October 22, 2025
What You Need to Know: CMS has lifted most Medicare claims payment holds tied to the federal government shutdown, meaning payments for most services will now resume. Newly released payments include ground ambulance and FQHC claims. However, telehealth and Hospital Care at Home claims remain on hold until Congress acts to extend key pandemic-era telehealth flexibilities.
The Centers for Medicare & Medicaid Services (CMS) has directed Medicare Administrative Contractors (MACs) to lift most claims holds tied to the federal government shutdown and resume processing payments for services provided on or after October 1, 2025. This includes claims under the Medicare Physician Fee Schedule, ground ambulance transports, and Federally Qualified Health Center (FQHC) services. Only a limited subset of claims remains affected—specifically, telehealth claims that CMS cannot confirm are definitively for behavioral or mental health care, and acute Hospital Care at Home claims.
Telehealth services limited pending congressional action
As of October 1, 2025, several pandemic-era Medicare telehealth flexibilities have expired. Unless Congress acts, Medicare will no longer pay for most telehealth services delivered to patients in their homes or outside rural areas. Only behavioral and mental health telehealth services will be paid, and hospice recertifications again require in-person encounters.
Congress has historically extended these flexibilities with broad bipartisan support, and another extension is expected. Moreover, Congress often reauthorizes payments retroactively but physicians who provide telehealth services do so at their own financial risk. In the meantime, 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) so physicians may bill patients if telehealth claims are later denied. Some Medicare Advantage plans and physicians participating in the ACO Medicare Shared Savings Program (MSSP) may continue telehealth services; physicians should confirm policies directly with each plan.
CMA physician support
Physicians experiencing Medicare payment issues can contact CMA’s Center for Economic Services at (800) 786-4262 or economicservices@cmadocs.org. CMA will continue monitoring federal developments and provide updates as new information becomes available.