Potential Change in Medicare Coverage for Our Members

Potential Changes to Medicare Telehealth Coverage in 2026

Telehealth has become an essential way for many Medicare beneficiaries to access care. However, several temporary telehealth flexibilities are scheduled to expire unless Congress takes further action. Understanding these changes now can help patients and providers prepare for what’s ahead.

Medicare Telehealth Coverage Through January 30, 2026

Through January 30, 2026, Medicare will continue to cover many telehealth services regardless of where a patient lives. During this time, beneficiaries can receive eligible telehealth services from any location in the United States, including their own homes.

What Changes on January 31, 2026?

Starting January 31, 2026, Medicare telehealth coverage will become more limited for most services:

• Patients must live in a rural area

• Telehealth visits must take place from an office or medical facility located in a rural area

• Home-based telehealth for primary care will no longer be covered for most beneficiaries who live in non-rural areas

These changes will apply unless Congress passes legislation to extend or modify current telehealth policies.

Telehealth Services That Will Still Be Covered (Even in Non-Rural Areas)

Even after January 31, 2026, Medicare will continue to cover certain telehealth services regardless of geographic location, including:

• Monthly End-Stage Renal Disease (ESRD) visits for patients receiving home dialysis

• Diagnosis, evaluation, or treatment of acute stroke symptoms, including services provided in a mobile stroke unit

• Mental and behavioral health services, including treatment for substance use disorders, delivered to patients in their homes

DEA Extends Telemedicine Flexibilities for Controlled Medications

Separately, the Drug Enforcement Administration (DEA), in coordination with the Department of Health and Human Services (HHS), has extended COVID-era telemedicine flexibilities related to prescribing controlled medications.

• These flexibilities are now extended through December 31, 2026

• They were previously set to expire on December 31, 2025

• The extension allows the DEA additional time to finalize permanent telemedicine prescribing regulations, helping ensure continuity of care for patients and providers

Other Medicare Telehealth Flexibilities Set to Expire

Absent further Congressional action, the following Medicare telehealth flexibilities will expire on January 30, 2026:

• The ability for patients to receive telehealth services in their homes, regardless of geographic location

• An expanded list of eligible telehealth practitioners

• The ability for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to serve as distant site providers

• The delay of the in-person visit requirement prior to receiving mental health telehealth services

Stay Informed

Telehealth policy continues to evolve, and future legislation could change these timelines. Patients and providers are encouraged to stay informed and plan ahead.

For the most up-to-date information, visit: Medicare payment policies | Telehealth.HHS.gov