Unless extended by Congress, in-person visits will be required for telehealth services to diagnose, evaluate, and treat mental health issues under Medicare beginning October 1, 2025. The telehealth flexibilities that behavioral health care providers have relied upon to expand access and scale care are set to expire at month’s end.
While many tele-behavioral health waivers have been made permanent, key provisions permitting remote mental health services under Medicare will revert to their far more limited pre-pandemic status unless Congress acts before September 30, 2025. These rollbacks could fundamentally limit and, in some cases, stop how behavioral health companies operate.
Some behavioral health flexibilities remain permanent: no geographic or originating site restrictions exist for behavioral health services furnished via telehealth to patients in their homes, regardless of location; audio-only telehealth is permitted without requiring video; and broader coverage of tele-behavioral health services in Federally Qualified Health Centers and Rural Health Clinics has been extended. However, by statute, Medicare covers telehealth mental health services only if a practitioner first sees a patient in person six months before beginning telehealth sessions and then annually thereafter. This provision was waived during the pandemic, but Congress has not made it permanent.
This means mental health providers relying on telehealth must ensure each telehealth patient has an in-person visit beginning October 1, 2025. Uncertainties remain about what options beneficiaries have for in-person visits if their mental health provider is not nearby, and what physical health providers can do to access crisis services via telehealth when no local behavioral health professionals are available. Providers must act quickly to develop plans for this change, including reaching out to Congressional representatives, developing plans for in-person visits, and communicating changes to staff and patients.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.jdsupra.com/legalnews/medicare-coverage-for-telehealth-ends-5156077/