By: Chaunte’ Causey, Communications Manager, PCC
In July 2025, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2026 Physician Fee Schedule (PFS), which outlines updates that may impact how telehealth services are reimbursed under Medicare.
As it stands, several temporary telehealth flexibilities—originally enacted during the COVID-19 public health emergency—are scheduled to expire on September 30, 2025, unless Congress takes further legislative action. If no changes are made, Medicare’s permanent telehealth statute will take effect on October 1, 2025, reinstating several pre-pandemic limitations on telehealth coverage.
If current statutory waivers are not extended or replaced, the following provisions will apply under Medicare’s permanent law:
- Most telehealth services will be limited to patients in rural areas.
- Home-based telehealth and audio-only visits will not be eligible for Medicare reimbursement.
- Certain provider types—including physical therapists, occupational therapists, speech-language pathologists, and audiologists—will no longer be able to bill for telehealth services.
- Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) will no longer be authorized to act as distant site providers for general telehealth services.
- Temporary programs such as Hospital-at-Home and virtual hospice recertification will no longer be permitted under Medicare.
Two bills have been introduced during the current Congressional session that seek to modify or extend telehealth-related policies:
- The Telehealth Coverage Act of 2025 (H.R. 2263)
Each bill proposes different mechanisms to update Medicare’s telehealth statute. These include removing geographic and site restrictions, expanding eligible provider types, and authorizing continued use of audio-only telehealth under specific conditions. Legislative language and implementation timelines vary between proposals.
Palmetto Care Connections (PCC) supports programs that use telehealth to improve access to healthcare in rural South Carolina. Any changes to Medicare’s telehealth reimbursement structure may impact how services are delivered and sustained across rural regions.
For example:
- Patients may no longer be eligible to access care from home under Medicare.
- Providers in rural settings may experience changes to billing eligibility for telehealth visits.
- Existing PCC-supported programs—such as school-based telehealth, and remote patient monitoring (RPM) —may be affected by policy shifts in reimbursement or eligibility.
PCC will continue to monitor developments and provide updates as more information becomes available.
