If Congress does not extend government funding before October 1, 2025, critical Medicare telehealth flexibilities will lapse. Physicians who provide telehealth services to Medicare patients should prepare for that possibility.

If lawmakers fail to act, beginning October 1:

• Geographic restrictions return: Only patients in rural areas will be eligible for Medicare telehealth.
• Home-based care no longer allowed: Patients would once again need to travel to a medical facility to receive telehealth.
• Audio-only visits prohibited: Physicians would no longer be able to use telephone visits to serve Medicare patients.
• Hospital at Home program ends: The Acute Hospital Care at Home waiver authority would expire.

Since the COVID-19 public health emergency, Congress has temporarily waived long-standing restrictions on Medicare telehealth. These flexibilities allow patients in every geographic area—not just rural communities—to access telehealth, permit patients to receive services from their homes, and enable audio-only visits. Congress most recently extended these provisions in March 2025, but only through September 30.

On Sept. 16, House Republicans introduced a stopgap continuing resolution to fund the government through Nov. 21, 2025, and extend Medicare telehealth flexibilities through that date. While the House passed the bill, the Senate has not acted, leaving Medicare beneficiaries at risk of losing access to the telehealth services they have come to rely on for their care.

In past shutdowns, Congress has typically made funding and policies retroactive once government operations resumed. However, the uncertainty over the likelihood and duration of a shutdown may warrant adjustments to patient schedules.

The California Medical Association (CMA) continues to strongly urge Congress to make these telehealth flexibilities permanent—or at a minimum, extend them beyond September 30.

What Physicians Should Do

Physician practices that rely on Medicare telehealth should prepare for the possibility that Medicare telehealth options will be significantly restricted after Sept. 30. Consider:

• Reviewing upcoming telehealth appointments for Medicare patients.
• Communicating proactively with patients who may be affected.
• Monitoring CMA and AMA updates for real-time developments from Washington, D.C.

CMA will continue to advocate for permanent telehealth reform and keep physicians informed.