Extension of certain telehealth flexibilities

(a) Removing geographic requirements and expanding originating sites for telehealth services Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended— (1) in paragraph (2)(B)(iii), by striking ending March 31, 2025 and inserting ending December 31, 2026; and (2) in paragraph (4)(C)(iii), by striking ending on March 31, 2025 and inserting ending on December 31, 2026. (b) Expanding practitioners eligible To furnish telehealth services Section 1834(m)(4)(E) of the Social Security Act (42 U.S.C. 1395m(m)(4)(E)) is amended by striking ending on March 31, 2025 and inserting ending on December 31, 2026. (c) Extending telehealth services for federally qualified health centers and rural health clinics Section 1834(m)(8) of the Social Security Act (42 U.S.C. 1395m(m)(8)) is amended— (1) in subparagraph (A), by striking ending on March 31, 2025 and inserting ending on December 31, 2026; (2) in subparagraph (B)— (A) in the subparagraph heading, by inserting before April 1, 2025 after rule; (B) in clause (i), by striking during the periods for which subparagraph (A) applies and inserting before April 1, 2025; and (C) in clause (ii), by inserting furnished to an eligible telehealth individual before April 1, 2025 after telehealth services; and (3) by adding at the end the following new subparagraph: (C) Payment rule for portion of 2025 and 2026 (i) In general A telehealth service furnished to an eligible telehealth individual by a Federally qualified health center or rural health clinic on or after April 1, 2025, and before January 1, 2027, shall be paid as a Federally qualified health center service or rural health clinic service (as applicable) under the prospective payment system established under section 1834(o) or the methodology for all-inclusive rates established under section 1833(a)(3), respectively. (ii) Treatment of costs Costs associated with the furnishing of telehealth services by a Federally qualified health center or rural health clinic on or after April 1, 2025, and before January 1, 2027, shall be considered allowable costs for purposes of the prospective payment system established under section 1834(o) and the methodology for all-inclusive rates established under section 1833(a)(3), as applicable. (iii) Requiring modifiers Not later than July 1, 2025, the Secretary shall establish requirements to include 1 or more codes or modifiers, as determined appropriate by the Secretary, in the case of claims for telehealth services furnished to an eligible telehealth individual by a Federally qualified health center or rural health clinic.. (d) Delaying the in-Person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology (1) Delay in requirements for mental health services furnished through telehealth Section 1834(m)(7)(B)(i) of the Social Security Act (42 U.S.C. 1395m(m)(7)(B)(i)) is amended, in the matter preceding subclause (I), by striking April 1, 2025 and inserting January 1, 2027. (2) Mental health visits furnished by rural health clinics Section 1834(y)(2) of the Social Security Act (42 U.S.C. 1395m(y)(2)) is amended by striking April 1, 2025 and inserting January 1, 2027. (3) Mental health visits furnished by Federally qualified health centers Section 1834(o)(4)(B) of the Social Security Act (42 U.S.C. 1395m(o)(4)(B)) is amended by striking April 1, 2025 and inserting January 1, 2027. (e) Allowing for the furnishing of audio-Only telehealth services Section 1834(m)(9) of the Social Security Act (42 U.S.C. 1395m(m)(9)) is amended by striking ending on March 31, 2025 and inserting ending on December 31, 2026. (f) Extending use of telehealth To conduct face-to-Face encounter prior to recertification of eligibility for hospice care Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is amended— (1) by striking ending on March 31, 2025 and inserting ending on December 31, 2026; and (2) by inserting, except that this subclause shall not apply in the case of such an encounter with an individual occurring on or after April 1, 2025, if such individual is located in an area that is subject to a moratorium on the enrollment of hospice programs under this title pursuant to section 1866(j)(7), if such individual is receiving hospice care from a provider that is subject to enhanced oversight under this title pursuant to section 1866(j)(3), or if such encounter is performed by a hospice physician or nurse practitioner who is not enrolled under section 1866(j) and is not an opt-out physician or practitioner (as defined in section 1802(b)(6)(D)) before the semicolon. (g) Requiring modifiers for telehealth services in certain instances Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at the end the following new paragraph: (10) Required use of modifiers in certain instances Not later than January 1, 2026, the Secretary shall establish requirements to include 1 or more codes or modifiers, as determined appropriate by the Secretary, in the case of— (A) claims for telehealth services under this subsection that are furnished through a telehealth virtual platform— (i) by a physician or practitioner that contracts with an entity that owns such virtual platform; or (ii) for which a physician or practitioner has a payment arrangement with an entity for use of such virtual platform; and (B) claims for telehealth services under this subsection that are furnished incident to a physician’s or practitioner’s professional service.. (h) Program instruction authority The Secretary of Health and Human Services may implement the amendments made by this section through program instruction or otherwise.