Effective Oct. 1, 2025, agencies cannot use telehealth visits for the face-to-face encounter when certifying a patient for home health.
 
CMS confirmed in a message Oct. 1 to providers and Medicare Administrative Contractors (MACs) that waivers expired for most telehealth services provided to patients in their home. This includes the face-to-face encounters used for home health certification, as well as hospice face-to-face visits at recertification.
 
For the past few budget cycles, Congress has extended telehealth waivers as part of short-term budget resolutions. With no agreement, yet, on federal spending, the waivers were left to expire.
 
The message in a Medicare Learning Network alert also noted that MACs will continue to perform all functions related to Medicare fee-for-service claims processing and payment.
 
“When certain legislative payment provisions are scheduled to expire, CMS directs all MACs to implement a temporary claims hold,” CMS states in the alert. “This standard practice is typically up to 10 business days and ensures that Medicare payments are accurate and consistent with statutory requirements. The hold prevents the need for reprocessing large volumes of claims should Congress act after the statutory expiration date and should have a minimal impact on providers due to the 14-day payment floor. Providers may continue to submit claims during this period, but payment will not be released until the hold is lifted.”
 
Read the full MLN alert through your MAC at: