Well, folks, here we are—October 2025, and the telehealth roller coaster just took another sharp turn. Congress hit the snooze button, the government is doing its best “out of office” impression, and those cozy pandemic-era telehealth rules officially bid us farewell at midnight on September 30. So, if you were betting on virtual visits being the norm, it might be time to hedge and check your practice’s WiFi… and patient zip codes.
What Just Happened, and Why Are My Patients Panicking?
Medicare’s pandemic waivers were like winning a golden ticket—home visits, urban coverage, video calls, and even some audio-only options. As of now, those perks have expired for most. Gone are simple home consults for the average city-dweller, unless your patient moonlights as a rural resident or qualifies for exceptions in mental health or certain ACO programs. The new rules basically require patients to haul themselves to a “qualifying originating site,” otherwise it’s “see you at the office” (or “see you at the not-covered ABN signing table”).
Behavioral Health: Still Special, Now More Complicated
For behavioral health pros, there’s good news—but it comes with a side of hoop-jumping. You’ll need an in-person visit within six months before you can send a Zoom link for therapy, and another face-to-face handshake (or elbow bump) every 12 months to keep the billable telehealth train rolling. Miss those visits? Well, you’ll need to dust off your ABN forms and maybe put on your best “I don’t make the rules” face.
CMS Plays ‘Red Light, Green Light’ With Your Money
Here’s a plot twist—CMS has told its MACs to hold your telehealth claims for 10 days. Yes, you still file them. No, you don’t get paid right away. This pause gives Congress time to find an “undo” button (so far, it’s missing). So, if you feel like your revenue is stuck in molasses, it’s not just you—CMS is literally waiting for a possible policy miracle. The good news: the 14-day payment floor means most practices already expect a brief wait, but remember, coffee budgets and payrolls should remain nimble.
Pro Tips to Thrive, Survive, and Maybe Even Smile
- Check patient addresses like a hawk—rural is the new VIP section.
- Schedule those in-person mental health visits with military precision (and maybe some “save the date” magnets).
- Review your telehealth eligibility for every consult, and prep ABNs for anyone outside the new coverage map.
- Tell your patients about the changes using easy language…and maybe a joke or two (“Medicare telehealth: now with more driving!”).
- Stay tuned for further updates—Congress may yet revive the flexibilities, but until then, play by the old-school rules.
- Practice some deep breathing (for you and your staff), keep your billing team caffeinated, and don’t hesitate to ping your MAC with questions.
Telehealth isn’t gone forever—but, like bell-bottom jeans and fax machines, it’s just taking a break until the world decides what’s next. In the meantime, keep delivering awesome care, let patients know how things will change, and maybe learn a new traffic joke for your waiting room. After all, rules may tighten, but a little humor always helps the medicine go down.The telehealth landscape just did a dramatic reset, folks—Congress is still in its “will they/won’t they” stage, but as of September 30, 2025, your pandemic-era telehealth privileges have lapsed, courtesy of a government shutdown and a missing policy extension. For providers everywhere, especially those in behavioral health, this is less a plot twist and more a series finale: gone are the days of relaxed rules and virtual visits from anywhere but a qualifying rural site or facility.
Remember all those happy Medicare patients who Zoomed you from their recliners with their cat? Now, unless they’re in a rural area or have a golden ticket via an ACO, it’s “back to the office” for most. Behavioral health specialists get an awkward consolation prize: yes, you can still do telehealth, but only after an in-person visit within six months, plus an annual face-to-face. If you skip these? Get ready with your best ABN spiel and maybe a therapy dog for the disappointed patients.
Meanwhile, CMS decided to play the slow game with reimbursement, instructing Medicare Administrative Contractors to hold telehealth claims for at least 10 days. It’s basically the claims processing version of “let’s wait and see if anyone fixes this.” If you’re wondering whether payroll will be late, don’t panic—most claims would take 14 days anyway, but maybe postpone the breakroom donut run just in case.
What’s a provider to do? First, double-check every patient’s zip code—rural is now the new platinum status. Schedule those behavioral health in-person visits early and often, and brush up on your ABN etiquette for anyone who suddenly falls outside Medicare’s telehealth comfort zone. Communicate with humor and candor; Medicare’s rules are changing, but your patient care skills are timeless. And hey, maybe dust off your fax machine for the nostalgia factor—retro rules call for retro vibes.
Bottom line: stay alert, keep your eligibility lists current, and hold out hope Congress puts telehealth back on the table. Need to vent? Billing departments everywhere feel your pain (and, apparently, your claims on hold). In the meantime, keep delivering high-quality care—now with extra paperwork and slightly fewer cat interruptions.
Resources:
https://www.ama-assn.org/health-care-advocacy/advocacy-update/oct-3-2025-advocacy-update-spotlight-government-shutdownhttps://www.cgsmedicare.com/articles/cope187495.html