Medicare Telehealth in 2025
What’s Changing — And What Providers Should Do About It
BLOG OUTLINE
- Understanding the September 30, 2025 Deadline
- What Stays in Place Until the Deadline?
- The Changes After September 30, 2025
- What Telehealth Services Will Still Be Covered?
- The Impact on Provider Reimbursement
- How Providers Can Prepare for the Transition
- Medicare Telehealth Codes: What’s Covered and What May Be Removed After 2025
- Frequently Asked Questions
- Final Thoughts
Telehealth has experienced explosive growth since the COVID-19 pandemic, becoming an essential tool for providing healthcare remotely. As Medicare led the charge in this digital transformation, many healthcare providers expanded their virtual services, offering patients better access to care and improving patient satisfaction. At the same time, providers maintained their revenue streams by adapting to a new, virtual environment.
However, as we move toward the end of 2025, several policies that facilitated this expansion are set to expire. With temporary flexibilities ending on September 30, 2025, providers must prepare for a more regulated, compliant telehealth environment. In this article, you will learn what is changing, how provider reimbursement will be impacted, and how healthcare practices can get ready for these shifts.
Understanding the September 30, 2025 medicare telehealth Deadline
At the start of the COVID-19 pandemic, Congress and CMS relaxed many long-standing restrictions on Medicare telehealth. These changes allowed beneficiaries to access care from home, even if they lived in urban areas or weren’t physically present in a clinic or hospital. This shift to virtual care bridged critical access gaps, especially during the height of lockdowns and public health surges.
But these flexibilities were tied to the public health emergency, which ended in May 2023. While Congress extended most telehealth provisions through September 30, 2025, providers will face significant adjustments once these extensions expire. Unless new legislation is passed, many of the temporary policies will disappear, and Medicare telehealth coverage will return to pre-pandemic restrictions.
What Stays in Place Until the Deadline?
Until September 30, 2025, providers can still enjoy several key flexibilities. Medicare will continue to allow patients to receive telehealth services from any location, including their homes, and will still reimburse for services delivered through audio-only technology, particularly for mental health and behavioral health visits.
A wide range of healthcare professionals—physicians, nurse practitioners, physical therapists, speech-language pathologists, and licensed clinical social workers—remain eligible to deliver and bill for Medicare telehealth services. Additionally, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can act as distant-site providers, allowing them to deliver and bill for telehealth services directly.
medicare telehealth After September 30, 2025
Once September 30, 2025 arrives, several flexibilities will expire, drastically changing the landscape of Medicare telehealth.
- First, the longstanding geographic and originating site restrictions will be reinstated. This means that patients will need to be in rural areas and physically present at qualifying medical facilities, like hospitals or clinics, to qualify for telehealth reimbursement. Home-based telehealth visits will no longer be reimbursable, a significant shift for both patients and providers who have adapted to receiving care remotely from home.
- Another major change is the expected rollback of audio-only telehealth coverage. While certain mental health services may still be reimbursed when delivered by phone, audio-only evaluation and management (E/M) codes—such as 99441 through 99443—are expected to become non-reimbursable. Providers will need to transition to video-enabled platforms to continue offering remote care and meet the updated documentation requirements, particularly for behavioral health services.
- Additionally, the list of providers eligible to bill for telehealth services will likely shrink. Professionals like physical therapists, occupational therapists, and speech-language pathologists—who were temporarily allowed to offer Medicare telehealth—may lose that ability unless Congress passes new legislation. Similarly, FQHCs and RHCs may no longer qualify as distant-site providers, limiting their ability to provide telehealth unless the patient is physically present at the clinic.
What medicare Telehealth Services Will Still Be Covered?
Despite some restrictions, many telehealth services are expected to remain reimbursable. Established Medicare telehealth codes—such as G0425 through G0427 for inpatient or emergency department consults—will continue to be reimbursed if the patient is located at an approved facility. Codes like G0406–G0408 for follow-up inpatient consults are also expected to remain billable.
For behavioral health services, codes such as 90832 through 90838—which represent various lengths of psychotherapy sessions—will still be covered when delivered via video. In some cases, these codes may even remain reimbursable for audio-only sessions, provided certain documentation requirements are met. E-visit codes, like 99421 through 99423 for asynchronous communication via patient portals, will likely continue to be reimbursed as part of Medicare’s virtual communication policy.
However, common codes like 99441–99443 for audio-only phone consultations will likely become non-billable. Additionally, codes like G2252 for brief telehealth services (11–20 minutes) and G0071 for virtual communication services for FQHCs and RHCs may be phased out or severely limited.
The changes in Medicare telehealth coverage will have varying impacts depending on factors such as patient population, specialty, and practice location. Providers in urban areas may see a sharp drop in telehealth-eligible visits as geographic restrictions limit coverage to rural patients. Practices that have relied heavily on telehealth, especially for routine follow-up or chronic care management, may experience significant losses in billable services. Moreover, failing to comply with the updated Medicare telehealth guidelines could result in claim denials, overpayment recoupments, and audits. Providers must be meticulous about documenting patient location, modality used (video vs. audio), and compliance with in-person visit requirements, especially for behavioral health.
