{"id":42411,"date":"2025-10-07T11:58:42","date_gmt":"2025-10-07T15:58:42","guid":{"rendered":"https:\/\/documentationwizard.com\/?p=42411"},"modified":"2025-11-24T14:36:46","modified_gmt":"2025-11-24T19:36:46","slug":"medicare-telehealth-coverage-the-government-shutdown","status":"publish","type":"post","link":"https:\/\/tewconsulting.com\/dw\/medicare-telehealth-coverage-the-government-shutdown\/","title":{"rendered":"Medicare, Telehealth Coverage &amp; the Government Shutdown: What You Need to Know Now 2.0"},"content":{"rendered":"<style>.kb-row-layout-id42411_ad6990-50 > .kt-row-column-wrap{align-content:start;}:where(.kb-row-layout-id42411_ad6990-50 > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:start;}.kb-row-layout-id42411_ad6990-50 > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);padding-top:var(--global-kb-spacing-sm, 1.5rem);padding-bottom:var(--global-kb-spacing-sm, 1.5rem);grid-template-columns:minmax(0, 1fr);}.kb-row-layout-id42411_ad6990-50 > .kt-row-layout-overlay{opacity:0.30;}@media all and (max-width: 1024px){.kb-row-layout-id42411_ad6990-50 > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}@media all and (max-width: 767px){.kb-row-layout-id42411_ad6990-50 > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id42411_ad6990-50 alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-1-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top\">\n<style>.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col,.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col{flex-direction:column;}.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column42411_d5ed7b-d0{position:relative;}@media all and (max-width: 1024px){.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column42411_d5ed7b-d0 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column42411_d5ed7b-d0\"><div class=\"kt-inside-inner-col\">\n<p>On March 2, 2025, I wrote a blog on the <a href=\"https:\/\/tewconsulting.com\/dw\/medicare-and-telehealth-coverage-clearing-up-the-confusion\/\">future of telehealth<\/a>. In March, we still hoped that the Medicare requirement to see telehealth clients once a year would be permanently eliminated. That might happen but not now. Due to the government shutdown, there was no opportunity for Congress to further discuss or vote on the issue. Consequently, after 5.5 years, the Covid-era Medicare telehealth waivers expired on October 1, 2025. The future is now.<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_d31eca-76, .wp-block-kadence-advancedheading.kt-adv-heading42411_d31eca-76[data-kb-block=\"kb-adv-heading42411_d31eca-76\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_d31eca-76 mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_d31eca-76[data-kb-block=\"kb-adv-heading42411_d31eca-76\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_d31eca-76 img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_d31eca-76[data-kb-block=\"kb-adv-heading42411_d31eca-76\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_d31eca-76 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_d31eca-76\"><strong>What mental health clinicians need to know\u2014facts and action steps.<\/strong><\/h2>\n\n\n\n<p><strong>Good News First<\/strong><\/p>\n\n\n\n<p>Unlike medical services, <a href=\"https:\/\/telehealth.hhs.gov\/providers\/telehealth-policy\/telehealth-policy-updates#behavioral-health\"><strong>Medicare permanently covers telehealth for mental health treatment<\/strong><\/a>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>No geographic restrictions for mental health<\/li>\n\n\n\n<li>Audio-only coverage remains permanent for mental health<\/li>\n<\/ul>\n\n\n\n<p><strong>What Changed On October 1, 2025<\/strong><\/p>\n\n\n\n<p>With the help of <a href=\"https:\/\/psychbillingcoach.com\/news\/what-happens-now-telehealth\/?ml_recipient=167368695140582676&amp;ml_link=167368681642264393&amp;utm_source=newsletter&amp;utm_medium=email&amp;utm_term=Sun+05+Oct+2025&amp;utm_campaign=Latest+News+Medicare+demands+in-person+What+happens+now+with+telehealth+%3e\">Susan Frager, the Psych Billing Coach<\/a>, <a href=\"http:\/\/www.socialworkers.org\/Advocacy\/Policy-Updates\/ID\/3271\/Congress-fails-to-Extend-Medicare-Telehealth-Flexibilities-by-September-30-Continuing-Resolution-Deadline\">NASW<\/a>, the <a href=\"https:\/\/www.apaservices.org\/practice\/reimbursement\/government\/medicare-inperson-telehealth-requirement\">APA<\/a>, and <a href=\"https:\/\/telehealth.hhs.gov\/providers\/telehealth-policy\/telehealth-policy-updates#behavioral-health\">HHS<\/a>, here\u2019s what I can tell you\u2026<\/p>\n\n\n\n<p><em>In-person visits are now required.