Telehealth Services on the Brink Again – Is a 7-Week Stopgap the Only Fix? | Robinson+Cole Health Law Diagnosis

[co-author: Paul Palma]*

Healthcare providers are again confronted with the potential termination of telehealth services unless Congress acts to extend the Medicare flexibilities implemented during the COVID-19 pandemic. If no legislative action is taken before September 30, 2025, those providers and patients who have depended on expanded telehealth options will encounter substantial limitations in access beginning October 1, 2025.

As a reminder, in March of this year the healthcare industry faced the imminent end of a number of COVID-era telehealth flexibilities, at which time Congress extended the flexibilities as part of a spending bill until September 30, 2025 (which we previously discussed here). Health care providers and their patients are now in the same position of looking to Congress to act to further extend those flexibilities to protect continued access to telehealth services.

On September 16, 2025, H.R. 5371 the “Continuing Appropriations and Extensions Act, 2026” (“the Bill”) was introduced in Congress The Bill primarily concerns federal funding, but if enacted, it would also extend the telehealth waivers established during the COVID-19 pandemic—which are currently scheduled to end on September 30, 2025—through November 21 (or November 22 as noted below), 2025. The Bill’s short-term extension comes after two separate bills seeking two-year extensions of the telehealth flexibilities had been proposed but not moved forward in recent weeks.

A summary of the existing telehealth waivers and their newly proposed expiration dates is included below.

Key Telehealth Provisions Proposed to be Extended

• Geographic and Originating Site Flexibility:
  • If the “cliff” is averted and the Bill passes: Medicare patients would be allowed to continue receiving telehealth services in any location through November 21, 2025
    • Without another extension, beginning October 1, 2025, Medicare beneficiaries may only receive telehealth services in approved health care facilities in rural locations (outside of metropolitan statistical areas)
    • Note that the Social Security Act contains exceptions that would permit telehealth services at home (or other locations) for patients in specific circumstances approved by law or regulation, including patients being treated for: (1) symptoms of acute stroke; (2) substance use disorder; or (3) patients with mental health disorder; and (4) patients on home dialysis.
• Expanded Practitioner Eligibility
  • If the “cliff” is averted: Medicare patients would be allowed to receive care from approved Medicare-enrolled providers, which under the prior COVID-era waiver includes occupational therapists, physical therapists, speech-language pathologists, and audiologists through November 21,2025.
  • If the “cliff” is not averted: Medicare beneficiaries will lose access to telehealth services provided by PTs, Ots, SLPs, and audiologists, all of whom play a key role in rehabilitation.
• Telehealth for FQHCs and RHCs
  • If the “cliff” is averted: Federally qualified health centers (FQHCs) and rural health clinics (RHCs) would be allowed to continue providing telehealth services to patients in other locations through November 21, 2025
• Audio-Only Telehealth
  • If the “cliff” is averted: Telehealth services could continue to be provided via audio-only communications systems through November 21, 2025
  • If the “cliff” is not averted: Substantial limitation on coverage for audio-only services and providers must be technically capable of using audio-video technology.
• In-Person Requirement for Mental Health Visits
  • If the “cliff” is averted: Medicare patients may continue to receive mental health services from FQHCs and RHCs via telehealth through November 22, 2025
  • If the “cliff” is averted: Medicare patients receiving services for the diagnosis, evaluation, or treatment of a mental health disorder may continue to do so without receiving in-person care through November 22, 2025
    • If the “cliff” is not averted: providers are required to furnish a Medicare-covered item to the beneficiary in-person at least 6 months prior to furnishing telehealth services. Additionally, the provider must furnish a Medicare-covered item in person at least once a year following each subsequent telehealth service. Note that the annual in-person follow-up requirement may be waived if the provider and beneficiary agree that the risks of receiving an in-person service outweigh the benefits
• Telehealth for the Recertification of Hospice Care
  • If the “cliff” is averted: Hospice physicians or nurse practitioners may continue having face-to-face encounters to recertify a patient’s eligibility to remain on hospice via telehealth through November 21,2025

As of September 25, 2025, the Bill has passed the House but has failed to pass the Senate, where it must receive a minimum of 60 votes. A motion to reconsider was granted and the Bill has once again been placed on the Senate legislative calendar. Congress is in recess through September 26, 2025, and will only have 2 days to pass this or another bill containing similar provisions before the existing waivers expire.

With the expiration date for the existing telehealth waivers looming, health care organizations should prepare to comply with additional telehealth restrictions beginning on October 1, 2025. Even if this stop-gap is passed, providers will soon be facing the same dilemma within a short period of time. We will continue to monitor this issue closely and will provide additional updates as soon as they become available.

*Legal Intern

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