Government Shutdown: Expiration of Telehealth and GPCI Policies

Congress failed to agree on a funding bill for fiscal year 2026, resulting in a government shutdown beginning October 1, 2025.

What does this mean for your practice?

1. Medicare reimbursements will continue. Standard Medicare reimbursement processes should continue as normal.
2. Certain telehealth flexibilities will revert to pre-pandemic policies, and the 1.0 work Geographic Practice Cost Index (GPCI) floor has expired – for now. Congress is expected to return this weekend to continue negotiating. There is bipartisan support for both these policies, which could be reinstated in a future funding bill.
3. Most Medicare operations are expected to continue as usual, and the Centers for Medicare and Medicaid Services (CMS) has sufficient funding for Medicaid to fund the first quarter of FY 2026. Activities such as facility survey and certification, policy and rulemaking, contract oversight, and outreach will be reduced or stopped during the shutdown.

What expired:

• Home as an Originating Site – the ability for Medicare beneficiaries to receive telehealth services from their homes.
• Geographic Restrictions – the prior requirement for patients to be in a designated rural area to receive Medicare telehealth services.
• Audio-only Visits – the allowance for audio-only telehealth services for non-behavioral health services.
• Expanded Provider Eligibility – waivers that allowed a broader set of providers (like physical and occupational therapists) to offer services via telehealth.
• Hospital at Home Programs – the waiver authority for Medicare’s ‘Hospital at Home’ program.

What to expect:

• Limited Access to Care – millions of Medicare beneficiaries will face barriers to receiving telehealth care.
• Increased Travel – patients will likely need to travel to a medical facility to receive telehealth services.
• Disruption to Services – providers who rely on telehealth will have to adjust their practices, and some critical programs could face major disruptions.
• Returning ‘Pre-Pandemic’ Rules – Medicare’s coverage will revert to rules that were in place before the COVID-19 public health emergency.

Update from CMS on the federal government shutdown

Please read the CMS’s special notice that provides an update on Medicare operations for claims processing, telehealth, and the status of Medicare Administrative Contractors (MACS) during the government shutdown.

We recommend that you monitor CMS and Department of Health and Human Services updates. These agencies may post contingency plans or guidance on billing, reimbursements, and regulatory changes. Also, prepare for delays in federal program communications, approvals, and audits.

Contact your Yeo & Yeo advisor with questions or for help navigating these changes.