Federal Telehealth Policy in 2026: What the Medicare Extensions Mean

Why It Matters

The extensions provide a multi‑year safety net for Medicare beneficiaries and providers, but the reliance on short‑term bills creates ongoing uncertainty that could disrupt care continuity. Permanent legislation would stabilize reimbursement and reduce administrative volatility across the health‑care system.

Key Takeaways

• Medicare telehealth flexibilities extended to Dec 31 2027.
• Behavioral telehealth coverage now permanent under Medicare.
• Audio‑only services allowed for home‑based visits.
• FQHCs/RHCs can act as distant‑site providers.
• Advocates push stand‑alone telehealth bill for stability.

Pulse Analysis

The 2026 Consolidated Appropriations Act marks a pivotal moment for Medicare telehealth, delivering a two‑year extension that safeguards the pandemic‑era flexibilities many providers rely on. By maintaining geographic and originating‑site waivers, allowing audio‑only encounters, and expanding eligible clinicians—including OT, PT, SLP, and audiology—the legislation ensures continued access for seniors in rural and urban settings. This stopgap also renews the Acute Hospital at Home program through 2030, underscoring the federal commitment to hybrid care models that reduce inpatient costs.

Beyond the temporary extensions, the policy landscape features permanent reforms in behavioral health telemedicine. Since the 2021 and 2023 appropriations acts, Medicare has eliminated location restrictions for mental‑health services, embraced audio‑only delivery, and recognized a broader array of providers such as marriage and family therapists. These enduring changes have already increased utilization, improved patient outcomes, and set a benchmark for other specialties seeking similar permanence. The distinction between permanent behavioral benefits and provisional general telehealth rules highlights a strategic legislative focus on high‑need areas.

Looking ahead, industry groups and policymakers are converging on the need for stand‑alone telehealth legislation, exemplified by the CONNECT for Health Act and the Telehealth Modernization Act. Such bills aim to codify the current suite of flexibilities, eliminating the cyclical uncertainty tied to omnibus funding packages. For health systems, insurers, and clinicians, a permanent statutory framework would streamline billing, reduce compliance overhead, and protect against utilization drops observed during past shutdowns. The push for enduring telehealth law reflects a broader recognition that virtual care is now a core component of the U.S. health‑care delivery model.

Federal Telehealth Policy in 2026: What the Medicare Extensions Mean

February 11, 2026 · 7:56 AM · Julia Ivanova, PhD, MA · Reading time: 5 min · Category: Policy & Compliance

Key Takeaways

• Many Medicare telehealth flexibilities were extended through Dec. 31, 2027 under the Consolidated Appropriations Act of 2026.

• A review of behavioral telehealth policies that are permanent, including home‑based care, audio‑only services, and expanded clinician eligibility.

• Stakeholders are increasingly pushing for stand‑alone telehealth legislation to reduce disruption caused by reliance on short‑term funding bills.

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Federal telehealth policy in 2026 is in transition following Congress’s action to end a partial government shutdown and extend several Medicare telehealth provisions. However, many key flexibilities remain temporary, and lawmakers are now turning to broader legislation to provide long‑term stability.

On Feb. 3, 2026, Congress approved a funding package—the Consolidated Appropriations Act of 2026 (H.R. 7148)—along with a two‑week continuing resolution to fund the Department of Homeland Security, bringing an end to the partial government shutdown and reinstating key telehealth flexibilities for multiple years. The legislation extends Medicare telehealth flexibilities through Dec. 31, 2027. These flexibilities include waiving the in‑person requirement for Medicare behavioral telehealth visits, allowing the home as an originating site and geographic waivers, and expanding Medicare clinician eligibility. The flexibilities also allow Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) to serve as distant‑site telehealth providers for Medicare patients, and they permit audio‑only telehealth services. Further information on the telehealth items included in the funding package is available from the legislation.

