Telehealth for Seniors: Latest Updates on Medicare Coverage and Mental Health Services
Introduction
Telehealth has become an essential component of healthcare delivery for seniors, offering convenient access to medical and mental health services. However, recent policy changes have impacted the scope of Medicare coverage for telehealth services. This article provides an overview of the latest developments affecting telehealth for seniors, focusing on Medicare coverage and mental health services.
Expiration of Medicare Telehealth Flexibilities
As of October 1, 2025, several Medicare telehealth flexibilities that were temporarily extended during the COVID-19 pandemic have expired. These changes have significant implications for seniors seeking telehealth services:
- Home-Based Telehealth Services: Medicare now restricts telehealth services to specific settings, such as rural hospitals or clinics, and only for certain conditions. Home-based telehealth visits are no longer covered unless the patient is in a designated rural area or facility. Source
- Claims Processing Delays: The Centers for Medicare & Medicaid Services (CMS) initially implemented a temporary hold on claims processing for services impacted by the expired flexibilities. While some claims, particularly those for behavioral and mental health services, are now being processed, others remain in limbo. Source
Impact on Mental Health Services
Despite the broader telehealth coverage lapse, Medicare continues to cover mental health services delivered via telehealth. This includes:
- Home-Based Mental Health Care: Seniors can still receive behavioral health services at home, even if they are not in rural areas.
- Audio-Only Telehealth: Audio-only consultations remain permissible for mental health services, accommodating patients who may lack video capabilities. Source
However, the expiration of other telehealth flexibilities has led to confusion and challenges for providers and patients alike. Source
Ongoing Uncertainty Amid Government Shutdown
The federal government shutdown continues to affect healthcare services:
- Uncertainty for Providers: Healthcare providers are facing challenges in delivering services due to the expiration of telehealth flexibilities and the ongoing claims processing delays.
- Potential Impact on Services: Without legislative action to reinstate the expired flexibilities, seniors may experience reduced access to telehealth services, particularly for non-behavioral health care. Source
Legislative Efforts to Reinstate Telehealth Access
In response to these challenges, there have been legislative efforts to reinstate and expand telehealth access for Medicare beneficiaries:
- Proposed House Bill: A bipartisan bill in the U.S. House of Representatives aims to make telehealth changes permanent, protecting Medicare patients' access to telehealth services. Source
- Advocacy for Rural Communities: Organizations like Sanford Health emphasize the importance of telehealth for rural communities, where it often serves as the primary means of accessing medical care. Source
Conclusion
These developments underscore the critical role of telehealth in providing accessible healthcare to seniors, especially those in rural or underserved areas. The ongoing legislative efforts and advocacy highlight the need for sustained support and expansion of telehealth services to ensure that seniors continue to receive the care they need.
