Updated Medicare telehealth guidance

Washington State Health Care Authority sent this bulletin at 10/17/2025 02:05 PM PDT

October 17, 2025

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Updated Medicare telehealth guidance

Starting October 1, 2025, Medicare telehealth coverage is changing because of federal law that only applies to Medicare. These changes do not impact Apple Health (Medicaid). Medicare and Apple Health (Medicaid) follow different federal laws, regulations, and policy structures.

The expiration of Medicare’s telehealth waiver does not change Apple Health’s telemedicine coverage. Providers can find the current Apple Health telemedicine information—including separate listings for audio-only coverage—on Health Care Authority’s (HCA) Provider Billing Guides and Fee Schedules webpage, under the Telehealth section.

Visit the Provider Billing Guides and Fee Schedules webpage

Learn more

Individuals dually enrolled in Medicare and Apple Health (Medicaid) are subject to Medicare’s restrictions for services under the Medicare benefit. For more detailed information view the Centers for Medicare and Medicaid Services' (CMS) telehealth changes FAQ.

View the CMS FAQ

Contact

Email: HCA Apple Health clinical policy

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.