Medicare Telehealth Flexibilities Extended Through 2027

For the first time since 2024, telehealth programs can plan more than a few months ahead. The Consolidated Appropriations Act, 2026 — signed into law on February 3, 2026 — extended the major Medicare telehealth flexibilities through December 31, 2027.

That ends, at least for now, the cliff-to-cliff cycle that defined the last several years: short extensions buried in spending bills, a brief lapse during the late-2025 government shutdown, and a stopgap that only ran through January 30, 2026. Anyone who ran a virtual care program through that stretch remembers building two budgets — one with telehealth revenue, one without. The 2027 date doesn't make anything permanent, but it's the longest runway Congress has provided since the 2023–2024 extension, which ran through December 31, 2024.

What the extension covers

Through the end of 2027, the familiar core of the flexibility package stays in place:

• No geographic or originating-site restrictions. Medicare patients can take telehealth visits from home, in any part of the country — not just from clinics in rural areas.
• The expanded practitioner list. Physical therapists, occupational therapists, speech-language pathologists, and audiologists can keep billing Medicare telehealth.
• FQHCs and rural health clinics as distant-site providers for non-behavioral telehealth services. (For dates of service on or after October 1, 2026, they bill individual CPT or HCPCS codes instead of G2025 — see RHC and FQHC telehealth billing after G2025.)
• Audio-only coverage for services where CMS permits it, which matters most for patients without reliable video access.

The same law extended the Acute Hospital Care at Home program on an even longer track, into 2030.

What was already permanent

Medicare coverage of behavioral and mental health telehealth in the patient's home, for patients in both rural and urban areas, became permanent in earlier legislation, so that access does not end with this extension. One condition attached to it does run on the extension's clock: an in-person visit requirement for mental health telehealth. CMS says that, starting after December 31, 2027, a patient receiving mental health telehealth at home will need an in-person, non-telehealth visit within 6 months before the first telehealth service, and, with limited exceptions, an in-person visit within 12 months of each telehealth service after that. CMS says patients who began receiving these services at home before January 1, 2028 will be treated as established: they will not need the 6-month visit, but they will need at least one in-person visit every 12 months after December 31, 2027. For mental health visits that rural health clinics and FQHCs furnish through telecommunications, the in-person visit requirements cannot apply before January 1, 2028 (P.L. 119-75, §6209(d)). That distinction matters for anyone building a virtual behavioral health program: home access is on firmer ground than general telehealth, but the in-person rules are scheduled to begin when this extension ends unless Congress acts again. Our telehealth reimbursement guide walks through the full coverage picture, and our guides to federal telehealth laws and how state telemedicine laws work cover each layer of the legal framework.

What to actually do with two years

The honest read: this is breathing room, not a settlement. Congress has extended these flexibilities repeatedly rather than making them permanent, and the debate over cost and utilization hasn't gone away. Programs that treat the next two years as a window to build durable economics — documented outcomes, clean billing, payer diversification beyond Medicare — will be in a far better position than programs that treat the extension as the end of the story. Verify the current status of any specific flexibility with CMS before making decisions that depend on it.