As of February 3, 2026, the legislative uncertainty surrounding Medicare telehealth has been resolved. President Trump signed H.R. 7148 (the Consolidated Appropriations Act, 2026) into law, ending a brief technical lapse in coverage. The law officially extends expanded Medicare telehealth flexibilities through December 31, 2027, with full retroactive coverage for services rendered during the lapse.
Current Legislative Status: Reinstated and Extended
The “telehealth cliff” those practitioners and patients faced on January 31, 2026, has been successfully bridged. While the previous waivers briefly expired due to a budget deadlock in the Senate, the final passage of H.R. 7148 restores stability to the virtual care landscape.
Crucially, this legislation was drafted with a retroactive clause. This means that any telehealth services provided during the four-day lapse (January 31 – February 3) will be recognized by Medicare as if the lapse never occurred. Providers who followed the professional recommendation to hold claims can now proceed with billing.
Quick Status: 2026-2027 Compliance Checklist
Feature | New Status / Action Required |
New Expiration Date | December 31, 2027 |
Medicare Part B Status | Fully Restored. The “rural-only” and facility-based restrictions remain waived. |
Originating Site Rules | Patients may continue to receive telehealth services from any location, including their homes. |
Provider Eligibility | PTs, OTs, SLPs, and Audiologists remain fully eligible to provide and bill for Medicare telehealth. |
Audio-Only Services | Coverage for audio-only telehealth is extended for both behavioral and non-behavioral health through 2027. |
In-Person Requirements | The requirement for an in-person visit within six months of a mental health telehealth service remains suspended. |
Strategic Clinical Pivot: The Hybrid Care Anchor
During the brief lapse, many clinics successfully utilized a Hybrid Care Model to maintain revenue. While virtual-only billing was temporarily in legal limbo, in-person care remained the stable “anchor” of the care plan. Moving forward, practitioners should view the hybrid model not just as a backup, but as a clinical best practice for rehabilitation.
Action Item: Re-integrate Manual Therapy
Now that the extension is signed, use this stability to plan your “Clinical Pivot.” If you shifted patients to in-person sessions to address manual therapy needs—such as joint mobilization or addressing tight calf muscles—you can now transition them back to a hybrid schedule. This allows for:
Tactile Correction: Use in-person visits for manual techniques that improve movement quality.
Virtual Validation: Use telehealth follow-ups to ensure the patient is performing their Home Exercise Program (HEP) correctly in their own environment.
Deep-Dive Compliance: Protecting Your Revenue Cycle
While the law is signed, the administrative machinery of CMS and its MACs may take several days to update systems. To ensure a clean revenue cycle:
1. Releasing Held Claims
Action Item: If you followed previous guidance to HOLD CLAIMS, you should now begin processing and submitting them for the period starting February 1, 2026.
Pro-Tip: Monitor your Remittance Advice (RA) closely. If you see denials for Jan 31–Feb 3, contact your MAC, as they may need to manually re-trigger the retroactive logic.
2. The Advance Beneficiary Notice (ABN) Update
Action Item: You may now stop issuing “Mandatory” ABNs related to the legislative lapse. Keep the signed copies from the lapse window in your records as a legal safety net.
3. Medicare Advantage & Private Payers
This extension is a massive relief for Medicare Part B (Fee-for-Service). For Medicare Advantage (Part C) providers, the landscape is even more stable.
Action Item: Verify individual policies, but most Advantage plans have already aligned their 2026-2027 benefits with this federal extension.
Looking Ahead: The Hospital-at-Home Evolution
A significant win in H.R. 7148 is the five-year extension for the Acute Hospital Care at Home waiver program through September 30, 2030. This signals a major policy shift: the federal government is viewing “at-home” acute care as a permanent fixture. For therapists, this means a growing market for high-acuity home health and rehabilitation services over the next five years.
The Push for Permanence
While we celebrate the relief that comes with a deadline of December 31, 2027, the push for permanent reform continues. Advocacy groups like the AOTA, APTA, and ASHA indicate this two-year window will be the “final evaluation period.” Between now and 2027, Congress will look for data on reimbursement parity and quality of outcomes.
Legislative leaders have indicated that this two-year window will be the “final evaluation period.” Between now and 2027, Congress will be looking for data on:
- Reimbursement Parity: Does virtual care cost the system more or less than in-person care?
- Quality of Outcomes: Are OTs and PTs achieving the same functional gains via telehealth?
- Fraud Prevention: Ensuring that the removal of geographic restrictions doesn’t lead to “tele-marketing” abuses of the Medicare system.
Frequently Asked Questions (FAQs)
Q1: Did the Medicare telehealth extension actually passes?
Yes. The extension was signed into law on February 3, 2026, as part of H.R. 7148. It extends current flexibilities through December 31, 2027.
Q2: Can I bill for telehealth services provided during the shutdown (Jan 31 – Feb 3)?
Yes. The law includes a retroactive clause. Medicare will process and pay for claims during that four-day window as if the lapse never occurred.
Q3: Are Physical Therapists still eligible to provide telehealth?
Yes. Under the new 2026-2027 extension, PTs, OTs, and SLPs remain authorized providers for Medicare telehealth services.
Q4: Does this extension cover audio-only visits?
Yes. Audio-only telehealth coverage for both behavioral and non-behavioral health has been extended through the end of 2027.
Future-Proofing Your Practice
While this extension buys time, the real solution is a system that stays ahead of the rules for you.
Book a Hellonote Demo See how our automated compliance engine and built-in telehealth features handle Medicare modifiers and retroactive billing automatically, so you can focus on your patients, not the legislation.
Legal Disclaimer: This update is for educational purposes only and does not constitute legal, financial, or medical billing advice. Healthcare providers should consult with their compliance officers and Medicare Administrative Contractors (MACs).
