The Medicare telehealth expansion has officially reached its end. As of September 30, 2025, the temporary broadened coverage for telehealth services has expired.
This change may leave many of your clients wondering what Medicare-covered telehealth options will look like going into 2026.
Here’s a clear breakdown of the 2025 Medicare telehealth changes and how they’ll impact both you and your clients moving forward.
Will Medicare Stop Covering Telehealth?
The so-called Medicare telehealth policy cliff happened because Congress did not pass legislation to keep the temporary telehealth expansions in place.
In response, the Centers for Medicare & Medicaid Services (CMS) issued an MLN Matters notice directing all Medicare Administrative Contractors (MACs) to implement a temporary claims hold.
This means providers can still submit telehealth claims, but payments will be paused until the hold is lifted.
Unless Congress acts to renew the flexibilities introduced during the Public Health Emergency (PHE), Medicare will significantly reduce the number of telehealth services it covers beginning October 1, 2025.
What Is Telehealth?
Telehealth — also called telemedicine or telecare — allows patients to connect with healthcare providers virtually through digital technology for specific medical services.
For a telehealth visit to qualify, both the patient and the provider must engage in real-time, two-way communication that includes both audio and video.
While telehealth has its advantages and drawbacks, its flexibility has played a major role in advancing value-based care, making it easier for patients to access care and for providers to manage outcomes efficiently.
Telehealth coverage varies depending on the type of insurance (such as ACA marketplace plans versus Medicare) and even between carriers (like Medicare Advantage plans). Some clients may still prefer in-person appointments, while others appreciate the convenience of virtual visits—understanding their preferences can help you recommend the right plan for their needs.
Telehealth use surged during the COVID-19 pandemic in 2020, when social distancing made virtual care essential. Although utilization has declined since vaccines and relaxed restrictions, it remains significantly higher than pre-pandemic levels. In fact, a 2025 survey found that 76% of U.S. hospitals now offer telehealth services.
2025 Updates for Medicare Telehealth Policy
Before the COVID-19 pandemic, Medicare telehealth access was limited — only beneficiaries in rural areas could receive telehealth services, and typically only when visiting an approved healthcare facility.
In March 2020, the Centers for Medicare & Medicaid Services (CMS) temporarily expanded telehealth coverage, allowing Medicare recipients — including those in urban areas — to access approved services from home. These changes were designed to maintain care access while limiting the spread of COVID-19.
Over the following years, Congress approved several extensions to continue this expanded access. However, the final extension expired on September 30, 2025, marking the end of these temporary flexibilities.
As a result, millions of Medicare beneficiaries will lose the ability to receive telehealth services from home, meaning many will once again need to travel to a healthcare facility for services that were previously available virtually.
In addition, once CMS and Medicare Administrative Contractors (MACs) lift the current temporary claims hold, providers may begin denying claims that no longer meet the new, more restrictive telehealth coverage rules.
Who Will Be Impacted by These Changes?
The end of the expanded telehealth provisions primarily affects Medicare beneficiaries and the providers who deliver telehealth services. The groups most impacted include:
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Beneficiaries with Original Medicare
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Rural residents
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Older adults
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Individuals with limited mobility
Beneficiaries who live in qualifying rural areas and travel to an approved medical facility or office within that area will still be eligible for certain telehealth services.
However, all Medicare beneficiaries will continue to have access to a few essential telehealth services, including:
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Monthly End-Stage Renal Disease (ESRD) visits for patients on home dialysis
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Acute stroke care, including diagnosis and treatment, even in mobile stroke units
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Mental and behavioral health services, including treatment for substance use disorders, from the comfort of home
Additionally, some Medicare Advantage (MA) plans may continue offering telehealth coverage regardless of where a member lives. Certain MA plans also provide transportation benefits to help members get to and from medical appointments — a helpful option for homebound or rural clients.
Be sure to review your client’s specific plan to confirm whether these telehealth or transportation benefits are included.
