Yes, your practice can bill Medicare for telehealth in 2026. The Consolidated Appropriations Act, 2026, signed on February 3, 2026, extended Medicare’s telehealth flexibilities through December 31, 2027. Patients can still join from home anywhere in the US. Audio only visits still pay under set conditions. Physical therapists, occupational therapists, speech language pathologists, and audiologists can still bill. The coding rules, though, keep moving.
Three changes landed this year that most practices haven’t absorbed. RHCs and FQHCs stopped billing G2025 on October 1. Modifiers BB and BC become mandatory on January 1, 2027. And the CY 2027 Physician Fee Schedule final rule lands in early November. If your providers see more than a handful of Medicare patients by video each week, all three touch your revenue.
This guide covers Medicare only. For commercial plans and Medicaid, our telehealth medical billing services page breaks the rules down payer by payer.
Which Medicare telehealth dates matter in 2026 and 2027?
Eight dates drive Medicare telehealth billing right now. Put them on your billing calendar so the next lapse doesn’t catch your team mid claim.
Medicare telehealth timeline, 2025 to 2028
What is the Medicare telehealth status in 2026?
Medicare telehealth flexibilities stay active through December 31, 2027. Congress set that date in the Consolidated Appropriations Act, 2026, which President Trump signed on February 3, 2026. Before that law, the flexibilities lapsed twice in four months.
After two lapses and a retroactive patch, the appropriations act gave practices something they hadn’t had since 2020: a runway longer than a few months. We think that runway matters more than the extension itself. Practices that froze telehealth plans can now budget and build workflows through 2027.
Still, the extension stays temporary. Section 1834(m) of the Social Security Act still holds the old rural and facility limits, and they come back on January 1, 2028 unless Congress acts again. Bills that would make the flexibilities permanent, such as the CONNECT for Health Act, haven’t passed as of this update.
Which Medicare telehealth flexibilities did Congress extend through 2027?
Section 6209 of the Consolidated Appropriations Act, 2026 extended six flexibilities, and CMS matched a seventh by policy. All seven now run through December 31, 2027.
- Home and geographic flexibility. Patients can receive Medicare telehealth anywhere in the United States and its territories, including their homes. No rural requirement, no facility requirement.
- Expanded practitioner list. Physical therapists, occupational therapists, speech language pathologists, and audiologists can keep billing Medicare telehealth.
- RHC and FQHC distant site status. Rural health clinics and FQHCs can keep furnishing nonbehavioral telehealth as distant sites.
- Audio only care. Audio only visits stay payable for nonbehavioral services when the patient sits at home, the provider can use video, and the patient can’t or won’t.
- Telemental health in person delay. Medicare won’t enforce the in person visit requirement for mental health telehealth until 2028.
- Hospice recertification. Hospice physicians and nurse practitioners can complete the face to face recertification encounter by telehealth.
- Hospital remote services (CMS policy). Hospitals can bill outpatient therapy, diabetes self management training, and medical nutrition therapy that hospital staff furnish remotely to patients at home.
The same law also extended the Acute Hospital Care at Home initiative through September 30, 2030.
Which Medicare telehealth rules are permanent no matter what Congress does?
Behavioral health telehealth to the home is permanent, and so are several CY 2026 Physician Fee Schedule changes. None of these depend on the December 31, 2027 deadline.
- Behavioral and mental health telehealth. The Consolidated Appropriations Act, 2021 permanently removed geographic and originating site limits for behavioral health, including substance use disorder care. Home visits and audio only both qualify.
- No more frequency limits. Effective January 1, 2026, CMS permanently removed telehealth frequency limits on subsequent inpatient visits, subsequent nursing facility visits, and critical care consultations.
- Virtual direct supervision. Since January 1, 2026, a supervising practitioner can meet direct supervision through real time audio and video (not audio only) for services without a 010 or 090 global indicator, including most incident to services.
- Teaching physician virtual presence. Teaching physicians can be virtually present in every residency training location, but only for services furnished as Medicare telehealth.
Can a practice bill Medicare for telehealth?
