Certain telehealth flexibilities, including geographic requirements, have officially been extended. Just before midnight on Friday, December 20, 2024, by a vote of 366-34, the U.S. House of Representatives passed the American Relief Act, 2025 (the Act), a short-term spending bill to keep the federal government open through March 14, 2025. Soon thereafter, the U.S. Senate approved the Act by a vote of 85-11. President Biden signed the Act into law on December 21, 2024.
The Act extends a variety of federal healthcare programs, including the telehealth flexibilities that were set to expire on December 31, 2024. Pursuant to the Act, the following Medicare telehealth flexibilities are now extended through March 31, 2025:
- Removing geographic requirements and expanding originating sites for telehealth services (42 USC § 1395m(m))
- Telehealth services can be delivered to any location in the U.S., including the home of an individual.
- Expanding practitioners eligible to furnish telehealth services (42 USC § 1395m(m)(4)(E))
- In addition to physicians, the following types of practitioners are eligible to furnish telehealth services: physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwifes, clinical social workers, clinical psychologists, registered dietitians or nutrition professionals, qualified occupational therapists, qualified physical therapists, qualified speech-language pathologists, and qualified audiologists.
- Extending telehealth services for FQHCs and rural health clinics (42 USC § 1395m(m)(8)(A)
- Federally qualified health centers and rural health clinics are authorized to provide and reimburse for telehealth services.
- Delaying the in-person requirements under Medicare for mental health services furnished through telehealth (42 USC §§ 1395m(m)(7)(B)(i), 1395m(m)(y)(2), and 1395m(o)(4)(B))
- Physicians and practitioners are not required to conduct an in-person exam prior to delivering telehealth services for purposes of diagnosis, evaluation, or treatment of a mental health disorder.
- Allowing for the furnishing of audio-only telehealth services (42 USC 1395m(m)(9))
- Audio-only telehealth services are covered and reimbursable.
- Extending the use of telehealth to conduct face-to-face encounters prior to recertification of eligibility for hospice care (42 USC § 1395f(a)(7)(D)(i)(II))
- Telehealth encounters prior to recertification of eligibility for hospice care are covered and reimbursable.
While these extensions are undoubtedly celebrated by telehealth providers and patients, they are pared down from broader protections contained in earlier versions of the Act. For weeks, Congress negotiated a funding bill that would have extended telehealth flexibilities through December 31, 2026, but support for this bill fell through last week.
In general, telehealth flexibilities enjoy broad bipartisan support in Congress, and many expect them to be made permanent or extended again prior to their March 31, 2025, expiration. However, as the new administration prepares to take office in January, it is currently unclear where telehealth will fall in their list of priorities.
