Telehealth in 2025: Medicare Providers Get Temporary Relief, But Uncertainty Remains

The end of 2024 came with great uncertainty for many providers. As the year drew to a close, patients and providers across the country awaited news of whether the federal government would renew many of the pandemic-era flexibilities that have transformed health care delivery. The DEA and HHS were first to make headlines, announcing a temporary rule extending telehealth prescribing flexibilities through the end of 2025. With these flexibilities renewed, all eyes turned to Congress in the final days of 2024 to determine if Medicare’s temporary coverage of telehealth services would be similarly extended. Congress ultimately passed The American Relief Act, 2025 (the “Act”), on December 20, 2024, less than two weeks before these flexibilities were set to expire. Passage of the Act comes as welcome news for Medicare beneficiaries and providers, offering a brief extension of key telehealth coverage provisions. Now set to expire on March 31, 2025, the Act temporarily prevents an immediate return to stringent pre-pandemic restrictions on telehealth coverage, leaving the future of telehealth coverage in Medicare in question. For providers, understanding these changes—and preparing for potential disruptions—is critical to ensure a smooth transition to pre-pandemic coverage rules.

Why Only Three Months?

The three-month extension resulted from a broader legislative compromise aimed at preventing a government shutdown. Although earlier drafts of the bill proposed a two-year extension, concerns about the potential cost of such an extension—which the Congressional Budget Office estimates could cost as much as $4 billion— scaled it back to a stopgap measure.

This temporary fix reflects ongoing challenges in securing permanent telehealth policies, despite enjoying bipartisan support. Providers and industry groups such as the American Telemedicine Association continue to advocate for more lasting solutions to ensure stability for patients and healthcare practices alike.

What the Extension Covers

The legislation maintains several critical telehealth flexibilities for Medicare providers. Patients can still receive care from home without geographic restrictions, and a broad range of providers, including physical therapists and speech-language pathologists, remain eligible to bill for telehealth services. Reimbursement for audio-only telehealth also continues, preserving a vital option for Medicare patients with limited internet access. Additionally, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) will remain eligible as “distant sites” from which providers can continue to deliver comprehensive virtual care.

However, not all of the flexibilities that Medicare patients enjoyed in the years after the pandemic were extended. The Act eliminates coverage of cardiac and pulmonary rehabilitation services offered via telehealth, leaving providers unable to bill the program for these services in the new year.

While the renewal of many of these provisions help maintain continuity of care in the short term, providers will need to act quickly to prepare for potential changes after March 2025.

Permanent Changes You Can Count On

Although many flexibilities are temporary, some have been made permanent in previous legislation. The Consolidated Appropriations Act of 2021 allows behavioral health providers to continue to bill for telehealth services from any location and use audio-only platforms if video isn’t feasible.

These permanent policies offer some stability, but primarily benefit behavioral and mental health care. Telehealth access for other types of care remains in a precarious position.

How This Impacts Providers and Patients

For the next three months, Medicare patients can continue to benefit from the convenience and accessibility telehealth services offer. Providers, meanwhile, avoid significant financial and operational disruptions to their practices that would have resulted from the expiration of these flexibilities.

But the future of Medicare’s coverage of telehealth services is far from certain. Without further action from Congress, geographic limitations will return, restricting telehealth coverage to patients in rural areas and requiring them to visit approved originating sites for care. Reimbursement for audio-only telehealth services will also end, creating further barriers for patients and impacting provider revenue. Certain types of providers will lose their ability to bill Medicare entirely.

How Providers Can Prepare

To navigate this uncertainty, providers should take proactive steps to protect their practices in the coming months. Start by assessing the telehealth services you offer. Identify which services at your practice depend on these telehealth flexibilities and calculate the potential financial impact of losing Medicare reimbursement. Updating your telehealth platforms is also a wise investment. Given that audio-only telehealth visits may soon be ineligible for reimbursement, ensuring your practice can facilitate audio-video calls preserves your ability to bill for telehealth services beyond the coming months. Additionally, create a plan to engage patients whose treatment plans may be affected by potential changes to Medicare’s reimbursement rules. Be sure to inform patients about their options and help them plan for the transition, whether they are moving to in-person visits or considering other care options. Finally, ensuring compliance with other Medicare requirements is paramount. Review your billing and documentation practices to reduce the risk of claim denials or audits as Medicare rules continue to evolve.

Looking Ahead

The American Relief Act, 2025, offers a temporary respite from a return to pre-pandemic telehealth rules, but looming uncertainty underscores the fragility of telehealth policy in the United States. Providers must prepare for potential disruptions while remaining engaged in the fight for more enduring reforms.

By staying informed, adapting your practice to potential changes, and preparing your patients for future treatment plans, you can navigate these challenges and continue delivering high-quality care to your patients.

Have questions about what the future of your practice looks like? Our team is ready to help.

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