Millions of Medicare beneficiaries lost access to telehealth services on January 31, 2026, after pandemic-era flexibilities expired without Congressional action. The so-called “Telehealth Cliff” marks the end of remote care coverage that helped seniors and disabled Americans receive doctor visits, therapy, and chronic disease management from home.
The change affects everything from routine checkups to physical therapy sessions. Starting today, telehealth rules revert to strict pre-pandemic limits that restrict who can use virtual care and where they can get it.
The U.S. House of Representatives passed H.R. 7148 on January 22, 2026, proposing a two-year extension through December 31, 2027. But the bill remains stalled in the Senate as of January 31, leaving millions in limbo.
“Without this extension, patients will face serious gaps in care,” said telehealth policy experts from KLGates, a national law firm tracking the changes. “Many who relied on virtual visits now have nowhere to turn.”
The expired waivers had allowed patients to use telehealth from anywhere, including their homes. That option is now gone for most services. Medicare telehealth is once again limited to patients in rural areas or those visiting medical facilities in person, according to updated guidance from the Centers for Medicare & Medicaid Services (CMS).
Here’s what changed on January 31:
- Geographic restrictions are back. Patients must live in rural areas or visit a clinic to qualify for telehealth coverage.
- Home visits no longer covered for services like physical therapy, nutrition counseling, or routine checkups.
- Therapists and specialists lose billing rights. Physical therapists, occupational therapists, speech pathologists, and audiologists can no longer bill Medicare for telehealth visits.
- Audio-only calls restricted. Phone-only appointments remain covered only for behavioral health services when video isn’t available.
- New mental health rule. Patients starting behavioral health telehealth must have an in-person visit within six months. Established patients need one every 12 months.
Some limited extensions remain in place. Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can continue telehealth for non-mental health services through the end of 2026, according to CMS documents.
The restrictions hit hardest for seniors managing chronic conditions like diabetes, heart disease, or mobility issues. “This could mean skipping care entirely for people who can’t travel,” one healthcare advocate told the American Physical Therapy Association (APTA).
Hospice care may also see disruptions. Remote recertification visits are no longer allowed, potentially delaying critical end-of-life services.
CMS confirmed that Medicare will make retroactive payments if Congress passes the extension later. But the agency warned providers to expect strict enforcement of pre-pandemic rules starting immediately.
The House bill also includes a separate provision extending the Hospital-at-Home program through 2030, which allows patients to receive inpatient-level care at home. That measure has bipartisan support but faces the same Senate delay.
Previous efforts like the CONNECT for Health Act have shown widespread backing for telehealth expansion. Yet partisan gridlock and budget concerns have repeatedly delayed action.
Providers are now advising patients to check eligibility before scheduling remote appointments. Many telehealth services booked for February or later may no longer be covered unless the Senate acts quickly.
For now, millions of Medicare beneficiaries face a sudden return to in-person-only care — a change that could strain both patients and the healthcare system.
