In November 2025, Congress extended telehealth coverage flexibilities. However, some of those flexibilities — including relaxed in-person visit requirements for behavioral health — are scheduled to expire Jan. 30.
For Medicare beneficiaries, CMS has confirmed that patients who begin receiving behavioral health telehealth services on or after Jan. 31, 2026, must complete an in-person, non-telehealth visit within the six months prior to their first telehealth appointment. After that, an in-person visit will be required at least once every 12 months. Patients who began receiving care on or before Jan. 30 are considered established and will only need to complete one in-person visit per year.
Audio-only visits for behavioral health furnished to patients in their homes will remain allowed under Medicare after Jan. 30 — but only when a practitioner is capable of audio-video communication and the patient cannot or does not consent to using video technology. This applies to both new and established patients. Beneficiaries receiving mental health services from hospital-employed staff in their homes may also continue using audio-only communication under specific rules.
According to a study from the Ann Arbor-based University of Michigan Institute for Healthcare Policy and Innovation, telehealth accounted for 44% of behavioral health visits among traditional Medicare beneficiaries between January 2019 and June 2024. Behavioral health was an early adopter of telehealth, following Medicare’s emergency expansion of coverage in March 2020.
Telehealth has played a key role in expanding behavioral health access, offering flexibility for both patients and providers, according to Bernard Jones, vice president for behavioral and mental health and the department of psychiatry at Somerville, Mass.-based Mass General Brigham.
“We were scared, and we continue to be scared about the telehealth cliff, and what that means for our ability to care for Medicare and Medicaid patients in a consistent fashion,” he said. “But I continue to see a huge amount of promise for virtual care, and particularly how valuable that is to behavioral health.”
Coalition groups are calling for a permanent extension of telehealth flexibilities, citing virtual care as a “critical lever” for stabilizing a strained workforce.
The Drug Enforcement Administration and HHS recently announced the extension of pandemic-era telemedicine flexibilities for prescribing controlled substances through Dec. 31. This allows DEA-registered practitioners to continue prescribing Schedule II through V controlled substances via audio-video telemedicine and Schedule III through V narcotic controlled medications to treat opioid use disorder via audio-only encounters without first conducting an in-person medical evaluation.
