The way healthcare practices deliver care has changed dramatically in the past few years, with telehealth becoming a cornerstone for patients and providers alike. However, the landscape of virtual care is set to shift again.
The end of 2025 marks a significant turning point, and understanding the upcoming telehealth changes is crucial for a smooth transition.
This article will walk you through what to expect (expiring waivers, new rules), how to prepare, and where the opportunities lie in this next era of care.
Key Takeaways:
- At the end of 2025, many temporary telehealth flexibilities from the public health emergency will expire, and practices will need to adapt to new virtual care rules.
- Audio-only telehealth visits will face many limitations, with payers pushing for video-enabled consultations as the norm.
- Practices should review their billing processes, improve their hybrid care setups, enhance compliance and security, and inform patients about upcoming changes to Medicare telehealth coverage.
The End of 2025 Marks a Turning Point for Telehealth
During the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) introduced broad waivers and flexibilities. These temporary measures allowed healthcare providers to offer a wide range of services remotely. This was a game-changer for patients who couldn’t leave their homes during the pandemic, and for providers who needed to ensure continuity of care while keeping all their patients safe.
For example, according to an American Hospital Association (AHA) fact sheet, waivers allowed patients to connect with their physicians from anywhere, regardless of their location, using both video and audio-only technology. Another waiver allowed additional providers, such as physical therapists, to perform telehealth services.
When these temporary flexibilities expire at the end of 2025, the post-pandemic telehealth rules will come into effect. This transition will impact how providers deliver and bill for virtual services, particularly for Medicare beneficiaries.
For instance, after January 30, 2026, physical therapists, occupational therapists, speech-language pathologists, and audiologists may lose the ability to bill Medicare for telehealth services. Practices that have built their workflows around the waivers should prepare now to avoid disruptions in care, reimbursement issues, and patient confusion.
RELATED CONTENT: How to Ensure a Seamless Transition to Telehealth in Your Practice
Key Medicare Telehealth Changes Coming in 2025
The end of Medicare telehealth flexibilities brings a mix of expirations, extensions, and uncertainties. Understanding the specifics of these Medicare telehealth changes is the first step toward adapting your practice.
Expiring Telehealth Waivers and Flexibilities
Telehealth waivers and flexibilities were primarily extended by the Consolidated Appropriations Act, 2023, through the end of calendar year 2024. Without further legislative action, many of the expanded services will revert to pre-PHE status in 2025.
Geographic and originating site requirements will likely be reinstated, meaning patients may need to be in a specific type of facility or a designated rural area to qualify for covered telehealth visits, according to the current CMS FAQ page.
For instance, beneficiaries may no longer be able to receive telehealth services for non-behavioral/mental healthcare at home. Coverage for in-home visits, a key feature of the pandemic-era rules, may also be scaled back, potentially limiting care for homebound patients.
Some services might return to being covered only when provided in a traditional healthcare facility. Similarly, the types of providers eligible to bill for telehealth services could become more restricted.
For example, currently, the CMS FAQ page states:
“Through January 30, 2026, beneficiaries can receive Medicare telehealth services anywhere in the US and territories. Starting January 31, 2026, except for behavioral health services, beneficiaries will generally need to be in a medical facility and in a rural area to receive Medicare telehealth services.”
It’s important to note that on January 1, CMS finalizes additions or deletions to Medicare telehealth services. The annual physician fee schedule final rule (published November 1) serves as the vehicle for these changes.
However, when it comes to expiring telehealth waivers and flexibilities, the best course of action is to consult the CMS website for the latest information and updates.
What May Remain Covered
Fortunately, not all telehealth access will disappear. The government has recognized the value of virtual mental and behavioral healthcare, and rules promoting telehealth parity for these services are expected to continue.
These include temporary extensions of Medicare flexibilities and new, permanent regulations from the Department of Labor. For example, there will be new rules designed to improve access and reduce disparity for mental health and substance use disorder benefits.
CMS telehealth updates also suggest that certain services for chronic care management and remote patient monitoring (RPM) will retain their reimbursement pathways. However, we will likely see tighter restrictions on audio-only visits, with payers prioritizing video-enabled consultations for most services.
What’s Still Uncertain
The future is not entirely set in stone. There is potential for new legislative extensions and advocacy from provider groups and patient organizations that could shape virtual care regulations in 2026.
However, most telehealth groups agree that the healthcare sector needs certainty on virtual care coverage in Medicare.
A statement from Chris Adamec, executive director of the Alliance for Connected Care, to HealthcareDive reveals, “Short-term, and even year-to-year, extensions are no longer sustainable for a care model that is now central to how America delivers health care. Telehealth is an integrated part of care delivery, and the current system needs to reflect that.”
How These Changes Impact Providers and Patients
These telehealth policy changes in 2025 will create ripple effects across the healthcare system and, possibly, your practice. One of the biggest concerns is reduced access for rural and mobility-limited patients who have come to rely on virtual visits. For example, rural areas in the United States account for approximately 15% of the population, about 51 million people.
Practices may also see an impact on appointment availability and no-show rates as more patients are required to attend appointments in person. This shift demands a careful review of reimbursement strategies, as payment for certain virtual services may change or be eliminated.
The increased demand for in-person appointments will put more pressure on hybrid and traditional workflows, testing the efficiency of your front desk and clinical staff.
At the same time, patient expectations for a convenient, digital-first experience remain high, creating a delicate balancing act for practices.
Preparing Your Practice for Post-2025 Telehealth Requirements
Preparation is necessary to navigate the evolving rules and maintain operational stability. Focus on these four key areas to ensure your practice is ready.
