Telehealth in Limbo: CMS Announces Hold Pending Congressional Action
When key Medicare telehealth flexibilities expired on September 30, 2025, providers found themselves facing renewed uncertainty. These flexibilities - originally granted during the COVID-19 pandemic - had allowed broader use of telehealth across settings, provider types, and patient locations. Without Congressional intervention, the rollback of telehealth rules will limit access for patients and jeopardize reimbursement for providers who have built care models around virtual care delivery.
Accordingly, on October 15, 2025, the Centers for Medicare & Medicaid Services (CMS) announced that it has instructed all Medicare Administrative Contractors (MACs) to continue to temporarily hold Medicare claims for telehealth services furnished after the September 30 expiration. (CMS MLN Connects Newsletter, Oct. 15, 2025)
The hold is designed to buy time for Congress to act - the guidance suggests that CMS is awaiting lawmakers to pass legislation reinstating the telehealth flexibilities. In the meantime, claims may be accepted by MACs, but providers will risk non-payment absent congressional action.
What This Means for Providers
- Providers need to plan accordingly - CMS suggests that providers may choose to hold claims associated with telehealth services that are not currently payable.
- Review your service mix - geographic restrictions, home-based telehealth, and certain practitioner types (such as Physical Therapists and Occupational Therapists) could lose eligibility under the pre-pandemic rules.
- Use Advance Beneficiary Notices (ABNs) to alert patients that certain telehealth visits may not be covered if Congress fails to act.
- Contact your Congressional representatives and implore them to act.
The Bottom Line
Telehealth providers should prepare for administrative delays and possible nonpayment - but remain hopeful. CMS’s decision to hold, rather than deny, claims signals confidence that Congress will act soon.
Our firm will continue monitoring legislative developments and CMS guidance. If your organization needs help navigating coverage uncertainty, patient communications, or compliance with new telehealth rules, contact Evan Sampson at esampson@postschell.com or 856.301.2561 for counsel and strategy support.
