Telehealth flexibilities reinstated through January 2026

The end of the government shutdown marks the end of a turbulent month for telehealth providers. The legislation, signed into law by President Donald Trump on Nov. 12, 2025, includes an extension of pandemic-era telehealth flexibilities through Jan. 30, 2026, and allows retroactive payment for telehealth services provided on or after Oct. 1, 2025.

The flexibilities expired at the end of September 2025 when Congress was unable to reach a deal to fund the government. That began the longest government shutdown in U.S. history, spanning 43 days, as lawmakers tussled over extensions of enhanced Affordable Care Act subsidies. Despite the bill not including an extension of the subsidies slated to expire at the end of the year, Democrats broke party ranks in the House and the Senate to join the Republicans in passing the legislation to end the shutdown.

The reinstated telehealth flexibilities will eliminate geographic restrictions and expand originating sites for Medicare telehealth services. They will also broaden the types of healthcare practitioners who can offer telehealth, reimburse federally qualified health centers and rural health centers for telehealth services and enable coverage for audio-only telehealth within the Medicare program.

The Acute Hospital Care at Home (AHCAH) waiver has also been extended through Jan. 30, 2025, enabling the more than 400 facilities approved for the waiver to provide hospital-level care in patients' homes.

The 43 days during which these flexibilities had expired were challenging for telehealth providers. Although widespread bipartisan support for the flexibilities had many providers optimistic about them being reinstated, the uncertainty led to providers making difficult operational and financial decisions, and in some cases, reverting to in-person and inpatient care.

In an early analysis of the shutdown's impact on telehealth, Brown University School of Public Health researchers found that the proportion of telehealth visits declined by 24% in the first 17 days of October 2025 for fee-for-service (FFS) Medicare beneficiaries and 13% for Medicare Advantage beneficiaries compared to the three-month period from July to September 2025.

The drop in telehealth visits was significantly larger in certain states, including Florida, Louisiana, Washington, Tennessee, Maryland, Oklahoma and New York, where telehealth utilization among FFS and Medicare Advantage beneficiaries declined by nearly 40% or more, according to the research.

The upheaval caused by the shutdown has led telehealth proponents to amplify their ask that the telehealth flexibilities be made permanent.

"[W]e are doubling down on our efforts to work with Congress and the Administration to secure a permanent solution -- or at minimum a years-long extension -- for these telehealth waivers," said Kyle Zebley, senior vice president of public policy at the American Telemedicine Association and executive director of its advocacy arm, ATA Action, in an emailed statement.

"We cannot continue to subject patients across the nation, in rural and urban communities, managing chronic and acute conditions, to ongoing uncertainty about their care," Zebley continued. "And with January 30 fast approaching, now just weeks away, swift action is essential. The clock is ticking, and the uncertainty created by this shutdown still looms large."

Zebley further emphasized that telehealth flexibilities must not be "entangled in partisan funding dynamics."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.