UPDATE: As of October 1, 2025, the federal government has shut down. Get important updates on what this means for telehealth below and further information at our Government Shutdown Update page.
Effective October 1, 2025, absent Congressional action, the continuing resolution (CR) providing funding for the federal government as well as providing for Medicare telehealth flexibilities will expire.
The Academy and its policy consultants are monitoring this closely. Since the end of the public health emergency, we have worked with healthcare associations, industry partners and coalitions to underscore the harm that rolling back telehealth flexibilities would have on RDNs, health systems and Medicare beneficiaries.
On September 16, 2025, the House Appropriations Committee released the Continuing Appropriations and Extensions Act, 2026, which would extend telehealth flexibilities through November 21, 2025. The bill still must pass the full House, then the Senate and both chambers must approve identical text before it goes to the President.
The text can change at any stage, and there is no assurance it will be enacted by September 30. If it is not enacted by September 30, Medicare telehealth flexibilities expire and remain expired until a bill is passed. At this time, we cannot predict whether these flexibilities will be extended or for how long.
If Congress does not act by October 1, 2025, Medicare telehealth geographic and originating site restrictions will resume. MNT, IBT and DSMT will remain available via telehealth but only for beneficiaries in rural areas and only when furnished at an originating site as defined in law.
Beneficiaries will no longer receive these services at home. They must go to an eligible originating site. Members can use the HRSA Medicare Telehealth Payment Eligibility Analyzer to verify whether an originating site is in a geographically eligible area.
Originating sites include:
- Offices of a physician or practitioner
- Critical access hospitals
- Rural health clinics
- Federally qualified health centers
- Hospitals
- Hospital based or critical access hospital based renal dialysis centers, including satellites
- Skilled nursing facilities
- Community mental health centers
- Renal dialysis facilities under specific circumstances
- Mobile stroke units under specific circumstances
- Rural emergency hospitals
To prepare for the possibility that Medicare telehealth flexibilities may expire, either briefly while Congress debates a continuing resolution or for a longer period, RDNs may wish to work with key leaders in their organizations to create a contingency plan. The goal is to protect patients' continuity of care and minimize disruption by practicing operations by assessing how a temporary or permanent loss of telehealth flexibilities would affect both patients and workflows.
This could include identifying which beneficiaries are likely to lose telehealth access, developing clear communications that explain any upcoming changes and outline options for continuing care, including in person visits or telehealth at an partnering eligible originating site.
The Academy will continue to monitor this issue and provide updates as they become available.
Frequently Asked Questions
Why doesn’t CMS make telehealth permanent?
How telehealth is provided under the Medicare program is dictated by federal law, specifically Section 1834(m) of the Social Security Act (SSA). CMS does not have the authority to change these statutory requirements. Only Congress can make permanent modifications to the statute.
Private Payers & Medicaid
Do the congressional flexibilities also apply to private payers and Medicaid?
No. The flexibilities set to expire only apply to Medicare. However, Medicare often serves as a benchmark, so some private payers may follow suit if state law allows.
How do state laws impact private payers and Medicaid?
Some states have specific laws governing Medicaid's telehealth payment and coverage, as well as coverage and payment parity laws that require private payers to provide and reimburse telehealth services at the same rate as in-person services for certain covered benefits, such as MNT.
The Center for Connected Health Policy is a valuable resource for information on payment parity, coverage parity and Medicaid telehealth policies.
Join the Academy
Members of the Academy of Nutrition and Dietetics receive exciting benefits including complimentary continuing professional education opportunities, discounts on events and products in eatrightSTORE.org, invitations to exclusive members-only events and more!