Telehealth Update: Flexibilities Extended Through January 2026

*Updated 2/4/26: Congress has officially passed a bipartisan funding bill that extends key Medicare telehealth flexibilities through December 31, 2027. 

Congress has approved a temporary extension of current Medicare telehealth flexibilities through Jan. 30, 2026. Further action from Congress will determine whether these flexibilities continue beyond that date.

Reimbursement Update: In-Person, Video, and Audio-Only Visits

Through January:

• In-person visits remain reimbursed at the full rate.
• Video visits continue to receive payment parity with in-person visits for Medicare Fee-for-Service.
• Audio-only visits remain reimbursable under current federal allowances.

If Congress does not extend the flexibilities beyond January:

• Video visit reimbursement will revert to lower rates beginning in February.
• Audio-only visits will no longer be reimbursable, except in limited behavioral health cases.

Clinical Guidance: Access and Modality

Thank you for prioritizing Access for our community and continuing to use Virtual care as a channel of care for our patients during the government shutdown. It displays our commitment to care. 

Carilion’s Next Steps

Our Ensemble, Legal, Compliance, Finance, Strategic Payment Relationships, and Digital Health Teams are closely monitoring federal developments and claim trends. This group is preparing for both potential outcomes  (continuation or expiration) as February approaches.

What to Expect

• Continue current telehealth operations through January.
• Continue using the .remotevisit and .remotevisitminor SmartPhrases when documenting telemedicine encounters. These SmartLists have recently been updated to reflect evolving CMS requirements. Do not create personal SmartPhrases, as doing so will bypass future updates and may result in missing required CMS elements, leading to denied claims.
• Prepare for potential reimbursement adjustments in February if Congress does not act.
• Look for a January Transition Guide and updated workflows from the Digital Health Hub.
• Stay tuned for further CMS and Carilion updates.

Other Payer Considerations

This change applies only to Traditional Medicare.

• Medicaid telehealth coverage remains broad, supporting both video and audio-only visits.
• Medicare Advantage and commercial plans continue to maintain the full pandemic-era flexibilities.
  These payer types will continue under existing telehealth policies without change at this time.

If you have questions, check with your manager or contact the Digital Health team at digital_health@carilionclinic.org.