CMS restores telehealth payments into 2026

The Centers for Medicare & Medicaid Services (CMS) has officially reinstated the pandemic-related telehealth billing flexibilities, extending them retroactively through January 30, 2026. This decision allows Medicare beneficiaries to access telehealth services from their homes without geographic limitations. The restoration reverses disruptions caused by the recent shutdown period that temporarily halted these provisions.

Providers affected by the shutdown should note that claims for telehealth services submitted during the interruption—often flagged with error codes CARC 16 or RARC M77—are now eligible for resubmission and approval if they comply with standard Medicare billing criteria. Industry organizations, including the American Hospital Association (AHA) and the California Medical Association (CMA), have issued guidance emphasizing the need to revisit any previously denied or returned claims related to services delivered from October 1 onward. Further, they recommend refunding patients who may have paid out of pocket during the coverage gap.

Medicare providers and billing specialists will need to review telehealth claim records to identify those affected by the lapse. Resubmitting corrected claims ensures compliance and appropriate reimbursement. Additionally, practices should audit patient billing for any charges applied during the shutdown timeframe to address refunds when necessary. This update reaffirms CMS’s ongoing commitment to telehealth access and may influence operational planning for remote service delivery well into 2026.