September Continuing Resolution Impasse: Can Congress Avert the Medicare Telehealth Cliff?

With key Medicare telehealth flexibilities set to expire on September 30, 2025, Republicans and Democrats have floated competing Continuing Resolutions to extend virtual care rules and Hospital-at-Home flexibilities. Notably, the GOP considered their proposal a clean extension of current spending, which would continue through November 21, 2025. The Democrats’ alternative would have funded the government only through October 31, 2025, and was part of a wider negotiation over Affordable Care Act premium subsidies and Medicaid policy. On September 19, 2025, the Senate rejected both the House-passed GOP proposal and the shorter Democratic alternative, sending negotiators back to the table just days before the flexibilities expire. If no extension is enacted by September 30, providers would immediately lose reimbursement for many Medicare telehealth visits, particularly those delivered to patients in their homes. Pre-pandemic restrictions would snap back, limiting coverage to rural areas and designated facilities. Critical initiatives such as Acute Hospital Care at Home could face significant disruption. Specifically, if Congress fails to enact either a CR (or another piece of legislation) by September 30, 2025, most pandemic-era Medicare telehealth flexibilities will expire on that date, including:

• Home as an originating site and geographic waivers.
• Expanded Medicare clinician eligibility.
• FQHC/RHC as distant-site telehealth providers for Medicare patients.
• Audio-only allowances (relevant for non-behavioral telehealth).
• Hospital-at-Home waiver authority.