Telehealth Coverage Act of 2025
H.R. 2263, the Telehealth Coverage Act of 2025, seeks to make permanent many Medicare telehealth flexibilities that were expanded during the COVID-19 public health emergency. By anchoring these flexibilities to the start of the emergency period described in 1135(g)(1)(B), the bill would allow telehealth to continue in expanded ways after the emergency ends. Key changes include widening who can provide telehealth, extending telehealth to more settings (such as Federally Qualified Health Centers and Rural Health Clinics), permitting audio-only telehealth in more scenarios, and relaxing in-person visit requirements for certain services furnished via telehealth. The bill also adds new billing requirements (modifiers/codes), extends related waivers (like acute hospital care at home), enhances accessibility for people with limited English proficiency, expands home-based cardiopulmonary rehabilitation, enables virtual participation in the Medicare Diabetes Prevention Program, and increases provider education on medication-induced movement disorders linked to mental health treatments. In short, the bill aims to normalize and broaden access to telehealth under Medicare, reduce barriers to remote care, and harmonize billing and reporting to reflect these persistent flexibilities across multiple services and settings.
Key Points
- 1Expanded and permanent telehealth access: Codifies Medicare telehealth flexibilities for services furnished on or after the start of the emergency period, expands the pool of practitioners who can furnish telehealth, and extends telehealth to more settings (including FQHCs and RHCs) and modalities (including audio-only where appropriate).
- 2Elimination of in-person visit requirements for certain telehealth services: Removes in-person encounter requirements for home dialysis ESRD visits, stroke-related telehealth, and certain substance use disorder and mental health services when provided by telehealth, with conforming adjustments across related Medicare sections.
- 3Hospice and face-to-face telehealth: Allows face-to-face encounters for hospice eligibility recertification to occur via telehealth, with added requirements for modifiers/codes to identify telehealth encounters starting in 2026.
- 4Billing and administration: Creates a new requirement that modifiers or codes be used to indicate telehealth via certain platforms or incident-to arrangements, with the Secretary establishing these requirements by 2026 and the ability for the Secretary to issue program instructions.
- 5Extensions and new flexibilities in other areas: Extends the Acute Hospital Care at Home waiver beyond March 31, 2025; requires guidance to improve telehealth access for individuals with limited English proficiency; expands in-home cardiopulmonary rehabilitation to include audio/video telehealth; allows virtual MDPP (Medicare Diabetes Prevention Program) suppliers to offer online services; and requires outreach to educate providers about screening for medication-induced movement disorders in at-risk patients.
- 6Additional implementation and guidance: Provides authority for the Secretary to implement these provisions via program instructions and to consult stakeholders, especially for sections addressing language access, telehealth platforms, and interpretation services.