Congress extends telehealth waivers retroactively through January 31

Updated 11/21/2025

On November 12, Congress enacted legislation to retroactively extend Medicare telehealth waivers which allow occupational therapy (OT) services to be provided via telehealth through January 31, 2026. These waivers had expired on September 30 as telehealth policy was ensnared in a Congressional spending debate that resulted in a 42-day government shutdown.

Congress has directed the Centers for Medicare and Medicaid Services (CMS) to provide retroactive reimbursement for Medicare telehealth services including those delivered by occupational therapy practitioners (OTPs) dating back to October 1. On November 21, 2025, CMS issued official guidance on how providers should handle claims for telehealth services delivered on or after October 1. CMS indicates that held telehealth claims may now be submitted to CMS for payment. Telehealth claims previously returned to providers can also be resubmitted at this time.

AOTA supports legislation to establish permanent Medicare telehealth policy

There has always been strong bipartisan support to extend telehealth waivers, and an earlier 2-year waiver extension was included as part of a package of healthcare bills ready for passage by Congress last December. However, that package was derailed by issues unrelated to Medicare or telehealth, and Congress subsequently enacted short-term telehealth extensions through September 30. Congress must now act again to extend government funding by January 31, so the potential exists for further disruption unless a longer deal is reached or Medicare telehealth policy is delinked from the federal spending debate.

AOTA continues to urge Congress to establish permanent Medicare telehealth policy. Reps. Buddy Carter (R-GA) and Debbie Dingell (D-MI) and Senators Tim Scott (R-SC) and Brian Schatz (D-HI) have introduced the Telehealth Modernization Act (H.R.5081/S.2709), which would extend telehealth waivers through September 30, 2027, and Reps Mike Kelly (R-PA), Mike Thompson (D-CA), and Adrian Smith (R-NE) have introduced legislation (H.R.1614) which would make OTPs, as well as other therapy providers, permanent Medicare telehealth providers. AOTA will continue working with Congressional champions to extend telehealth waivers beyond January 31 and to establish permanent telehealth policy to prevent further disruption.