12/19/2025

[Duplicate] Post-Shutdown Update on Medicare Telehealth Flexibilities and CMS Operations

On November 12, the president signed a continuing resolution reopening the federal government and restoring Medicare telehealth flexibilities through January 30, 2026. The Centers for Medicare & Medicaid Services (CMS) updated Medicare claims processing guidance to reflect the legislation.

All Medicare telehealth claims are now payable, provided they meet applicable requirements. As such, clinicians may submit any telehealth claims held during the shutdown in anticipation of possible Congressional action and resubmit any returned claims to CMS.

CMS also posted answers to frequently asked questions on telehealth services, which states it will continue to pay telehealth claims in the “same way they had been paid before October 1. Telehealth flexibilities will apply retroactively as if there hadn’t been a temporary lapse in the application of the telehealth flexibilities through January 30, 2026.”

Clinicians are also encouraged to identify beneficiaries who were charged for telehealth services with dates of service on or after October 1, that are retroactively payable. They should then submit claims to Medicare and refund any overpayment to beneficiaries.

Providers no longer need to use the -GY modifier CMS mentioned in the previous guidance.

Read more on ASCO in Action.