Medicare telehealth policies continue to evolve as the Centers for Medicare & Medicaid Services (CMS) transitions away from COVID-19–era flexibilities. While many telehealth allowances remain in place through early 2026, several statutory requirements are scheduled to return—with important implications for psychiatrists and other behavioral health clinicians.

Below is a summary of the most recent CMS guidance and what it means for psychiatric practice.

Key Takeaways

• Most Medicare telehealth flexibilities remain in effect through January 30, 2026.
• CMS has indicated it will allow retroactive claims processing during recent coverage gaps.
• Virtual supervision by teaching physicians is permitted beginning in 2026.
• Geographic, originating site, and audio-only flexibilities remain time-limited unless Congress acts.
• The DEA prescribing of controlled substances via telehealth extended through December 31, 2026.

In-Person Visit Requirements for Behavioral Health Telehealth

CMS updated its Telehealth FAQ for Calendar Year 2026 which explains how the statutory in-person visit requirement will apply to Medicare beneficiaries receiving behavioral health services via telehealth in their homes.

Through January 30, 2026

Medicare beneficiaries may continue to receive behavioral health telehealth services in their homes without meeting an in-person visit requirement.

Beginning January 31, 2026 (unless further congressional action)

Medicare generally requires:

• An in-person, non-telehealth visit within six months prior to the initial telehealth behavioral health service delivered in the home.
• At least one in-person visit every 12 months thereafter.

Important Exceptions

• Patients who began receiving behavioral health telehealth services on or before January 30, 2026 are considered established patients and will only be subject to the annual in-person visit requirement.
• CMS allows limited exceptions based on patient-specific circumstances, such as access barriers, when appropriately documented.

Claims Processing and Coverage Gaps

CMS has indicated that due to recent legislative actions resolving the government shutdown, telehealth flexibilities were restored and extended through January 30, 2026, and CMS will retroactively pay claims for services furnished during the lapse period. Clinicians should continue submitting telehealth claims with correct dates of service and documentation supporting telehealth eligibility at the time of care.

Teaching Physician and Supervision Flexibilities

CMS finalized a policy allowing teaching physicians to provide virtual supervision using real-time audio-video technology, beginning January 1, 2026 permanently. This applies to both telehealth and in-person services and lets teaching physicians be “virtually present” during the key portion of the service.

For more information about supervision and other Medicare telehealth policies, see the CMS Telehealth resources for providers below.

Geographic and Originating Site Flexibilities

CMS has extended several telehealth flexibilities related to where beneficiaries may receive care:

Through January 30, 2026

• Patients may receive telehealth services from any location, including their homes.
• Geographic restrictions (such as rural requirements) remain waived.
• Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) may serve as both originating and distant sites.

After January 30, 2026, non-behavioral telehealth services may again be subject to geographic and originating site limitations unless Congress intervenes.

For additional originating site and telehealth coverage information, explore the Medicare telehealth policy page on CMS.gov below.

Telehealth Billing for RHCs and FQHCs

CMS maintains telehealth payment policies for RHCs and FQHCs:

• Behavioral health telehealth services continue to be reimbursed under the All-Inclusive Rate (AIR) or Prospective Payment System (PPS).
• RHCs and FQHCs may bill for certain non-behavioral telehealth services using HCPCS code G2025 through December 31, 2026.
• The patient’s home may continue to serve as the originating site.

Audio-Only Telehealth for Behavioral Health

Audio-only telehealth remains a key access option:

• Allowed for behavioral health services in the home through January 30, 2026.
• After that date, audio-only may still be used if the clinician is capable of video and the patient cannot or does not consent to video.

DEA Rule on Prescribing Controlled Substances via Telehealth

The DEA and HHS have issued a fourth temporary rule extending COVID-era telemedicine flexibilities for prescribing controlled substances through December 31, 2026. This extension allows DEA-registered clinicians to continue prescribing Schedule II–V medications via telemedicine without an initial in-person visit, helping prevent disruptions in care.

Under the federal Ryan Haight Online Pharmacy Consumer Protection Act of 2008, prescribers generally must conduct an in-person medical evaluation before issuing a prescription for controlled medications unless an exception applies. During the COVID-19 public health emergency, the DEA and HHS jointly issued temporary flexibilities allowing DEA-registered practitioners to prescribe Schedule II-V controlled substances via telemedicine without a prior in-person visit if certain conditions are met.

Looking Ahead

While CMS has extended many telehealth flexibilities into early 2026, several key policies, particularly in-person visit and originating site requirements, are tied to statutory law and are scheduled to take effect unless Congress acts.

Guidance for Psychiatrists:

• Prepare clinical and billing workflows for the potential upcoming in-person visit requirements
  • Read previous guidance from APA
• Monitor patient eligibility timelines closely
• Stay informed about legislative changes affecting telepsychiatry

Additional Resources

Here are key resources clinicians can reference for full telehealth guidance:

• CMS Telehealth FAQ (Calendar Year 2026) – comprehensive answers on telehealth policy changes CMS Telehealth FAQ (CY 2026 PDF)
• Telehealth.HHS.gov – Policy & Provider Resources – telehealth policy and best practices for clinicians Telehealth.HHS.gov Provider Resources
• Medicare Telehealth Coverage & Billing Information – official CMS page on telehealth policies and covered services Medicare Telehealth Policy on CMS.gov
• CMS Telehealth Toolkit for Providers – downloadable guidance for telehealth implementation and billing CMS Telehealth Toolkit (PDF)