This post is co-authored with Paul Palma, legal intern at Robinson+Cole. Paul is not admitted to practice law.
On November 12, 2025, President Trump signed H.R. 5371 the “Continuing Appropriations, Agriculture, Legislative Branch, Military Construction, and Veterans Affairs and Extensions Act, 2026” (the Act). The Act ended the federal government shutdown by providing necessary funding; it also extends key Medicare telehealth flexibilities to January 30, 2026. While a welcome development for health care organizations, this represents another short-term extension of Medicare telehealth flexibilities that will again need to be revisited in January 2026. Additionally, despite its passage, questions remain regarding the ability of providers to be paid for telehealth services furnished during the recent shutdown because the Act does not specifically provide for retroactive reimbursement.
Medicare Telehealth Flexibilities Extended by the Act
- Geographic and Originating Site flexibilities: Medicare beneficiaries may continue to receive telehealth services in any location through January 30, 2026.
- Expanded Practitioner Eligibility: Occupational therapists, physical therapists, speech-language pathologists, and audiologists may continue providing Medicare-covered services via telehealth through January 30, 2026.
- Telehealth for FQHCs and RHCs: Federally qualified health centers (FQHCs) and rural health clinics (RHCs) may continue providing telehealth services through January 30, 2026, including the provision of mental health visits via telehealth to Medicare beneficiaries without needing to meet annual in-person service requirements.
- Audio Only Telehealth: Telehealth services can continue to be provided via audio-only communications systems through January 30, 2026.
- In-Person Requirement for Mental Health Visits: Medicare patients receiving services for the diagnosis, evaluation, or treatment of a mental health disorder via telehealth may continue to do so without having received a Medicare-covered in person item or service through January 30, 2026.
- Telehealth for the Recertification of Hospice Care: Hospice physicians and nurse practitioners may continue having face-to-face encounters to recertify a patient’s eligibility to remain on hospice via telehealth through January 30, 2026.
It is expected that the Centers for Medicare and Medicaid Services (CMS) will provide guidance regarding the submission of claims, eligibility for retroactive payments, and how to address claims that have been on hold, following up on prior guidance offered in connection with telehealth services and the government shutdown.
While this extension provides temporary relief for providers and patients, health care organizations could face the same telehealth dilemma in a few months absent a long-term fix. As such, organizations should remain prepared to comply with additional telehealth restrictions (which we previously discussed here) and to transition some services back to in-person where necessary. We will continue to monitor this issue and legislative updates closely.