Telehealth Flexibilities Update

As of January 30, 2026, Congress is close to finalizing an agreement to continue funding the government.  However, inking the deal will not happen in time to completely avoid a shutdown.  Therefore, the telehealth flexibilities will end tonight.  It is likely the shutdown will be short-lived, expected to end next week when House members are expected to return for a vote.  The Alliance recommends that home health agencies and hospices prepare for the telehealth flexibilities to end on January 30, as we have previously recommended. While it would be anticipated that there would be a retroactive approval of the telehealth flexibilities that covers the anticipated short shutdown period, it is not guaranteed.

As a reminder, for home health, to be eligible to receive home health services under the Medicare home health benefit the patient must have a face-to-face encounter with a physician or an allowed practitioner (nurse practitioner, physician assistant, clinical nurse specialist, certified nurse-midwife) within 90 days prior or up to 30 days after the start of home health care. Home health agencies will need to closely review face-to-face encounter documentation to ensure that the encounter is in compliance with the telehealth flexibilities in place at the time for physicians and practitioners.

For hospice, a physician or nurse practitioner must have a face-to-face encounter with the patient before a hospice physician can re-certify patient eligibility within 30 days prior to the start of the third and later benefit periods (or in documented exceptional circumstances within 2 days after the start of the third and later benefit periods for newly admitted patients). Hospices may want to observe the most conservative approach to completing the face-to-face encounters during the shutdown and ensure they are completed in person.

What is expected to be finalized for telehealth flexibilities upon the government reopening is outlined below. There are limits to which hospices will be able to utilize telehealth flexibilities. Please note that if this package is passed as written, which is expected, it will take some time for CMS to implement the parameters for the hospice F2F flexibilities.  The Alliance is working to make this as seamless as possible for providers and will provide updates as they become available.

• For home health agencies, it extends provisions removing geographic requirements and expanding originating sites through December 31, 2027. This allows the required face-to-face visit (F2F) to be performed via telehealth
• For hospice providers, it extends the hospice F2F telehealth flexibility through December 31, 2027; however, telehealth is NOT permitted, beginning January 31, 2026, if:
  1. the individual receiving hospice is located in an area subject to a CMS moratorium on enrollment of hospice programs;
  2. the individual is receiving hospice care from a provider subject to the Provisional Period of Enhanced Oversight (PPEO); or
  3. the encounter is performed by a hospice physician or nurse practitioner who is not enrolled in Medicare and is not an opt-out physician or practitioner.
• For hospice providers, requires CMS to create a claims modifier or code to indicate if a F2F encounter was conducted via telehealth starting January 1, 2027.

Telehealth policies for Medicaid are contingent on the state and not addressed in or impacted by the January 30 deadline.

The Alliance will continue to update members with the latest news as it happens.