As of December 31, 2024, federal waivers regarding Medicare telehealth policies will expire. No definitive action has been announced, but recent rumors suggest a possible extension, though it may be brief or come with conditions. Without an extension, Medicare telehealth policies will revert to pre-waiver regulations, which differ significantly from the expanded allowances during the waiver period.
“The expiration of Medicare telehealth waivers in 2025 could severely limit access to critical care for millions of Americans. As we face this approaching deadline, it’s essential to find sustainable solutions to preserve and expand access to telehealth, ensuring that no one is left behind in receiving the care they need,” Dr. Karen Rheuban, VTN Board Chair, Professor of Pediatrics Director, and Center for Telehealth Senior Associate Dean for CME and External Affairs.
The Center for Connected Health Policy (CCHP) recently addressed common questions about the potential impact of this reversion to assist providers, organizations, and patients in understanding the changes. Below are takeaways from CCHP:
- Providers may continue to use telehealth to provide health care services, but those virtual services may no longer be eligible for Medicare coverage and reimbursement under the Medicare program.
- Patients receiving telehealth from a Federally Qualified Health Center or a Rural Health Clinic will continue to be able to receive care paid for by Medicare.
- Patients may be required to be in an office or medical facility located in a rural area to receive most Medicare telehealth services with the exception of behavioral health services, services for diagnosis, evaluation, or treatment of systems of an acute stroke, and monthly End-Stage Renal Disease visits for home dialysis.
- If a patient meets location requirements, permanent telehealth policies in federal law limit the types of providers who are eligible for reimbursement from Medicare if they use telehealth to provide those services, including physicians, nurse practitioners, physician assistant, clinical psychologists, marriage and family therapists, registered dietitians, and other providers types.
- For behavioral health, the geographic/site requirements would no longer have to be met in order to receive Medicare coverage, if certain conditions such as prior and subsequent in-person visits with the telehealth provider are met.
- Licensure will not be impacted as licensure requirements are in the jurisdiction of each individual state and separate from reimbursement policies. Additionally, Medicaid waivers do not impact the extension of federal waivers that is in place for the prescribing of controlled substances via telehealth.
An extension of the federal Medicare waivers is still possible, which could delay the implementation of the permanent policy scenarios until later in 2025 or beyond. Additionally, congress may act to revise some of the permanent Medicare telehealth policies. But at this point in time, it remains uncertain. You can continue to track developments through CCHP’s website.