Telehealth Cliff Averted, for Now (But September is Six Months Away)

The potential plunge off the telehealth cliff that we warned you about in our March 3, 2025, blog post has been averted, for now.

With the passage of the Continuing Resolution (CR) by the House and Senate, and the subsequent signing by the president, current telehealth flexibilities and Medicare coverage for the benefit will not expire on March 31. With funding established through the end of the fiscal year—September 30, 2025—the CR provides at least a brief extension of telehealth flexibilities for those, particularly in rural areas or with mobility problems, who have come to rely on telehealth for access to critical health care services since March 2020.

As we noted on March 3, COVID-19 shifted perceptions of telehealth in a way that is not likely to ever return to pre-2020 notions, despite the wrangling over extensions. Between April and June of 2020, nearly half of all Medicare beneficiaries had at least one virtual medical visit. The COVID-19 public health emergency officially ended in May 2023, but the Medicare telehealth flexibilities have been extended several times.

The Continuing Resolution: Telehealth

Section 2207 of the CR, “Extension of Certain Telehealth Flexibilities,” is substantively identical to Section 3207 of the American Relief Act of 2025 (which granted the 90-day extension for telehealth flexibilities through March 2025). The new Section 2207, with the September 30 date,

1. Removes geographic requirements and expands originating sites for telehealth services (including patients’ homes);
2. Expands the list of practitioners who are eligible to furnish telehealth services (includes all practitioners who are eligible to bill Medicare for covered services, such as physical and occupational therapists, speech pathologists, audiologists, marriage and family therapists, and mental health services);
3. Extends telehealth services to federally qualified health centers (FQHCs) and rural health clinics (RHCs), who may serve as distant site providers;
4. Delays the Medicare in-person requirements for mental health services furnished through telehealth and telecommunications technology, including FQHCs and RHCs;
5. Allows for the payment/furnishing of audio-only telehealth services;
6. Extending use of telehealth to conduct face-to-face encounter(s) prior to recertification of eligibility for hospice care; and
7. Granting program instruction authority, meaning that the secretary of the Department of Health and Human Services may implement the amendments made by this section through program instruction or otherwise.

Utilization and Costs

Immediately following the passage and signing of the CR, the Center for Connected Health Policy and the National Telehealth Policy Resource Center issued an article pointing out that recent Medicare utilization and spending findings actually support Medicare telehealth expansions—and do not in fact support discontinuing the extensions on the grounds of increased patient utilization or costs.

As these organizations noted, the University of Michigan’s Institute for Healthcare Policy and Innovation has concluded—with respect to outpatient utilization—that while mental health is a high driver of telehealth use, and primary care is a moderate one, telehealth did not cause a rise in total post-pandemic evaluation and management visits among Medicare fee-for-service beneficiaries when compared to prepandemic levels (orthopedic surgery, for example, has low telehealth use).

A second study by the Institute for Healthcare Policy and Innovation similarly lends support for permanent telehealth coverage when examining the question of costs. This study found that telehealth-initiated visits were actually associated with lower 30-day spending compared to in-person-initiated visits. Though return visit rates were higher for telehealth, lab testing and imaging rates were lower, suggesting that telehealth may reduce overall Medicare spending.

The Next Six Months?

The American Telemedicine Association and its advocacy arm, ATA Action, have called the March 14 vote on the CR “a big victory for telehealth, and a huge relief for patients and clinicians in every state and region of the United States, especially those in underserved communities.” Yet Kyle Zebley, ATA Action’s executive director, called the short extensions “an impediment to long-term certainty.”

Certain provisions that were left out of the year-end funding package of December 2024 remain excluded, such as

• First dollar coverage of High Deductible Health Plans/Health Savings Accounts (HDHP-HSA) tax provision;
• In-home cardiology rehabilitation flexibilities;
• Virtual diabetes prevention program suppliers in Medicare Diabetes Prevention Program (MDPP); and
• SPEAK Act which facilitates guidance and access to best practices on providing telehealth services accessibly.

Some organizations, such as the National Consortium of Telehealth Resource Centers, are already preparing for the next telehealth policy cliff on October 1, 2025. For now, as the Telehealth Policy website of the Department of Health and Human Services states, telehealth services can still be provided by all eligible Medicare providers through September 30, 2025. Until that date:

• There are no geographic restrictions for originating sites for Medicare telehealth services, and Medicare patients can receive these services in their home.
• An in-person visit within six months of an initial Medicare behavioral/mental telehealth service, and annually thereafter, is not required.
• FQHCs and RHCs can serve as Medicare distant site providers for nonbehavioral/mental telehealth services.
• Telehealth services in Medicare can be delivered using audio-only communication.

Epstein Becker Green continues to closely follow all relevant telehealth developments. For additional information about the issues discussed above, or if you have other telehealth-related questions or concerns, please contact the Epstein Becker Green attorney who regularly handles your legal matters, or one of the authors of this blog post. Read more about our expansive capabilities and offerings here.

Epstein Becker Green Attorney Ann W. Parks contributed to the preparation of this post.