Congress passes spending bill, extended Telehealth Flexibilities
Congress has extended the expiration dates for certain telehealth flexibilities from Jan 30, 2026, to Dec 31, 2027 (unless otherwise stated), as follows:
- Geographic requirements and originating sites
- Medicare patients can receive telehealth services anywhere in the United States and territories, including in their homes.
- In the MLN Connects Newsletter for Jan. 22, 2026, the Centers for Medicare & Medicaid Services (CMS) announced some policy changes for telehealth CY 2026. These changes were finalized in the CY 2026 Medicare Physician Fee Schedule.
What’s Changed?
- CMS removed telehealth frequency limitations for subsequent inpatient and nursing facility and critical care consultations
- CMS permanently allow teaching and supervising physicians to supervise through virtual presence
- CMS will continue to pay Rural Health Clinics and Federally Qualified Health Centers for medical telehealth services through December 31, 2026
- Starting in CY 2026, CMS will only add services to the Medicare telehealth services list on a permanent basis
- CMS added 5 new CPT and HCPCS codes to the Medicare telehealth services list
Authorized originating sites include:
- Physician and practitioner offices
- Hospitals
- Critical access hospitals (CAHs)
- Rural health clinics (RHCs)
- Federally Qualified Health Centers (FQHCs)
- Hospital-based or CAH-based renal dialysis centers (including satellites)
- Skilled nursing facilities
- Community health centers
- Renal dialysis facilities
- Mobile stroke units
Currently Covered Telehealth
They have permanently removed telehealth frequency limitations on:
- Subsequent inpatient visits (CPT codes 99231, 99232, and 99233)
- Subsequent nursing facility visits (CPT codes 99307, 99308, 99309, and 99310)
- Critical care consultations (HCPCS codes G0508 and G0509)
- Teaching physicians may permanently have virtual presence when billing for services provided involving residents in all teaching settings but only in clinical situations when they provide the service virtually (for example, a 3-way telehealth visit with the patient, resident, and teaching physician in separate locations)
- For services without a 010 or 090 global surgery indicator, we permanently revised the definition of direct supervision that allows the supervising physician or practitioner to provide supervision through a virtual presence using real-time audio-visual interactive telecommunications
- Periodic assessments via audio-only telecommunications
Telehealth Requirements
Technology
You must use 2-way, interactive, audio-video technology that allows for communication between the patient and distant site provider. As of January 1, 2025, you may also use 2-way, interactive, audio-only technology if the distant site provider is technically capable of using an audio-video telehealth system and the patient is in their home but isn’t capable of, or doesn’t consent to, using video technology.
Remote Monitoring Requirements
- Remote physiologic monitoring, but not RTM, requires an established patient relationship
- Only physicians and non-physician practitioners eligible to provide evaluation and management services can bill remote monitoring services
Remote Monitoring Components
Remote monitoring consists of 3 main components, each building off the step before it.
- Patient education and device setup: How to use the device and how to accurately collect data
- Device supply: Device examples, connecting the device so you can read results, and how often patients should use devices
- Treatment management: Reviewing patient data to improve patient health outcomes See the CY 2021, CY 2022, CY 2024, and CY 2026 PFS Final Rules for more information on billing processes and policy.
Consent for Care Coordination & Virtual Communication Services
CMS requires patient consent for all services, including non-face-to-face services. You may get patient consent at the same time you initially provide the services. We don’t require direct supervision to get consent. In general, auxiliary personnel under general supervision of the billing practitioner can get patient consent for these services. The person receiving consent can be an employee, independent contractor, or leased employee of the billing practitioner.
Resources:
https://www.cms.gov/files/document/mln901705-telehealth-remote-monitoring.pdf
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