Miscellaneous

CMS issued a letter to clarify for states that Medicaid and CHIP coverage and payment of interprofessional consultation is permissible, even when the beneficiary is not present, as long as the consultation is for the direct benefit of the beneficiary.

SOURCE:  Centers for Medicare & Medicaid Services, Coverage and Payment of Interprofessional Consultation in Medicaid and the Children’s Health Insurance Program (CHIP), SHO #23-001, Jan. 5, 2023, (Accessed Dec. 2025).

CMS will add a telehealth indicator to the Physician Compare Finder found on the Medicare website as is applicable and technically feasible.

SOURCE: CY 2023 Physician Fee Schedule, CMS, p. 2089, (Accessed Dec. 2025).

What special telehealth flexibility applies to Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program?

The Bipartisan Budget Act of 2018 allows clinicians in applicable Medicare Shared Savings Program Accountable Care Organizations (ACOs) to provide and receive payment for covered telehealth services to certain Medicare beneficiaries without geographic restriction and in the beneficiary’s home. Physicians and practitioners participating in an applicable ACO may furnish telehealth services to beneficiaries assigned to the applicable ACO in accordance with these flexibilities. To receive payment for covered telehealth services under the special telehealth flexibilities for ACOs, the telehealth service must be billed through the TIN of an ACO participant in an applicable ACO. Applicable ACOs are those with prospective assignment for a performance year in the ENHANCED track or BASIC track levels C, D, or E. CMS allows clinicians in applicable ACOs to provide and receive payment for covered telehealth services to prospectively assigned beneficiaries. Risk-based ACOs that participate under the preliminary prospective assignment with retrospective reconciliation method do not meet the definition of an applicable ACO, because final assignment is not performed until after the end of the performance year. Clinicians in these ACOs and those in non-risk based ACOs may provide telehealth services subject to the current Medicare FFS rules. There is no special application or approval process for applicable ACOs or their ACO participants or ACO providers/suppliers. Clinicians in applicable ACOs can furnish and receive payment for covered telehealth services under these special telehealth flexibilities. For additional information, please refer to the Medicare Shared Savings Program Telehealth Fact Sheet and additional updates available at the All Fee-For-Service Providers webpage on CMS.gov.

What will happen to telehealth services that were provided during the government shutdown?

CMS will continue to pay telehealth claims in the same way they had been paid before October 1, 2025. Telehealth flexibilities will apply retroactively as if there hadn’t been a temporary lapse in the application of the telehealth flexibilities through January 30, 2026.

SOURCE: Centers for Medicare and Medicaid Services, Telehealth FAQ Calendar Year 2026, Updated 11/14/25, (Accessed Dec. 2025).

Medicaid Requirements

Unless required by regulation or policy, states are not required to submit a (separate) SPA for coverage or reimbursement of Medicaid coverable services delivered through telehealth if they decide to reimburse for services delivered through telehealth in the same way/amount that they pay for face-to-face services.

States must submit a (separate) reimbursement (attachment 4.19B) SPA if they want to provide reimbursement for services or components of services delivered through telehealth differently than is currently being reimbursed for face-to-face services.

States may submit a coverage SPA to better describe the services they choose to cover through telehealth, such as which providers/practitioners are identified by the state to use telehealth to deliver services; where it is provided; how it is provided, etc. In this case, and in order to avoid unnecessary SPA submissions, it is recommended that a brief description of the framework of telehealth may be placed in an introductory section of the state plan, e.g., Section 3 – Services: General Provisions 3.1 Amount, Duration and Scope of Services, and then a reference made to coverage through telehealth in the applicable benefit sections of the state plan. For example, in the physician section it might say that dermatology services can be delivered via telehealth provided all state requirements related to telehealth as described in the state plan are otherwise met.

SOURCE: Medicaid.gov.  Telehealth (Accessed Dec. 2025).

