As of October 8, 2026
The Consolidated Appropriations Act, 2026 (Pub. L. 119-75), signed Feb 3, 2026, extended Medicare’s telehealth flexibilities, audio-only included, through Dec 31, 2027, and the delay of the tele-mental-health in-person requirement through Jan 1, 2028. It followed a lapse that began Oct 1, 2025, and a short extension to Jan 30, 2026. Nothing beyond behavioral health and substance use disorder care from home is permanent.
What runs until when
| Flexibility | Until | Source |
|---|---|---|
| Patient’s home as the originating site, any service on the telehealth list | Through Dec 31, 2027 | Consolidated Appropriations Act, 2026 |
| No geographic (rural) restriction on the originating site | Through Dec 31, 2027 | Consolidated Appropriations Act, 2026 |
| Physical, occupational and speech therapists and audiologists as telehealth practitioners | Through Dec 31, 2027 | Consolidated Appropriations Act, 2026 |
| FQHCs and RHCs as distant sites for non-behavioral services | Through Dec 31, 2027 | Consolidated Appropriations Act, 2026 |
| Audio-only telehealth | Through Dec 31, 2027 | Consolidated Appropriations Act, 2026, sec. 6209(e) |
| Delay of the in-person visit requirement for tele-mental health | Through Jan 1, 2028 | Consolidated Appropriations Act, 2026, sec. 6209(d) |
| Acute hospital care at home waiver | Through Sept 30, 2030 | Consolidated Appropriations Act, 2026, sec. 6210 |
| Mental health services to patients at home, with no geographic restriction | Permanent | Consolidated Appropriations Act, 2021 (in-person requirement deferred, above) |
| Substance use disorder treatment at home, with no geographic restriction | Permanent | SUPPORT Act, 2018 |
| Virtual direct supervision by real-time audio and video for most services | Permanent from 2026 | CY2026 Physician Fee Schedule, 90 FR 49266 |
The 2027 fee schedule proposals
CMS’s CY2027 Physician Fee Schedule proposed rule (91 FR 43842, Jul 16, 2026) proposed new BB and BC modifiers for telehealth claims starting Jan 1, 2027, which section 6209(g) of the Consolidated Appropriations Act, 2026 requires CMS to establish. It also proposed additions to the Medicare telehealth services list and changes to remote patient monitoring, including a requirement that the clinical staff furnishing it be the billing practitioner’s direct employees. Comments closed Sept 14, 2026; the final rule is expected in early November.
For 2026, the final fee schedule (90 FR 49266) made virtual direct supervision by real-time audio and video permanent for most services, dropped the provisional category of the telehealth services list, and added remote patient monitoring codes for 2 to 15 days of data.
How to plan for the end of 2027
- Sort your Medicare telehealth visits by service, patient location and modality.
- Mark the visits that continue after 2027: behavioral health and substance use disorder care from home, and visits from qualifying rural originating sites.
- For tele-mental health patients, plan the in-person visits the requirement will call for once its delay ends.
- Decide what happens to everything else: in-person visits, a different service, or a non-Medicare arrangement where allowed.
- Track Congress. The deadline has moved before and may move again, and the plan should work either way.
Our Medicare 2027 Cliff Plan does this for your practice. Coding and claims stay with your billing team.
Questions
- Is Medicare telehealth permanent?
- Only in part. Behavioral health and substance use disorder treatment from the patient’s home are permanent. Most of the other flexibilities, including home visits for other services and the lifting of the rural restriction, are extended only through Dec 31, 2027.
- What happens to Medicare telehealth on Jan 1, 2028?
- Unless Congress acts again, the originating site and geographic restrictions return for most services, so a patient at home outside a rural area can no longer receive most telehealth services under Medicare. Behavioral health and substance use disorder care from home continue, and the in-person requirement for tele-mental health starts to apply.
- What did CMS propose for telehealth in 2027?
- In its CY2027 Physician Fee Schedule proposed rule (91 FR 43842, Jul 16, 2026), CMS proposed new BB and BC modifiers for telehealth claims starting Jan 1, 2027, additions to the telehealth services list, and a requirement that clinical staff furnishing remote patient monitoring be direct employees. The final rule is expected in early November 2026.
- Would the CONNECT for Health Act make it permanent?
- It would make more of the flexibilities permanent. It had been introduced (S. 1261 and H.R. 4206) but had not passed as of October 2026.
Sources
- CY2027 Physician Fee Schedule proposed rule, 91 FR 43842 (Jul 16, 2026), reciting sec. 6209 of the Consolidated Appropriations Act, 2026
- CY2026 Physician Fee Schedule final rule, 90 FR 49266 (Nov 5, 2025)
- CONNECT for Health Act, S. 1261 (119th Congress)
Research, not legal advice. Confirm with your counsel before relying on it.