Government Shutdown Ends; Medicare Telehealth Flexibilities Extended Through January 30, 2026
What Happened?
Congress has passed and the President has signed a Continuing Resolution (CR) to end the 43-day federal government shutdown and fund the government through January 30, 2026. As part of this package, Medicare telehealth flexibilities that expired on October 1 are now restored and extended through January 30, 2026. Additionally, telehealth services delivered during the shutdown will be covered retroactively. American College of Cardiology
This update follows multiple warnings about a telehealth “cliff” on October 1, 2025, when pandemic-era flexibilities were scheduled to end absent Congressional action. Axios
The news has been highlighted by ACC/MedAxiom and other national advocacy groups monitoring the shutdown and telehealth policy developments.
Key Medicare Telehealth Flexibilities Restored & Extended
Under the new CR, the pre-October 1 telehealth rules are back in place for traditional Medicare and extended through January 30, 2026. Telehealth.org
Key flexibilities include:
Patient’s home as an originating site for non-behavioral Medicare telehealth visits (no rural/geographic restrictions).
Audio-only telehealth allowed for certain non-behavioral services when appropriate.
Expanded provider types as distant-site practitioners (e.g., PT, OT, SLP, audiology) in addition to physicians and APPs.
FQHCs and RHCs may continue to serve as distant-site telehealth providers.
Hospice recertification may be completed via telehealth under specified conditions.
Delayed in-person visit requirements for many behavioral telehealth services.
Retroactive Coverage: What It Means for Your Revenue Cycle
The legislation and related policy commentary indicate that: PALTmed
Telehealth claims held or underpaid due to the lapse (services on or after October 1, 2025, and before enactment) will be paid retroactively under the restored flexibilities.
Claims that were processed at reduced rates because certain geographic rules snapped back may be reprocessed and corrected once CMS issues instructions.
CMS is expected to release detailed guidance for submitting or adjusting claims now that the CR is law.
For practices, this means revenue tied to Medicare telehealth during the shutdown period is not lost, but you will need to track and follow up on those claims.
What This Means for Specialty Practices (Orthopaedics, Neurosurgery, ENT, General Surgery, etc.)
For KZA’s clients, this extension is particularly important for:
Post-op and routine follow-up visits that were being performed by telehealth for Medicare patients at home.
Pre-op consultations, imaging review, and chronic condition management visits that shifted to virtual formats.
Ancillary services (therapy, rehab, etc.) that rely on telehealth in group or hospital-aligned settings.
Practices that paused, reduced, or rerouted telehealth due to the shutdown can resume scheduling under the familiar pandemic-era rules—with the important caveat that this is another short-term extension, not a permanent fix.
Immediate Action Steps for Your Practice
KZA recommends the following steps for practice leaders, managers, and billing teams:
Build a Telehealth “Gap List” (Oct 1 Enactment Date)
Identify all traditional Medicare telehealth encounters provided from October 1, 2025, through the date the CR was signed.
Flag whether claims were:
Held and not yet submitted,
Submitted and denied due to telehealth policy changes, or
Paid at lower amounts due to geographic/originating site limits.
Coordinate With Your Billing Vendor and MAC
Confirm how your billing vendor/clearinghouse is flagging telehealth claims associated with the shutdown period.
Watch for MAC-specific instructions on whether to adjust, resubmit, or allow the MAC to auto-reprocess impacted claims.
Confirm Coding & Billing Details Are Still Aligned With CMS Guidance
Continue using appropriate place of service (e.g., 10 vs 02) and telehealth modifiers (e.g., 95, GQ/GT, FQ/FR where applicable) based on the latest CMS and MAC guidance.
Ensure that your team knows that the rules have reverted to the pre-October 1 framework, now extended through January 30, 2026.
Update Scheduling & Patient Messaging
Inform schedulers and clinical teams that Medicare telehealth from the patient’s home is back on the table—for now.
Update patient-facing messaging and website information to reflect that telehealth is again available for eligible Medicare visits, with the current end date of January 30, 2026.
Reinforce Documentation Expectations
Reinforce that telehealth visits must meet the same documentation standards as in-person visits, including:
Clear location of patient and provider,
Documentation of technology used (audio-only vs audio/video),
Time or MDM details for E/M level selection,
Notation of patient consent for telehealth.
Plan Ahead for the Next Telehealth Cliff
This CR creates another policy cliff on January 30, 2026. Unless Congress passes longer-term legislation, we may repeat the uncertainty seen this fall. Telehealth.org
Include telehealth risk in your 2026 budgeting and access-to-care planning, and prepare contingency plans (e.g., ramped-up in-person access) if flexibilities are allowed to expire.
KZA Perspective
While this is a welcome development for providers and Medicare beneficiaries, the short duration of the extension continues the pattern of “just-in-time” fixes that complicate operational planning and revenue forecasting. Practices should treat this as breathing room - not permanence.
KZA will continue to monitor:
CMS guidance on retroactive billing and claim reprocessing,
Further Congressional action on permanent telehealth legislation, and
Interactions between telehealth policy and the 2026 Medicare Physician Fee Schedule.
We will issue additional updates and education as more details become available.
This KZA Alert is for informational and educational purposes only and does not constitute legal or financial advice. Practices should consult their legal counsel, compliance officer, and Medicare Administrative Contractor (MAC) for organization-specific guidance.