It’s October 2025, and while football fans are glued to unpredictable plays this season, healthcare providers are stuck watching their own kind of gridiron drama — Medicare’s latest “hold everything” game plan.
The Play-by-Play
CMS has directed Medicare Administrative Contractors to continue holding claims affected by expired payment provisions — that means telehealth, ground ambulance, and FQHC claims are all on ice. Regular services are still moving through, but anything connected to the now-expired “extenders” is waiting for Congress to act.
For providers, this is no quick timeout: the 14‑day payment floor has passed, and many offices are seeing major cash flow impacts — payroll delays, postponed reimbursements, and mounting uncertainty.
Telehealth: The Benched MVP
Telehealth got hit hardest. When pandemic‑era Medicare waivers expired October 1, many common virtual services became non‑payable again — unless you’re delivering behavioral health care or working under a Shared Savings ACO.
That reversal has left providers explaining to patients why yesterday’s covered visit is today’s surprise expense. The official CMS word: continue submitting claims, issue Advance Beneficiary Notices (ABNs) when required, and await legislative renewal.
The Human Cost of a Policy Timeout
The unfairness here isn’t abstract. Providers are people — people with rent, payrolls, and lives built around the assumption that Medicare is a steady partner. Every day this shutdown drags on, clinics are asked to deliver care without compensation, absorb delays, and “wait patiently” while Washington plays budget chess.
Final Thoughts: The Game That Never Ends
No referee whistle, no end zone in sight. CMS is punting; providers are left guessing the next play. When the government finally restarts, there’ll be a scramble to catch up — but for now, the most vital payer in American healthcare is running on nothing but hope and coffee.
Written by Wendy Samuels, Healthcare Revenue Cycle Specialist.
Wendy has over 30 years of experience in medical billing, coding, and compliance. She leads educational outreach and policy updates for AIE Medical Management, helping providers nationwide stay informed on Medicare, CMS regulations, and telehealth billing. She’s passionate about helping healthcare professionals get paid accurately and compliantly — without the jargon.
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