicare policies and is regularly updated to reflect recent legislative or regulatory changes, such as those made each year by the Physician Fee Schedule (PFS). This latest MLN update primarily focuses on changes made by the 2026 PFS final rules.

    Among some of the clarifications noted include guidance regarding practice location enrollment.  The MLN notes that practitioners may provide telehealth services from their homes. CMS writes that if a practitioner has a physical practice but also provides services via telehealth from their home, the practitioner can enroll with Medicare and bill from that physical practice location. They do not need to report their home address on their Medicare enrollment application. However, a practitioner that is virtual-only with only a physical practice location that is their home, would need to enroll with that home address. In this scenario, the practitioner may suppress the street address detail by marking the address as “home office for administrative or telehealth use only” location in their enrollment application or by emailing the Quality Payment Program service center (QPP@cms.hhs.gov). This policy is to address the issue that practitioners have raised in recent years regarding the potential to have their home addresses made publicly accessible because they happen to primarily provide services via telehealth from that location.

    In this update, CMS also notes that they now consider all services on the Medicare eligible telehealth services list to have a status of permanent. In previous iterations of the list, services had a status of “permanent” or “provisional.” In the 2026 PFS, CMS eliminated this distinction.

    The CMS Telehealth & Remote Patient Monitoring MLN is available on the CMS website. You can also access a copy of CCHP’s fact sheet on the final rule of the 2026 PFS.
     

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