Medicare Telehealth Flexibilities Set to Expire in 2025
Centers for Medicare & Medicaid Services expect to end key telehealth flexibilities introduced during the COVID-19 public health emergency on the date of March 31, 2025, which will modify healthcare delivery for providers and their patients.
On April 1, 2025, previous telehealth regulations that existed before the pandemic will reenter into effect. Telehealth services delivered in homes will become one of the primary modifications to Medicare. The only approved telehealth locations beyond substance use disorder (SUD) treatment along with behavioral and mental health care are facilities designated as originating sites but not patient residences. Medical providers will be restricted from receiving Medicare reimbursement when delivering services in rural Health Professional Shortage Areas (HPSA) or non-metropolitan Statistical Areas (non-MSA counties).
Provider eligibility is also changing. After March 31, 2025, only physicians together with practitioners defined by federal law will have the ability to bill telehealth services, which was temporarily opened up to occupational therapists and other licensed healthcare professionals. All behavioral/mental telehealth services now need patients to come in for physical visits at least once every six months after their first appointment, including yearly sessions. The requirement for an in-person appointment before FQHCs and RHCs provide telehealth services will remain waived through the end of 2025.
Audio-only services have become an exception for behavioral/mental health services since all other telehealth services lose coverage, but these services keep their permanent audio-only access.
Patients under Medicare can access behavioral/mental health services from their homes without geographical boundaries, and this benefit persists indefinitely. The delivery of remote care by marriage and family therapists along with mental health counselors now qualifies them as distant site practitioners.
The Drug Enforcement Administration and Department of Health and Human Services implemented extended telemedicine flexibility in controlled medication prescribing until December 31, 2025, while implementing patient protection standards and extended buprenorphine therapy access.
The telehealth flexibilities passed by Congress will expire by March 31, 2025, yet provisions granting HDHP and HSA first-dollar coverage ended on December 31, 2024.
