Medicare telehealth waivers expired at midnight on January 30

Updated February 3, 2026

Efforts continue in Congress to resume waivers

On January 30 at midnight, Medicare waivers that allowed occupational therapy (OT) services via telehealth expired after Congress failed to extend them even though the Senate voted to extend the waivers late in the day as part of ongoing budget negotiations. The House must now approve the Senate budget package which includes the waiver extension, and there is optimism that this will happen soon. In the meantime, however, therapy providers, including occupational therapy practitioners (OTPs), will not be reimbursed by Medicare for OT telehealth services provided to beneficiaries unless Congress reinstates the waivers and makes coverage of these services retroactive as it did in November 2025.

As during the previous lapse in Medicare telehealth coverage, OTPs should consider the following:

• Review your current caseload to identify clients who receive occupational therapy services via telehealth and may be affected by the shift back to in-person care.
• Consult with your employer or facility partners to determine options for meeting affected clients' therapy needs
• CMS has not issued specific guidance for Medicare Part A. If your facility decides to provide telehealth services for Medicare Part A patients, you must accurately document the services you provide.
• During the last waiver interruption, CMS recommended that providers issue an Advance Beneficiary Notice of Non-coverage (ABN) to clients who request telehealth services under Medicare Part B. The ABN informs the client that the service may not be covered by Medicare and that they may be liable for payment for the service if Medicare denies the claim.

The waiver extension under consideration includes language from the Telehealth Modernization Act which was introduced by Reps. Buddy Carter (R-GA) and Debbie Dingell (D-MI) and Senators Tim Scott (R-SC) and Brian Schatz (D-HI). Medicare telehealth waivers were first enacted by Congress in 2020, and they were periodically extended until September 2025 when telehealth policy became ensnared in the Congressional spending debate that resulted in a 42-day government shutdown and expiration of the waiver. Congress eventually acted to end the government shutdown in November and extended the telehealth waivers through January 30, 2026 and applied them retroactively. It is possible that when an agreement has been reached, Congress will authorize retroactive reimbursement for OT telehealth services provided during the lapse as they did in November; however, retroactive coverage is not guaranteed.

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