In 2022, 74.4% of U.S. physicians worked in practices that used telehealth, underscoring how routine virtual care has become. “No Access” – Medicare coverage at risk. Unless Congress acts, on Oct 1, 2025 Medicare’s pandemic-era flexibilities for non-behavioral telehealth from the home expire. Most beneficiaries will again need to be in a rural office or medical facility for telehealth, with limited exceptions (stroke evaluation, monthly ESRD home dialysis, and telemental health, including audio-only). The American Hospital Association warns that allowing the waivers to lapse would “negatively impact patient access.”
“No Prescription” – controlled substances. DEA/HHS extended COVID-era telemedicine prescribing flexibilities through Dec 31, 2025. After that, absent a new special-registration pathway (proposed Jan 17, 2025, not final as of today), most new controlled-substance prescriptions via telehealth would again require an in-person exam (with exceptions for the U.S. Department of Veterans Affairs and Opioid Use Disorder).
How we got here. The pandemic measures were designed as temporary. Short-term extensions (most recently to Sept 30, 2025 for broad Medicare telehealth coverage) kept access in place while longer-term policy was debated creating today’s deadline.
What should happen.
• Congress: Extend or make permanent Medicare coverage for home-based non-behavioral telehealth (and related provisions), avoiding a reversion to pre-COVID site/geography rules.
• DEA: Finalize telemedicine rules (special registration) to preserve safe, remote access to necessary controlled medications beyond Dec 31, 2025.
Prognosis.
There’s active, bipartisan legislation – e.g., the CONNECT for Health Act of 2025, and agencies have created limited carve-outs. But no law currently extends Medicare’s broad home-based non-behavioral telehealth past Sept 30, 2025, and DEA’s special-registration rule remains proposed. Absent action, Medicare coverage narrows on Oct 1, and most tele-prescribing reverts to pre-COVID rules on Jan 1, 2026.