Yes. A practice can bill Medicare for telehealth when six conditions line up: the service appears on the Medicare Telehealth Services List, an eligible practitioner delivers it, the technology qualifies, the claim shows where the patient sat, the practitioner holds valid enrollment, and the note supports the code. Miss one and the claim denies or pays short.
- The code sits on the Medicare Telehealth Services List for that date of service. CMS updates the Medicare Telehealth Services List every year. Bill an unlisted code with POS 02 or 10 and the MAC denies it with group code CO, CARC 96, and RARC N776. Non face to face services like chronic care management and remote monitoring don’t need the list at all, because telehealth rules don’t apply to them.
- An eligible practitioner furnishes it within their scope and with a license in the state where the patient sits during the visit.
- The technology qualifies. Medicare wants two way, real time audio and video. Audio only works for behavioral health, and for other services through 2027 under the conditions above.
- The claim shows the patient’s location. POS 10 means the patient sat in their own home. POS 02 means anywhere else.
- The practitioner holds valid enrollment. Your providers can work from home. If they also have a physical practice location, they bill from it as if they saw the patient in person. Virtual only practitioners must enroll their home address and mark it “Home office for administrative/telehealth use only” so Care Compare hides the street address.
- The note supports the code. Record the modality, the patient’s location, who joined the visit, and the time or medical decision making. For audio only, write down why video didn’t happen.
Want the full workflow, from scheduling to payment posting? Read our step by step guide to billing a virtual visit.
How do you code a Medicare telehealth claim in 2026?
Bill the same CPT or HCPCS code you’d use in person, add POS 10 or POS 02 based on where the patient sat, and append modifier 95 for audio and video or 93 for audio only. Medicare doesn’t pay the AMA’s 98000 to 98015 telemedicine codes.
Medicare telehealth coding by scenario (2026 dates of service)
Picture a 25 minute video followup with a Medicare patient at home and moderate medical decision making. The claim line reads 99214 with modifier 95, and box 24B shows POS 10. Medicare pays it at the same rate as a 99214 in your office.
Some billers drop modifier 95 on Medicare claims because the POS already flags telehealth. Don’t. Chapter 26 of the Medicare Claims Processing Manual pairs POS 02 or 10 with modifier 95 or 93, and adding it costs nothing. Skipping it hands your MAC an easy edit.
If the provider serves as the patient’s continuing focal point for care, you can add G2211 to a telehealth office visit. Our breakdown of how G2211 works with ongoing care covers when it applies.
Stop Telehealth Claims From Losing Money After the Visit
Wrong POS codes, missing modifiers, and audio only notes without a reason all pull money out of Medicare telehealth claims weeks after the visit. Medicotech gives you a team that checks every virtual visit claim against current CMS rules before it leaves your system, so you can reduce claim denials. Talk with us about the claims that worry you most.
What changed for RHC and FQHC telehealth billing on October 1, 2026?
RHCs and FQHCs stopped billing G2025 for nonbehavioral distant site telehealth on October 1, 2026. They now bill the individual CPT or HCPCS code for the service, plus the right revenue code and modifier 95 or 93. CMS kept the payment method the same.
CMS announced the change in MLN Matters MM14468 (Change Request 14468), released May 27, 2026, with an implementation date of October 5, 2026. Here’s what clinic billing teams need to know:
- Payment barely moves. CMS still pays a distant site rate based on volume weighted average fee schedule payments for telehealth. The specific code mostly gives CMS better data.
- Cost sharing still applies. RHC patients owe coinsurance and deductible. FQHC patients owe coinsurance.
- Behavioral health stays separate. Mental health visits under revenue code 0900 still pay under the RHC all inclusive rate or the FQHC PPS, outside this change.
- The originating site fee still applies. When the clinic hosts the patient, bill Q3014 under revenue code 0780.
One pattern worth hunting for this month: a clinic updates its charge master but leaves G2025 in an EHR quick pick list. A provider clicks it out of habit, and the claim bounces. Run a report of every G2025 line with a date of service after September 30, 2026, and correct each one before timely filing becomes a problem.
What are the BB and BC telehealth modifiers required in 2027?
