As the federal government shutdown enters its third week, the Centers for Medicare & Medicaid Services (CMS) has directed all Medicare Administrative Contractors (MACs) to continue holding Medicare claims for services impacted by the federal shutdown with dates of service on or after October 1, 2025. This includes most telehealth services, ground ambulance transport claims and Federally Qualified Health Center claims. For all other services, Medicare claims will continue to be processed and paid in a timely manner.

Earlier this week, CMS instructed contractors to hold all Medicare claims for services provided on or after October 1, 2025, while awaiting congressional action to renew certain payment provisions that expired under the Full-Year Continuing Appropriations and Extensions Act of 2025. This raised concerns that widespread payment delays could occur if the shutdown persisted. Overnight, CMS issued revised instructions narrowing the scope of the hold. MACs are now directed to delay payments only for services directly impacted by the expired provisions.

Because Medicare is required by statute to hold physician claims for 14 days before issuing payment, physicians have not yet begun to feel the impact of the shutdown-related delays.

Physicians may continue to submit affected claims, which will be released once the government reopens and the relevant payment provisions are reauthorized.

Telehealth Flexibilities

The COVID-era Medicare telehealth waivers expired on October 1, 2025, and funding for most telehealth services will not resume until Congress acts to extend them. In the meantime, only telehealth services for behavioral or substance use disorder treatment remain covered. (CMS has updated its telehealth FAQs to reflect these changes.)

Because payment is uncertain, the California Medical Association (CMA) advises practices to consider converting telehealth visits to in-person care or rescheduling when possible. CMS also recommends having patients sign an Advance Beneficiary Notice of Noncoverage (ABN) to allow billing of patients if claims are ultimately denied. Some Medicare Advantage plans may continue to cover telehealth; physicians should verify coverage with each plan.

CMA Physician Support

CMA urges physicians experiencing Medicare payment delays or other issues tied to the shutdown to contact CMA’s Center for Economic Services at (800) 786-4262 or economicservices@cmadocs.org. Physicians can also alert AMA advocacy staff about Medicare claims problems at ama.advocacy@ama-assn.org with the subject line “Medicare Payment Delay.”

CMA will continue to provide updates as new information becomes available.