Medicare Telehealth Update

Congress has extended Medicare telehealth flexibilities for occupational therapists (OTs) through December 31, 2027. Here is what this means for you and your patients.

Your Ability to Bill Medicare for Telehealth Is Extended

President Trump signed the Consolidated Appropriations Act, 2026 (H.R. 7148) on February 3, 2026. This law extended the ability of OTs, occupational therapy assistants (OTAs), physical therapists, speech-language pathologists, and audiologists to bill Medicare for telehealth services through December 31, 2027.

This is a change from earlier guidance. Before this law passed, OTs were expected to lose Medicare telehealth billing authority on January 31, 2026.

What You Can Do Through December 31, 2027

The Centers for Medicare & Medicaid Services (CMS) updated its Telehealth FAQ on February 26, 2026. According to CMS, through December 31, 2027:

• Your patients can receive telehealth services from anywhere in the United States and its territories - they do not need to be in a rural area or a medical facility.
  
  
• Audio-only telehealth visits remain covered when the patient cannot use or does not consent to video technology.
  
  
• Hospitals can still bill for outpatient therapy services furnished remotely by hospital staff to patients in their homes.
  
  
• Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can continue to bill for non-behavioral health telehealth services.
  
  
• If you provide telehealth from your home, you generally do not need to list your home address on your Medicare enrollment application if you have a separate physical practice location.

What Changed Starting January 1, 2026

The CY 2026 Medicare Physician Fee Schedule (PFS) final rule made several permanent changes that apply now:

• Frequency limits are gone for subsequent inpatient visits, nursing facility visits, and critical care consultations. CMS permanently removed these limits.
  
  
• Virtual direct supervision is now permanent. Supervising physicians and practitioners may now be present through live audio-video technology for most services that require direct supervision (except those with global surgery periods).
• Teaching physicians may now supervise residents via virtual presence for telehealth services in all training settings.
  
  
• Five new CPT and HCPCS codes were added to the Medicare telehealth services list, effective January 1, 2026.
  
  
• The originating site facility fee increased to $31.85 for CY 2026, reflecting a 2.7% Medicare Economic Index increase.

Claims During the 2025 Government Shutdown

A federal government shutdown ran from October 1 through November 12, 2025. Some Medicare telehealth claims were returned during that time. CMS confirmed that telehealth flexibilities apply retroactively, as if there had been no lapse. If you had claims returned, you may resubmit them as long as they meet all applicable Medicare requirements.

Plan Ahead: What Happens After December 31, 2027

Unless Congress acts again, OTs, OTAs, and other therapy practitioners will no longer be able to furnish Medicare telehealth services starting January 1, 2028. Beginning that same date, patients will generally need to be in a rural area and in a medical facility to receive Medicare telehealth services, except for behavioral health services.

Want to Know More?

Visit the CMS Telehealth page for the latest list of covered services, billing codes, and FAQ documents:

CMS Telehealth: cms.gov/medicare/coverage/telehealth

HHS Telehealth Policy Updates: telehealth.hhs.gov/providers/telehealth-policy/telehealth-policy-updates