Starting January 1, 2027, Medicare requires modifier BB on telehealth furnished through a virtual platform owned by an entity the practitioner contracts with or pays, and modifier BC on telehealth furnished incident to a practitioner’s professional service. Neither modifier changes payment.
Section 6209(g) of the appropriations act ordered CMS to create them. The CMS telehealth FAQ updated in October 2026 confirms both modifiers and confirms they carry no payment impact.
Here’s the part that worries us. Read literally, “a payment arrangement with an entity for use of such virtual platform” could sweep in a small practice that simply pays a monthly video subscription. We doubt CMS means it that broadly, but CMS hasn’t published its modifier use guidance yet. Don’t guess. Get ready instead:
- List every video platform your providers use, who owns it, and what contract or payment ties you to it.
- Flag every telehealth service your practice bills incident to a physician or practitioner.
- Ask your EHR and clearinghouse vendors when they’ll support BB and BC on the 837P.
- Set a reminder to read CMS guidance the week it posts, then lock your rules before January dates of service go out.
What does the CY 2027 Physician Fee Schedule propose for telehealth?
CMS released the CY 2027 proposed rule on July 14, 2026. For telehealth, it proposes five new list codes, conforming rules for BB and BC, a looser teaching physician policy, and a higher originating site fee. Comments closed September 14, 2026, and the final rule should arrive in early November.
- Five new telehealth list codes: GACP1 and GACP2 (advance care planning by clinical staff under practitioner direction), GSMAS (group medical session for 2 to 10 patients), GSLPP (pediatric speech, language, voice, and communication treatment), and GADV1 (E/M for vaccine adverse effects).
- Originating site fee: Q3014 would rise from $31.85 to $32.65.
- Conversion factor: The proposed nonqualifying conversion factor drops to $32.8409, down 1.68 percent, because the one year 2.5 percent bump for 2026 expires. Telehealth E/M visits pay off the same fee schedule, so this cut reaches your virtual visits too.
- Remote monitoring: CMS proposes direct employee clinical staff and a separate initiating visit for RPM and RTM.
Hold these codes out of your charge master until the final rule confirms them. Read the full CY 2027 Physician Fee Schedule proposed rule in the Federal Register. Want a code added for CY 2028? CMS needs the request by February 10, 2027.
How does the in person requirement work for Medicare telemental health?
Medicare won’t apply the in person requirement for telemental health until January 1, 2028. After that, a new patient needs an in person visit within six months before the first home telemental health service, then one at least every 12 months, with documented exceptions.
CMS gave established patients a break. If a patient started home mental health telehealth on or before December 31, 2027, Medicare treats them as established. They skip the six month rule but still need an in person visit every 12 months after 2027. When the treating practitioner isn’t available, a practitioner of the same specialty in the same group can furnish that visit. For RHC and FQHC behavioral visits, CMS won’t apply in person rules before January 1, 2028 either.
Audio only behavioral care survives 2027. From January 1, 2028, a practitioner can still use audio only for behavioral health at home when they can use video and the patient can’t or won’t.
If you bill therapy or psychiatry for Medicare patients, start logging each patient’s first home telemental health date now. That one field decides which rule applies in 2028. Our mental health billing team can build that tracker into your existing workflow.
Prescribing runs on a separate track. The DEA’s telemedicine flexibilities for controlled substances end December 31, 2026 unless the DEA acts again, so psychiatry practices should watch that date too.
What happens to Medicare telehealth on January 1, 2028 if Congress doesn’t act?
Medicare snaps back to the Section 1834(m) rules for nonbehavioral care. Patients must sit in an eligible facility in a rural area, most medical home visits stop paying, therapists and audiologists lose telehealth billing rights, and audio only shrinks to behavioral health.
Medicare telehealth before and after the 2027 deadline
Run the math for your own practice. Take a hypothetical internal medicine group that bills 150 Medicare home video visits a month for nonbehavioral care at an average allowed amount of $110. That’s $16,500 a month, roughly $198,000 a year, riding on one congressional vote. Swap in your own volume and allowed amounts, and you’ll know exactly what you’re watching.
Which Medicare telehealth billing mistakes cause the most denials?
