Telehealth Flexibilities in 2026: What Expired and What Remains

Congress extended the geographic, originating-site, and audio-only Medicare telehealth flexibilities that providers have relied on since the COVID-19 public health emergency through December 31, 2027, under Section 6209 of the Consolidated Appropriations Act, 2026 (Public Law 119-75), signed February 3, 2026. That date matters because one piece of the same framework already changed. The billing shortcut Federally Qualified Health Centers and Rural Health Clinics used for non-behavioral telehealth, HCPCS code G2025, stopped working on October 1, 2026, and a clinic still filing it is billing a code CMS no longer recognizes for that purpose.

What Remains in Effect Through 2027

Section 1834(m) of the Social Security Act, as amended by Section 6209, keeps four flexibilities in force through December 31, 2027. Medicare beneficiaries can receive telehealth services anywhere in the United States and its territories, not only at a rural originating site. The expanded list of eligible practitioners, including physical therapists, occupational therapists, speech-language pathologists, and audiologists, can still bill for Medicare telehealth. Federally Qualified Health Centers and Rural Health Clinics can still bill for non-behavioral telehealth services. Beneficiaries can still receive audio-only telehealth visits in their homes. CMS's own Telehealth FAQ, updated October 8, 2026, states each date without qualification.

The Mental Health In-Person Requirement Moves to 2028

Section 1834(m)(7)(B)(i) requires an in-person visit within six months before a beneficiary's first mental health telehealth service, and at least once every twelve months after that. Section 6209 moved the date that trigger applies from January 31, 2026 to January 1, 2028. A beneficiary who began mental health telehealth services on or before December 31, 2027 skips the six-month trigger and is treated as established, needing only an in-person visit every twelve months after that date. The requirement survives in narrower form, reaching only beneficiaries who start mental health telehealth on or after January 1, 2028.

What Actually Expired October 1

Through September 30, 2026, Rural Health Clinics and Federally Qualified Health Centers billed non-behavioral telehealth with HCPCS code G2025. CMS's October 8, 2026 Telehealth FAQ confirms that beginning October 1, 2026, those clinics must bill the individual CPT or HCPCS code for the specific distant-site service, with the applicable telehealth modifier, in place of G2025. A separate change is still ahead. Starting January 1, 2027, CMS will require modifiers BB and BC on telehealth claims billed through a contracted virtual platform or furnished incident to a physician's service. Both changes affect what a correct claim looks like, not payment amounts. A claim filed the old way after the switch is the kind of documentation mismatch a UPIC audit flags first, the same pattern examined in Time-Based Telehealth Coding and Audit Findings.

The Medicare flexibilities Congress extended run through December 31, 2027. The DEA's separate telemedicine prescribing flexibility for controlled substances expires December 31, 2026, a full year earlier.

The DEA Deadline Runs on a Different Clock

The Medicare telehealth flexibilities and the DEA's telemedicine prescribing flexibility travel on separate statutory tracks administered by separate agencies, which is exactly why providers conflate the two deadlines. Section 6209 governs what Medicare pays for under the Social Security Act. The Drug Enforcement Administration and the Department of Health and Human Services govern what a DEA-registered practitioner may prescribe by telemedicine without a prior in-person evaluation, under a rule published December 31, 2025, extending Schedule II through V controlled-substance telemedicine prescribing through December 31, 2026. A telehealth practice that tracks only the Medicare date and keeps prescribing controlled substances by telemedicine past December 31, 2026 is prescribing outside the DEA's flexibility, risking both a recoupment demand and controlled-substances exposure in the same file, the kind of overlap addressed in When a Telehealth Audit Signals a Criminal Investigation.

Why Early Legal Counsel Is Critical

Telehealth providers should retain healthcare defense counsel as soon as a documentation request, audit notice, or other government inquiry names telehealth billing or prescribing. Counsel can confirm which rule set, Medicare's or the DEA's, actually governs the claims or prescriptions at issue, correct a response before it locks in an admission, and communicate with investigators on the provider's behalf.

Health Law Alliance has represented 2,500+ clients nationwide.

How Health Law Alliance Can Help

Health Law Alliance's telehealth practice tracks the Medicare extension, the delayed in-person requirement, and the DEA's separate prescribing deadline so a documentation request does not catch a provider on a billing or prescribing rule that already changed. If a program integrity contractor has flagged telehealth claims or a recoupment demand has arrived, contact our telehealth law and telemedicine attorneys for a free, confidential consultation.