Song Remains the Same – Medicare Telehealth Services At Risk of Expiring Again on January 30, 2026

Healthcare providers are currently facing yet another termination of Medicare telehealth flexibilities at the end of the day on January 30, 2026, unless Congress acts on proposals to further extend the COVID-era flexibilities for telehealth. If no legislative action is taken before January 30, 2026, the providers and Medicare patients who have depended on expanded telehealth options will encounter substantial limitations in access beginning January 31, 2026.  

As a reminder, in October-November 2025, in connection with the government shutdown, federal COVID-era telehealth flexibilities for Medicare beneficiaries expired, which led to significant billing challenges and restrictions in access for patients (which we previously discussed here). Those flexibilities were retroactively extended as part of the government funding bill passed in November 2025, through January 30, 2026. Health care providers, and their patients, are now in the same position of looking to Congress to act to further extend those flexibilities to protect continued access to telehealth services.

It remains to be seen whether Congress will be able to pass another extension and, if so, how long the extension may be. There has been at least one proposal passed in the House of Representatives that would extend the telehealth flexibilities through December 31, 2027, but it remains to be seen if that will be taken up by the Senate.

A summary of the existing telehealth waivers and their newly proposed expiration dates is included below.

Key Telehealth Provisions Proposed to be Extended

• Geographic and Originating Site Flexibility:
  • Without another extension, beginning January 31, 2026, Medicare beneficiaries may only receive telehealth services in approved health care facilities in rural locations (outside of metropolitan statistical areas);
  • Note that the Social Security Act contains exceptions that would permit telehealth services at home (or other locations) for patients in specific circumstances approved by law or regulation, including patients being treated for: (1) symptoms of acute stroke; (2) substance use disorder; or (3) patients with mental health disorder; and (4) patients on home dialysis;
• Expanded Practitioner Eligibility:
  • If the “cliff” is averted: Medicare patients would be allowed to receive care from approved Medicare-enrolled providers, which under the prior COVID-era waiver includes occupational therapists, physical therapists, speech-language pathologists, and audiologists;
  • If the “cliff” is not averted:  Medicare beneficiaries will lose access to telehealth services provided by PTs, Ots, SLPs, and audiologists, all of whom play a key role in rehabilitation;
• Telehealth for FQHCs and RHCs:
  • If the “cliff” is averted: Federally qualified health centers (FQHCs) and rural health clinics (RHCs) would be allowed to continue providing telehealth services to patients in other locations;
• Audio-Only Telehealth:
  • If the “cliff” is averted: Telehealth services could continue to be provided via audio-only communications systems;
  • If the “cliff” is not averted: Substantial limitation on coverage for audio-only services and providers must be technically capable of using audio-video technology;
• In-Person Requirement for Mental Health Visits:
  • If the “cliff” is averted: Medicare patients may continue to receive mental health services from FQHCs and RHCs via telehealth;
  • If the “cliff” is averted: Medicare patients receiving services for the diagnosis, evaluation, or treatment of a mental health disorder may continue to do so without receiving in-person care;
    • If the “cliff” is not averted:  providers are required to furnish a Medicare-covered item to the beneficiary in-person at least six months prior to furnishing telehealth services. Additionally, the provider must furnish a Medicare-covered item in person at least once a year following each subsequent telehealth service. Note that the annual in-person follow-up requirement may be waived if the provider and beneficiary agree that the risks of receiving an in-person service outweigh the benefits; and
• Telehealth for the Recertification of Hospice Care:
  • If the “cliff” is averted: Hospice physicians or nurse practitioners may continue having face-to-face encounters to recertify a patient’s eligibility to remain on hospice via telehealth.

With the expiration date for the existing telehealth waivers looming, health care organizations should prepare to comply with additional telehealth restrictions beginning on January 31, 2026, similar to the situation faced in October 2025. We will continue to closely monitor this issue and will provide additional updates as soon as they become available.