CMS has directed all Medicare Administrative Contractors (MACs) to lift the claims hold and resume processing claims dated October 1, 2025, and later for several service types impacted by recently expired Medicare payment provisions. This includes claims under the Medicare Physician Fee Schedule, ground ambulance transports, and Federally Qualified Health Center (FQHC) services.
Telehealth claims that are confirmed behavioral or mental health services will also be processed, while other telehealth and Hospital Care at Home claims remain temporarily on hold.
As of October 1, 2025, many of the COVID-era telehealth flexibilities have expired. Medicare coverage for certain telehealth services—such as those provided outside of rural areas or in a patient’s home—has reverted to prior restrictions. Providers offering services that may no longer be covered should consider using an Advance Beneficiary Notice of Noncoverage (ABN). More information and ABN form instructions are available on the CMS Beneficiary Notices Initiative page.
Clinicians participating in Medicare Shared Savings Program ACOs continue to have additional flexibility to provide covered telehealth services without geographic restrictions. These ACO providers may still receive payment for covered behavioral and mental health telehealth services. Further details are available in the CMS Shared Savings Program Telehealth Fact Sheet.
Providers are encouraged to continue monitoring CMS Telehealth Coverage updates for any changes to current payment and coverage policies.
Resource: Claims Hold Update