As most practices are aware, the government didn’t pass a funding bill by the time the October 1, 2025 deadline arrived. And while CMS will retain about half of its staff during the government shutdown, practices are still likely to see some big changes due to the shutdown — most significantly to telehealth and payment timeliness.

Check out a few key facts about how the government shutdown impacts telehealth and the speed of your Medicare payments.

Telehealth Waivers Have Now Expired

Due to the lack of Congressional action, most of the pandemic-era telehealth waivers have now expired. “Many of the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 Public Health Emergency will take effect again for services that are not behavioral and mental health services,” CMS said in a statement.

What this means for you: Medicare will no longer cover telehealth when patients are in their homes during the encounter. Instead, telehealth will apply in cases when patients from rural areas (typically health provider shortage areas) access telehealth, as was the case prior to the pandemic. In addition, audio-only visits will no longer be payable.

Exceptions apply for mental health and substance use disorder treatment, as well as cases where the providers are participating in certain Medicare Shared Savings Program Accountable Care Organizations.

It’s possible that Congress may include telehealth extensions in the funding bill that eventually gets passed, until that time, it’s important to consider changing current telehealth appointments for Medicare beneficiaries to in-person appointments so you won’t lose payment.

Expect Possible Payment Delays

CMS has advised its MACs to begin instituting a 10-day hold on claims affected by telehealth and other expired programs, which will make it easier to reprocess claims if Congress later extends these programs retroactively.

What this means for you: Your practice should continue submitting claims on the normal schedule. The MACs will hold the claims, but you don’t have to, CMS advises. “Providers may continue to submit claims during this period, but payment will not be released until the hold is lifted.”

Your payments may be delayed during this period, so ensure you have a tracking process in place. When payments resume, you want to make sure your payers haven’t missed any payments you’re due.