Telehealth providers split on continuing services amid shutdown

Modern Healthcare – Thursday, October 9, 2025
By Hayley DeSilva and Noah Tong

Telehealth providers are facing difficult choices more than a week into the government shutdown that coincided with the end of Medicare reimbursement for telehealth services.

There’s been an even divide between telehealth providers on how to handle the reimbursement cutoff. Some are shutting down services, others are planning to continue submitting claims for care and are optimistic they’ll be reimbursed down the line, and a third group has yet to make a decision either way, according to Alexis Apple, head of federal affairs for the American Telemedicine Association, a nonprofit that works with telehealth providers and insurers.

“They’re divided into thirds,” Apple said. “But more [providers] are preparing an advanced beneficiary notice to let patients know that they’ll be financially responsible if Medicare doesn’t end up covering the visits during the shutdown.”

The Centers for Medicare and Medicaid Services released guidance to telehealth providers when the shutdown went into effect, saying it would continue to collect claims for services for Medicare members for 10 days. However, it remains unclear whether reimbursement will be provided after the 10-day period ends.

The uncertainty has left many providers unsure of what to do next and eager for additional guidance.

“Across the Athenahealth network, our providers see around 2.5 million telehealth visits per month,” said Joe Ganley, vice president of government and regulatory affairs for the virtual health provider. “Doctor’s offices need to know that they can continue to do telehealth and when the government funding situation is resolved, they will be reimbursed for this care.”

Todd Suntrapak, president and CEO of Valley Children’s Healthcare, said the Madera, California-based system plans to make telehealth services fully available for at least a year, but that it’s not banking on retroactive reimbursement.

“If we’re able to bill for it, we will,” Suntrapak said. “And if we are not able to bill for it, then it’ll be a write-down, so there will be a cost for sure. And I’m not going to tell you we’re excited about that.”

Novant Health, which offers a wide variety of telehealth services, both inpatient an outpatient, is another healthcare provider concerned about reimbursement. Last week alone, the Winston-Salem, North Carolina-based system said it served more than 2,000 patients via telehealth.

“We cannot bill from an outpatient perspective in an originating site where the patient is at home,” said Meghan Huffman, vice president of digital health at Novant Health. “From an inpatient perspective, unless that hospital is in a [federally designated Health Professional Shortage Area,] which none of ours are, we cannot bill for inpatient services like our tele [intensive care unit] program and our telepsychiatry program.”

While so far it has been business as usual for Novant, the system plans to move all telehealth visits to in-person if the shutdown lasts too long and retroactive reimbursement doesn’t come to fruition.

Huffman said the organization is continuing to push for the continuing resolution bill already passed in the House, which could briefly extend telehealth reimbursement under Medicare, but said the legislation won’t be enough.

“Even if the continuing resolution bill does pass, it only gets us to a November date,” Huffman said. “Without federal government action to pass something beyond that, we’re going to be completely changing how we think about being able to provide telehealth visits to Medicare beneficiaries and hospital-at-home programs we’ve invested in.”

Evanston, Illinois-based Endeavor Health also has no immediate plans to cut services.

“We are closely monitoring the situation and hope for a resolution that continues to provide this essential access to care for patients,” the system said in a statement. “For now, current telehealth appointments for Medicare and Medicare Advantage patients remain scheduled.”

On the payer side, despite the expiration of telehealth flexibilities through traditional Medicare, insurers offering Medicare Advantage plans can still provide coverage as part of a company’s benefits package.

A majority of eligible Medicare beneficiaries are enrolled in Medicare Advantage. Some major Medicare Advantage insurers say coverage will not change, including UnitedHealth Group subsidiary UnitedHealthcare, CVS Health subsidiary Aetna, Vermont Blue Advantage, Blue Cross Blue Shield of Michigan, as well as other Blue Cross companies including Health Care Service Corp. and Highmark Health.

Medicare Advantage insurers can offer enhanced telehealth services under the Bipartisan Budget Act of 2018 and codified Medicare Advantage regulations, said a spokesperson with America’s Health Insurance Plans, an industry lobbying group.

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