Critical Medicare Telehealth Flexibilities Expire After Congressional Deadline Missed

On October 1, 2025, federal telehealth policies for Medicare beneficiaries reverted to restrictive pre-pandemic rules. Despite broad support from lawmakers and the public, Congress failed to pass legislation extending crucial Medicare telehealth payment waivers before the September 30, 2025 deadline, and no extension was included in the government budget process.

This legislative failure immediately halts key flexibilities that had vastly expanded access to care since 2020, leading to significant disruptions for both patients and clinicians.

Key Impacts of the Policy Reversion:

• Home Visits End: Medicare will no longer reimburse clinicians for telehealth visits delivered to beneficiaries while the patient is in their home. This immediately reinstates the restrictive pre-pandemic policy.

• Rural Restrictions Return: Reimbursement for telehealth visits is now restricted to patients in rural geographic areas, even if the patient is accessing the service from an approved location, such as a hospital or clinic.

• Hospital-at-Home Ends: The Acute Hospital Care at Home waiver has expired, ending Medicare reimbursement for these initiatives.

• Medicare Advantage (MA) Uncertainty: Because MA plans must cover existing Medicare benefits, the termination of telehealth and hospital-at-home coverage in traditional Medicare creates significant uncertainty for MA enrollees and their providers.

• DEA Prescribing Flexibilities Undermined: Although the DEA extended its flexibility for prescribing controlled substances via telehealth through December 2025, the lack of reimbursement may make it financially unsustainable for clinicians to continue providing this care. Further, there is no information on DEA controlled substance prescribing requirements for the new year.

NJPCAPNC  advocates for the restoration of these flexibilities, viewing them as critical tools for caring for people with serious illness.