How Providers Can Prepare for medicare Transition
To stay ahead of these changes, practices should start by auditing their current telehealth usage. Evaluate which CPT or HCPCS codes are most commonly used and determine whether they will remain billable after September 2025. Practices should also assess their patient base, noting the number of rural versus urban patients, as well as how many services are being delivered via audio-only.
Adopting a hybrid care strategy that blends in-person and virtual visits will provide flexibility as you adjust to these changes. For example, prioritize in-person visits for new patients or more complex cases, while offering virtual check-ins for behavioral health or chronic disease management, as long as it aligns with updated Medicare rules.
Staying informed is critical to navigating the post-2025 telehealth environment. Keep an eye on CMS updates, including the 2026 Medicare Physician Fee Schedule proposed rule, which will likely address telehealth policies in detail. Professional organizations like the AMA and AAPC also provide valuable resources to help practices stay compliant with Medicare telehealth regulations. Finally, be sure to update your documentation templates. For mental health providers, this includes documenting the need for audio-only services and ensuring that all in-person visits are appropriately tracked, particularly for annual requirements.
Medicare Telehealth Codes: What’s Covered and What May Be Removed After 2025
FAQs: Medicare Telehealth Changes in 2025
What changes are happening to Medicare telehealth after September 30, 2025?
After September 30, 2025, many of the temporary telehealth policies put in place during the COVID-19 pandemic will expire. This includes the relaxation of geographic and originating site restrictions, meaning patients will need to be located in rural areas and physically present at qualifying medical facilities to receive telehealth reimbursement. Additionally, audio-only telehealth services will likely be limited, and certain providers (like physical therapists) may no longer be able to bill for telehealth services unless new legislation is passed.
Will audio-only telehealth services still be reimbursed after 2025?
Audio-only telehealth services, particularly for mental health visits, will likely be phased out for most services, with a few exceptions. Mental health services might still be reimbursed for audio-only consultations, but most other audio-only codes, including common evaluation and management (E/M) codes (99441–99443), are expected to become non-reimbursable.
Which Medicare telehealth codes will still be reimbursed after the changes?
Some telehealth codes will remain reimbursable, including:
- G0425–G0427: Inpatient or emergency department consults.
- G0406–G0408: Follow-up inpatient consults.
- 90832–90838: Psychotherapy sessions (video-based, and potentially audio-only for behavioral health).
- 99421–99423: E-visit codes for asynchronous communication.
However, certain codes, such as 99441–99443 (audio-only phone consultations), may no longer be reimbursed.
How will these changes impact providers who have relied heavily on telehealth?
Providers who have built their practice around telehealth, particularly those offering services like chronic care management or mental health consultations, may experience a decrease in billable services once these policies change. Practices in urban areas may face a particularly sharp decline due to the reinstatement of geographic restrictions that limit telehealth eligibility to rural patients.
What steps can healthcare providers take to prepare for these changes?
To prepare, practices should begin by auditing their telehealth services, evaluating which CPT codes are being used most often, and determining which will remain billable after September 2025. Providers should consider transitioning to a hybrid care model, combining in-person visits with virtual check-ins where applicable. Staying informed by following CMS updates and industry guidelines is also essential. Additionally, updating documentation practices, especially for mental health services, will help ensure compliance with new Medicare guidelines.
Will Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) still be able to offer telehealth after September 2025?
After September 30, 2025, FQHCs and RHCs may no longer be allowed to act as distant-site providers. This means they would no longer be able to deliver most telehealth services unless the patient is physically present at the clinic. This change could limit access for many rural patients who rely on these facilities for telehealth services.
Can Medicare beneficiaries still receive telehealth services from home?
After September 30, 2025, home-based telehealth will no longer be covered for most services. Patients will need to be located at qualifying medical facilities, such as hospitals or clinics, to receive reimbursement for telehealth services. This shift will particularly affect urban patients who have grown accustomed to receiving care from home.
What should healthcare providers do if they are unsure about the reimbursement status of a code?
Healthcare providers should stay proactive in reviewing updates from CMS and professional organizations like the AMA and AAPC. If unsure about the reimbursement status of specific codes, it’s a good idea to consult with a medical billing expert or telehealth compliance specialist to ensure accurate billing and avoid costly mistakes.
Are there any opportunities for new telehealth policies to be introduced before the September 2025 deadline?
It’s possible that Congress may pass new legislation before September 2025 to extend or adjust some of the telehealth provisions. Providers should monitor CMS and legislative updates regularly to stay informed of any last-minute changes that may impact reimbursement or coverage.
Final Thoughts
While Medicare telehealth is not going away, the way it’s reimbursed is about to change dramatically. What started as a temporary measure during the pandemic is transitioning into a more controlled and selective model of virtual care. Practices that begin preparing now, adjust their workflows, and understand the new rules will be better positioned for success in the evolving telehealth landscape.
At Medstates, we specialize in helping healthcare providers navigate regulatory changes and reimbursement challenges. From billing compliance to telehealth documentation support, our team is ready to guide your practice through the shifting Medicare telehealth landscape.
Need help preparing for the transition? Contact Medstates today to ensure your practice’s revenue stays strong, no matter how the rules evolve.