Review Your Billing and Coding Workflows
Start by auditing your most frequently used telehealth CPT codes. Work with your billing team to confirm Medicare telehealth coverage after 2025 and get clarity from your major commercial payers, as their policies may also change.
Identify services that are likely to shift back to in-person only and update your documentation procedures to meet the stricter requirements.
Strengthen Your Hybrid Care Model
The most successful practices will be those who effectively offer hybrid care. Redefine your internal policies on when telehealth versus in-person visits are most appropriate from a medical and reimbursement standpoint. For example, telehealth visits make the most sense for general wellness and follow-up visits.
Build “follow-up via telehealth” options into your care plans for eligible services and integrate your telehealth platform with your patient portal to create a unified experience.
Enhance Patient Communication Around Changes
Clear communication can prevent confusion and frustration. According to the National Consortium of Telehealth Resource Centers, you should plan for multiple distribution channels, such as email, patient portals, office signage, and website updates, to deliver clear messaging about your telehealth services and any coverage changes.
Send notifications to patients who may be affected, explaining why a service may no longer be covered via telehealth and offering convenient in-person alternatives. For example, gather information on transportation options available in your area to help accommodate patients who may need help getting to your practice.
Reassess Telehealth Technology and Compliance
Ensure your technology stack is ready for the new regulations. For instance, evaluate whether your current platforms meet the updated requirements for video versus audio-only visits.
Also, remember that your platform must be HIPAA compliant to protect patient information. It’s essential to explore how secure messaging and other asynchronous tools can complement your real-time virtual visits and support ongoing patient engagement.
For example, Updox, a communications platform that integrates seamlessly with most electronic health records (EHRs), offers telehealth services that provide secure, HIPAA-compliant virtual visits.
This feature enables state-of-the-art video and audio calls, along with a streamlined workflow and waiting room that mimics an in-person visit. This solution helps meet the updated telehealth requirements for video versus audio-only visits.
The Updox platform also offers tools that complement telehealth visits, including:
- A HIPAA-compliant Secure Text feature that enables you to communicate with patients without compromising their privacy or protected health information.
- A HIPAA-compliant Patient Portal that offers secure access to health information, appointments, and communication tools.
Opportunities in the Next Era of Virtual Care
As some doors may be closing, new ones are opening. The telehealth innovations of 2025 and beyond present exciting opportunities for forward-thinking practices. A few innovations to note:
- Remote monitoring: The growth of remote monitoring for chronic conditions allows for more proactive and continuous care. These digital devices may include blood pressure cuffs for hypertension, glucometers for diabetes, and smart scales for heart failure.
- Digital therapeutics (DTx): The use of DTx software to prevent and manage diseases is increasingly common in treatment plans. Examples of software include mobile apps and games that address specific conditions, such as Akili Interactive’s EndeavorRx for ADHD and Sleepio for insomnia.
- AI and telehealth: The expansion of these technologies is enabling powerful tools, such as AI-powered triage and automated follow-up, freeing up staff time and improving efficiency. For example, AI-powered triage uses machine learning to assess patient conditions, predict severity, and guide the next steps in care. These tools can be used at home via chatbots to help patients choose the right level of care or in clinical settings to support providers in decision making.
- On-demand messaging and asynchronous care: Examples include patients sending secure messages or images via text message or patient portal, with providers reviewing and responding later, improving efficiency and patient convenience.
- Virtual front desk: This is a self-service software-based patient experience powered by cloud access control and AI. These services can be filled by automated, software-based front desk solutions that handle tasks such as patient intake forms, sending appointment reminders, and providing after-hours support.
RELATED CONTENT: The Future of Telehealth: Predictions and Trends for the Next Decade
Best Practices to Maintain Strong Patient Engagement
As your telehealth strategy evolves, remember to keep patients engaged as well. Make your self-service tools, like online scheduling and bill pay, as intuitive and easy to use as possible. Use automated reminders, secure messaging, and follow-up communications to keep patients on track with their care plans.
Continue to offer telehealth for appropriate use cases, such as chronic care check-ins and post-operative follow-ups, as patients value the convenience. By ensuring a simple and reliable scheduling process through your patient portal, you empower patients to take an active role in their health.
FAQs: What Practices Need to Know About 2025 Telehealth Changes
Will Medicare telehealth end in 2025?
No, Medicare is not ending telehealth. However, many of the broad flexibilities introduced during the pandemic will expire, and stricter rules regarding location, service type, and technology will be reinstated.
What services will still be covered after the waiver expires?
Mental health services are expected to retain broad coverage. Many services related to chronic care management and remote patient monitoring will also likely remain covered, though specific requirements may change.
Will patients still be able to use audio-only telehealth?
Coverage for audio-only telehealth will become much more limited. Payers are shifting their preference toward video-based consultations for most types of care.
How should practices communicate these changes to patients?
Be proactive. Use your website, patient portal, email, and text messages to inform patients about what to expect. Explain which services may require an in-person visit and provide clear instructions for scheduling.
Will reimbursement decrease for telehealth?
Reimbursement rates may change. Some services may see payment reductions or have their telehealth coverage eliminated. Practices must verify coverage with both Medicare and commercial payers.
Building a Future-Proof Telehealth Strategy
Telehealth isn’t disappearing; it’s evolving into a more integrated part of healthcare delivery. Practices that succeed in this next era will be those that intentionally adapt their clinical and operational workflows.
Long-term success will be built on a foundation of smart hybrid care models, clear patient communication, and HIPAA-compliant, user-friendly technology. By preparing now, your practice can continue to leverage virtual care to improve patient outcomes and thrive in the years to come.
Contact Updox today to request a personalized demo to see how our telehealth platform and additional solutions can help prepare your practice for the next era of care!
