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SPECIAL ALERT: CMS Releases Updated Medicare Telehealth Guidance – Clarifications Provided!

On October 1, 2025, the Centers for Medicare and Medicaid Services (CMS) issued guidance regarding Medicare telehealth claims during the government shutdown via a special edition of the Medicare Learning Network (MLN) Newsletter. In the update, CMS stated that when legislative payment provisions are scheduled to expire, CMS directs Medicare Administrative Contractors (MACs) to implement a temporary claims hold, typically of up to 10 business days. The hold is meant to prevent a large reprocessing of claims if Congress acts after the statutory expiration date, which was September 30, 2025. As the 10-day hold period had expired on October 14, CMS has now issued an additional claims hold update on October 15, 2025, stating that in anticipation of possible Congressional action, CMS has instructed all MACs to continue to temporarily hold claims with dates of service of October 1, 2025 and later for services impacted by the expired Medicare legislative waivers.

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