Pub. L. 119-75, div. J, tit. II, sec. 6209 (as amended)
EXTENSION OF CERTAIN TELEHEALTH FLEXIBILITIES.
SEC. 6209. 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 January 30, 2026” and inserting “ending December 31, 2027”; and
(2) in paragraph (4)(C)(iii), by striking “ending on January 30, 2026” and inserting “ending on December 31, 2027”.
(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 January 30, 2026” and inserting “ending on December 31, 2027”.
(c) Extending Telehealth Services for Federally Qualified Health Centers and Rural Health Clinics.—Section 1834(m)(8)(A) of the Social Security Act (42 U.S.C. 1395m(m)(8)(A)) is amended by striking “ending on January 30, 2026” and inserting “ending on December 31, 2027”.
(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“on or after January 31, 2026” and inserting “on or after January 1, 2028”.
(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 “January 31, 2026” and inserting “January 1, 2028”.
(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 “January 31, 2026” and inserting “January 1, 2028”.
(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 January 30, 2026” and inserting “ending on December 31, 2027”.
(f) Extending Use of Telehealth to Conduct Face-to-face Encounter Prior to Recertification of Eligibility for Hospice Care.—
(1) In general.—Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is amended—
(A) by striking “ending on January 30, 2026” and inserting “ending on December 31, 2027”; and
(B) by inserting “, except that this subclause shall not apply in the case of such an encounter with an individual occurring on or after January 31, 2026, 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.
(2) Requiring use of modifier.—Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)), as amended by paragraph (1), is further amended by inserting “, but only if, in the case of such an encounter occurring on or after January 1, 2027, any hospice claim includes 1 or more modifiers or codes (as specified by the Secretary) to indicate that such encounter was conducted via telehealth” after “as determined appropriate by the Secretary”.
(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, 2027, the Secretary shall establish requirements to include one 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.”
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(h) [42 U.S.C. 1395m note] Implementation.—Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by program instruction or otherwise.
- Cross-references to the US Code
- 42 U.S.C. 1395m note