What Changes Will Your Clients Notice?
With the expiration of expanded telehealth flexibilities, several important differences now apply to how Medicare beneficiaries can access telehealth care. These are key points to review with your clients:
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Telehealth from home is largely discontinued — Most beneficiaries can no longer complete telehealth visits from their residence.
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Approved “originating site” required — Clients must now visit a designated facility, such as a doctor’s office, hospital, or skilled nursing facility, to receive telehealth services.
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Rural area restriction — These originating sites must be located within a rural health professional shortage area, making telehealth access far more limited for beneficiaries in urban or suburban regions.
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Audio-only calls reduced — Audio-only telehealth is now covered only in limited situations, such as when a patient cannot or refuses to use video. The broader flexibility for phone visits no longer applies to most non-behavioral health services.
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In-person visit requirement for new patients — Anyone new to a provider must have an in-person appointment within six months before starting telehealth care.
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Annual in-person follow-up — To continue using telehealth services, patients must have an in-person check-in at least once every 12 months.
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Exceptions remain — Patients receiving substance use disorder treatment or those in qualifying rural areas are exempt from the above in-person requirements.
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Fewer eligible telehealth providers — Many clinicians who were permitted to deliver telehealth during the pandemic are no longer authorized to do so for Medicare beneficiaries.
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“Hospital at Home” program discontinued — Medicare coverage for this initiative has ended, meaning affected patients may face discharges or transfers back to inpatient hospital settings.
These changes significantly reshape how — and where — clients can receive virtual care under Medicare in 2025 and beyond.
How Can Your Clients Prepare for These Changes?
It’s natural for your clients to feel uncertain about how the new Medicare telehealth rules will affect them. Here’s how you can guide them through the transition:
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Verify their coverage — Encourage clients to review their plan details and confirm whether upcoming telehealth visits are still covered under the updated Medicare rules.
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Reschedule when necessary — If a service is no longer eligible for telehealth coverage, advise clients to switch to an in-person appointment at an approved facility to avoid payment delays or claim denials.
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Monitor billing and notices — Remind clients to keep an eye on their billing statements and any Medicare notices, especially Advance Beneficiary Notices of Non-coverage (ABNs), which indicate they may be financially responsible for certain services.
By taking these steps early, your clients can stay informed, avoid surprise bills, and continue receiving the care they need under the new Medicare telehealth guidelines.
Will Medicare Telehealth Services Expand Again in 2026?
At this time, it’s unclear whether Medicare telehealth flexibilities will be renewed for 2026, largely due to the ongoing government shutdown and stalled legislative activity. The best way to stay informed is to follow updates from Congress and reliable healthcare news sources as new bills and policy discussions emerge.
Despite the uncertainty, there is bipartisan support for continuing and expanding telehealth access. Several proposed bills aim to preserve these benefits, including:
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H.R. 4206 — Seeks to amend the Social Security Act to broaden access to telehealth services.
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H.R. 5081 — Proposes extending certain telehealth flexibilities under the Medicare program.
Additionally, on September 19, 2025, the U.S. Senate passed S. Res. 417, officially designating September 14–20, 2025, as Telehealth Awareness Week. This resolution highlights the essential role telehealth has played in improving healthcare access and calls for continued efforts to expand its availability nationwide.
While the future of Medicare telehealth remains uncertain, these legislative actions demonstrate a strong recognition of its value and the growing push to keep it accessible for all beneficiaries.
Helping Your Clients Navigate the Medicare Telehealth Changes
Although the end of expanded Medicare telehealth coverage may feel unsettling for your clients, your understanding of these changes can be a powerful tool. Use this knowledge to guide them with confidence, helping each client make informed choices that fit their unique healthcare needs.
By staying informed and proactive, you can clarify their concerns, offer practical solutions, and be a steady source of support during this period of transition and uncertainty.
Not affiliated with or endorsed by Medicare or any government agency.
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