Medicare telehealth waivers set to expire on September 30 unless Congress acts

Action needed by September 30

Current Medicare waivers that allow occupational therapy (OT) services to be provided via telehealth are slated to expire on September 30, unless Congress acts before that date. These waivers, along with other Medicare policies, are tied to the ongoing federal budget debate, which is highly controversial in Congress.

On September 19, the U.S. House of Representatives included a provision to extend telehealth waivers through November 21 as part of a Continuing Resolution (CR) to fund the federal government during that time. The Senate, however, failed to adopt the House-approved CR or an alternative proposed by the Democratic minority.

There is broad bipartisan support to extend telehealth waivers. An earlier 2-year extension for therapy telehealth services 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. Due to Senate rules that require a 60-vote majority to enact budget legislation, bipartisan cooperation is essential to extend waivers beyond September 30 if they remain linked to the budget debate.

How occupational therapy practitioners can prepare for the potential expiration of telehealth waivers

We anticipate that Congress will not act in time to prevent the temporary expiration of telehealth on September 30. If this happens, OT practitioners will no longer be reimbursed for telehealth services provided to Medicare beneficiaries on or after October 1.

In preparation for this potential change, OT practitioners may want to consider the following steps:

• Evaluate your current caseload to identify clients who receive services via telehealth and may be impacted by a shift back to in-person care.
• Discuss with your employer or facility partners to determine options for addressing affected clients' therapy needs
• Consider whether it would be appropriate to issue an Advance Beneficiary Notice of Non-coverage (ABN) to clients who may continue to request telehealth services during the pause.
• Consider holding claims for telehealth services provided on or after October 1, 2025, until CMS releases updated billing guidance. This may help avoid denied claims or the need for reprocessing.

Please note that this situation is still evolving. AOTA will continue to monitor developments and provide updates as soon as new information becomes available—whether related to the waivers or CMS guidance on handling telehealth claims.

Legislation specific to telehealth therapy services

Reps. Buddy Carter (R-GA) and Debbie Dingell (D-MI) and Senators Tim Scott (R-SC) and Brian Schatz (D-HI) have already reintroduced 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 reintroduced 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 September 30 to prevent a telehealth reimbursement cliff in Medicare and urge a fast restoration of waivers if they are allowed to lapse.

Take Action: Contact Congress Today!

Please contact your Representative and Senators to urge them to extend telehealth waivers before the September 30 deadline expires.