Six errors drive most Medicare telehealth denials and underpayments. Two of them don’t even trigger a denial. They just pay you less.
Common Medicare telehealth errors and fixes
Most practice managers overrate EHR telehealth features and underrate a boring daily habit: matching the video schedule against posted charges. When a denial keeps repeating, denial management for telehealth claims should trace it back to the template or front desk step behind it, then fix that step before the next claim goes out.
Do Medicare Advantage plans follow the same telehealth rules?
Not exactly. Medicare Advantage plans must cover what Original Medicare covers, but they can offer extra telehealth benefits and they write their own claim edits. Some MA plans adopted the G2025 retirement for their members on the same October 1 date, while others publish separate POS and modifier rules. Check each plan’s current telehealth policy before you assume it mirrors CMS.
How should your practice prepare for 2027 right now?
Five moves cover most of the risk:
- Audit every RHC or FQHC telehealth claim with an October 2026 date of service for leftover G2025 lines.
- Inventory platforms, contracts, and incident to workflows for BB and BC.
- Read the CY 2027 final rule in November and update your charge master before January 1.
- Log the first home telemental health date for each Medicare patient.
- Book a mid 2027 checkpoint with your billing lead. By then you’ll know whether Congress plans another extension, with time left to move nonbehavioral followups back into the office.
Get Ahead of the 2027 Medicare Telehealth Changes
Medicare telehealth rules shift again on January 1, 2027, and could shift harder in 2028. Medicotech’s Medicare telehealth billing support tracks each CMS update, applies POS, modifier, and BB or BC logic before claims go out, and reports virtual visit revenue on its own line so you can improve reimbursement. Request a review of your last 90 days of telehealth claims.
Frequently asked questions about Medicare telehealth billing
Is Medicare telehealth still covered in 2026?
Yes. The Consolidated Appropriations Act, 2026 extended Medicare’s telehealth flexibilities through December 31, 2027. Patients can receive covered telehealth services at home anywhere in the US, and audio only visits stay payable under set conditions. Behavioral health telehealth to the home is permanent under earlier law, so it continues after 2027 as well.
When do Medicare telehealth flexibilities expire?
The current flexibilities expire after December 31, 2027. Starting January 1, 2028, nonbehavioral telehealth generally requires the patient to sit in an eligible facility in a rural area, and therapists and audiologists lose telehealth billing rights. Only a new act of Congress can push that date out again.
Does Medicare pay telehealth at the same rate as an office visit?
It depends on the place of service. Medicare pays POS 10, telehealth to a patient at home, at the nonfacility rate, which matches an office visit. It pays POS 02, telehealth to a patient anywhere else, at the lower facility rate. Picking the wrong POS quietly underpays the claim without a denial.
Can physical therapists bill Medicare for telehealth in 2026?
Yes. Physical therapists, occupational therapists, speech language pathologists, and audiologists can bill Medicare telehealth through December 31, 2027 under the 2026 appropriations act. Starting January 1, 2028, they lose that ability unless Congress extends it again, so therapy practices should plan their 2028 schedules now.
Does Medicare still cover audio only telehealth?
Yes, through December 31, 2027, for patients at home when the provider can use video and the patient can’t or won’t. Bill the regular E/M code with modifier 93 and document why video didn’t happen. After 2027, audio only continues for behavioral health but not for most medical services.
Do I need modifier BB or BC on my 2026 claims?
No. Modifiers BB and BC apply to telehealth with dates of service on or after January 1, 2027. BB covers services delivered through a platform owned by an entity you contract with or pay, and BC covers telehealth furnished incident to a practitioner’s service. Neither modifier changes the payment amount.
Can a provider bill Medicare telehealth from their home?
Yes. A provider with a physical practice location can work from home and bill from that practice address. A virtual only provider whose only location is home must enroll that address and mark it as a home office for administrative or telehealth use only, which hides the street address on Care Compare.
Sources: CMS Telehealth FAQ, October 2026; MLN Matters MM14468; CY 2027 PFS proposed rule; Medicare Telehealth Services List. Medicotech is a billing company and doesn’t give legal or medical advice. Confirm payer rules for each date of service.
