Congress has once again sidestepped a disruptive lapse in Medicare telehealth access, with a provision in the government-funding continuing resolution (CR) in mid-November that restores pandemic-era flexibilities through January 30, 2026. The flexibilities had expired with the fall government shutdown.
The temporary fix averts deeper disruptions for Medicare patients and providers. But according to the National Law Review, the restoration of the flexibilities underscores the precarious, stopgap nature of federal telehealth policy and raises the stakes for Congress to enact a long-term solution.
The shutdown triggered the latest so-called “telehealth cliff.” When the most recent extension ended on September 30, 2025, Medicare’s expanded telehealth coverage, including coverage for care delivered to a patient’s home and audio-only visits, also expired. According to a research brief by the Center for Advancing Health Policy Through Research (CAHPR) and the Brown University School of Public Health Research, telemedicine visits for Medicare fee-for-service beneficiaries dropped by 24%, in the first 17 days of October, and fell 13% for Medicare Advantage beneficiaries compared with the period from July through September. Providers and patients faced significant uncertainty about whether virtual visits would be reimbursed if telehealth rules were later restored.
The CR extends the telehealth flexibilities originally expanded during the COVID-19 public health emergency. Under the extension, Medicare beneficiaries may continue to receive telehealth services from any location, including their homes. They can also access care delivered by a wide range of clinicians — including mental health counselors, occupational therapists and physical therapists — and utilize audio-only telehealth in appropriate cases. Recipients can seek telehealth services from federally qualified health centers and rural health clinics and receive certain hospice-related services required for patient certification via telehealth.
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Congress also delayed previously scheduled in-person visit requirements for mental health teleservices, preserving one of the most important coverage changes for individuals managing depression, anxiety and other behavioral health conditions.
Telehealth is no longer a niche service, according to CAHPR and Brown. In the first half of 2025, 4.3 million Medicare fee-for-service beneficiaries—15% of all enrollees—received at least one telehealth visit, accounting for more than 11 million virtual encounters. Nearly 30% of all Medicare clinicians provided telehealth at least once during that period. Clinicians delivering telehealth most often included primary care providers, nurse practitioners, and mental health specialists. Telehealth played a particularly significant role in managing mental health and chronic conditions, including diabetes and hypertension.
If lawmakers do not adopt a longer-term extension or enact permanent legislation, Medicare patients and providers face a return to pre-pandemic restrictions. Analysts warn that expiration could lead to disruptions in access to care, particularly for behavioral health and chronic disease management, especially in rural and community health centers, and reduced appointment availability as clinicians hesitate to schedule telehealth visits near another potential expiration date.
Providers could face uncompensated visits or delayed reimbursement decisions as well as lost value from infrastructure investments, including telehealth platforms and training.
Bipartisan proposals including the CONNECT for Health Act would make telehealth coverage permanent by removing geographic restrictions, expanding distant-site eligibility, and eliminating in-person requirements for mental health services. Despite broad support from health systems and patient groups, Congress has repeatedly relied on temporary measures rather than passing long-term reform.
With Medicare telehealth use now deeply embedded in U.S. clinical practice, lawmakers face growing pressure to move beyond emergency-era policymaking. As the latest January deadline approaches, the nation may be—but cannot indefinitely remain—one continuing resolution away from another telehealth cliff.