Section 6209 of the funding package also renews the Acute Hospital at Home Program through Sept. 30, 2030, and continues in‑home cardiopulmonary rehabilitation flexibilities through Jan. 1, 2028. The bill requires the Department of Health and Human Services to issue guidance within one year on providing telehealth services to individuals with limited English proficiency. It also expands the Medicare Diabetes Prevention Program to include virtual diabetes suppliers through Dec. 31, 2029.

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Temporary Extensions and Their Impact

The reinstated Medicare telehealth flexibilities under the funding package renew policies that had previously lapsed or were set to lapse amid the 2025‑26 funding negotiations. These include waivers that allow beneficiaries to receive telehealth services in their homes regardless of geographic location and expanded provider eligibility for occupational therapists, physical therapists, speech‑language pathologists, and audiologists—provisions originally created during the COVID‑19 public‑health emergency and repeatedly extended through short‑term legislative action.

Despite bipartisan support for telehealth, most of these policies remain temporary. Historically, Congress has extended such flexibilities through continuing resolutions and omnibus packages, a strategy that often leaves Medicare telehealth coverage and reimbursement vulnerable to shutdown negotiations and deadlines.

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What Is Permanent

Even amid these stopgap measures, several telehealth flexibilities have already been made permanent, most notably in the behavioral health space. Medicare’s expanded coverage for behavioral telehealth is now a permanent Medicare benefit.

• Consolidated Appropriations Act of 2021 eliminated long‑standing Medicare restrictions on behavioral health telemedicine, expanding where and how mental‑health services may be delivered. The law allows Medicare beneficiaries to receive behavioral health care from any location, including their homes, and removes the requirement that patients be located in rural areas. It also authorized the use of audio‑only technology for behavioral health visits when patients cannot access or decline real‑time video services. The Centers for Medicare & Medicaid Services (CMS) later incorporated these changes into the 2022 Physician Fee Schedule, clarifying that clinicians must be able to offer video services and document the reason for providing audio‑only care.

• Consolidated Appropriations Act of 2023 further expanded Medicare behavioral health telehealth by broadening the range of clinicians and facilities able to bill for telehealth. Beginning Jan. 1, 2024, marriage and family therapists and mental‑health counselors were recognized as Medicare telehealth practitioners, allowing them to enroll in Medicare and bill for virtual behavioral health services. The law also permanently designated FQHCs and RHCs as distant‑site providers for behavioral telehealth, enabling clinicians based in those settings to be reimbursed for delivering virtual behavioral health care to Medicare beneficiaries regardless of patient location.

These permanent behavioral telehealth policies stand in contrast to the broader set of flexibilities for general telehealth services, which, under the latest legislative action, continue only through specific future dates rather than enduring law.

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Toward Stand‑Alone Legislation in 2026

With the shutdown ended and temporary coverage secured through 2027 for many policies, the focus of telehealth advocates and lawmakers is likely to shift to passing stand‑alone telehealth legislation. Proposed measures such as the CONNECT for Health Act and the Telehealth Modernization Act aim to make a broader suite of telehealth flexibilities permanent, reducing the recurring uncertainty created by attaching critical coverage to must‑pass funding bills.

Without statutory protections, providers and patients will continue to face episodic disruptions and administrative complexities whenever Congress confronts budget deadlines. In a Brown University policy brief, during the 2025 shutdown there was a 24 % drop in telehealth utilization in the first 17 days compared with prior months, with states such as Florida, Louisiana, and New York seeing drops of 40 % or more. The same brief noted that telehealth levels returned to pre‑shutdown levels once funding was restored. However, even brief lapses can be consequential for patients relying on programs such as the Acute Hospital at Home program. Health‑care groups such as the American Medical Association have pressed Congress to enact permanent authorization of Medicare telehealth services. Even with this year’s multiyear runway, many clinicians and health systems seek lasting certainty.

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Disclosures

This article was developed with AI‑assisted research tools and edited by the Telehealth News editorial team for accuracy and clarity.