ABN issuance is NOT required in the following HHA situations:…

• telehealth monitoring used as an adjunct to regular covered HH care

SOURCE: Centers for Medicare and Medicaid Services, Medicare Claims Processing Manual, Ch. 30: Financial Liability Protection, 10/31/24, pg. 62, (Accessed Dec. 2025).

Notwithstanding any other provision of law, the Secretary may make payments to or for any person traveling in, to, or from the Freely Associated States for receipt of care or services authorized to be legally provided by the Secretary…

Before delivering hospital care or medical services under subsection (f) of section 1724 of title 38, United States Code, as added by paragraph (2)(B), the Secretary of Veterans Affairs, in consultation with the Secretary of State, shall enter into agreements with the governments of the Freely Associated States to—

• facilitate the furnishing of health services, including telehealth, under the laws administered by the Secretary of Veterans Affairs to veterans in the Freely Associated States, such as by addressing.

The Secretary of Veterans Affairs may pay tort claims, in the manner authorized in the first paragraph of section 2672 of title 28, United States Code, when such claims arise in the Freely Associated States in connection with furnishing hospital care or medical services or providing medical consultation or medical advice to a veteran under the laws administered by the Secretary, including through a remote or telehealth program.

SOURCE: HR 4366 (2024 Session), (Accessed Dec. 2025).

Through CY 2024, we will continue to permit the distant site practitioner to use their currently enrolled practice location instead of their home address when providing telehealth services from their home. We will also consider this issue further for future rulemaking and request that interested parties provide clear examples of how the enrollment process shows material privacy risks to inform future enrollment and payment policy development. We request further information from interested parties to better understand the scope of considerations involved with including a practitioner’s home address as an enrolled practice location when that address is the distant site location where they furnish Medicare telehealth services. 

SOURCE: Center for Medicare and Medicaid Services, CY 2024 Physician Fee Schedule, Final Rule, CMS 1784-F, (Accessed Dec. 2025).

Teaching physicians may have virtual presence when billing for services provided involving residents in all teaching settings, but only in clinical situations when the service is provided virtually (for example, a 3-way telehealth visit with the patient, resident, and teaching physician in separate locations) through December 31, 2025

For all services, we’ve extended the definition of direct supervision that allows the supervising physician or practitioner to provide supervision through a virtual presence using real-time audio-visual interactive telecommunications through December 31, 2025

For a subset of services, we’ve permanently adopted the definition of direct supervision that allows the supervising physician or practitioner to provide supervision through a virtual presence using real-time audio-visual interactive telecommunications

SOURCE: Centers for Medicare and Medicaid Services (CMS), Telehealth Services MLN Fact Sheet, Apr. 2025, (Accessed Dec. 2025).

Veterans Affairs

The Department of Veterans Affairs (VA) is issuing this interim final rule to confirm that its health care professionals may practice their health care profession consistent with the scope and requirements of their VA employment, notwithstanding any State license, registration, certification, or other requirements that unduly interfere with their practice. Specifically, this rulemaking confirms VA’s current practice of allowing VA health care professionals to deliver health care services in a State other than the health care professional’s State of licensure, registration, certification, or other State requirement, thereby enhancing beneficiaries’ access to critical VA health care services. This rulemaking also confirms VA’s authority to establish national standards of practice for health care professionals which will standardize a health care professional’s practice in all VA medical facilities.

SOURCE: Federal Register Interim Final Rule 85 FR 71838 (Nov. 12, 2020). (Accessed Dec. 2025).

CMS chose not to extend the allowance this time for distant site providers to continue to use their 2025 enrolled practice location address instead of their home address, however CMS notes that they issued an FAQ on how to suppress that information. CMS also states that they defer to each state’s policies regarding licensure requirements for distant site Medicare telehealth providers and that a separate Medicare enrollment is required for each state in which the provider furnishes services.

SOURCE: CMS 2026 Final Physician Fee Schedule, pg. 172, (Accessed Dec. 2025).