<\/em> That&#8217;s it. Everything else about mental health telehealth coverage remains the same. Here\u2019s the recap:<\/p>\n\n\n\n<p><strong>The Rules:<\/strong><\/p>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li><em>New<\/em> clients must be seen at least once in-person <em>before <\/em>starting telehealth visits. There are NO exceptions to this requirement.<\/li>\n\n\n\n<li><em>On-going clients<\/em>, those you\u2019ve been seeing via telehealth since the pandemic, do NOT need an initial in-person session. (They\u2019ve already had an initial session!)<\/li>\n\n\n\n<li><em>All <\/em>clients will be required to have one in-person session once per year, or every 365 days starting October 1, 2025.<\/li>\n<\/ol>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_04a8f7-27, .wp-block-kadence-advancedheading.kt-adv-heading42411_04a8f7-27[data-kb-block=\"kb-adv-heading42411_04a8f7-27\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_04a8f7-27 mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_04a8f7-27[data-kb-block=\"kb-adv-heading42411_04a8f7-27\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_04a8f7-27 img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_04a8f7-27[data-kb-block=\"kb-adv-heading42411_04a8f7-27\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_04a8f7-27 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_04a8f7-27\"><strong>Are there exceptions?<\/strong><\/h2>\n\n\n\n<p><strong>For new clients:<\/strong> To repeat \u2013 no, new clients <em>must <\/em>be seen in person first.<\/p>\n\n\n\n<p><strong>For the annual in-person follow-up:<\/strong> Yes, there are exceptions. However, <a href=\"https:\/\/www.federalregister.gov\/documents\/2021\/11\/19\/2021-23972\/medicare-program-cy-2022-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part#p-528\">Medicare&#8217;s language is non-specific<\/a> and leaves the rationale to us:<\/p>\n\n\n\n<p><em>If the patient and practitioner consider the risks and burdens of an in-person service and agree that \u2026 these outweigh the benefits \u2026 and the practitioner documents the basis for that decision in the patient&#8217;s medical record, then the in-person visit requirement is not applicable for that 12-month period. \u2026<\/em><\/p>\n\n\n\n<p><em>\u2026situations in which the risks and burdens associated with an in-person service may outweigh the benefit could include \u2026 instances when an in-person service is likely to cause disruption in service delivery or has the potential to worsen the patient&#8217;s condition(s). \u2026 Other examples \u2026 may include the clinician&#8217;s professional judgement that the patient is clinically stable and\/or that an in-person visit has the risk of worsening the patient&#8217;s condition, creating undue hardship on self or family, or if it is determined that the patient is at risk for disengagement with care that has been effective\u2026<\/em><\/p>\n\n\n\n<p><strong>Translation:<\/strong> I hesitate to give them too much credit but, it could be that Medicare trusts the clinician and the client to make the determination.<\/p>\n\n\n\n<p><strong>Recommendation:<\/strong> Carefully and thoughtfully document why in-person visits aren&#8217;t appropriate.<\/p>\n\n\n\n<p><strong>Examples of documentation that would likely support an exception:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Medical condition\/disability makes in-person visits impossible or harmful (be specific about how and why)<\/li>\n\n\n\n<li>Transportation difficulties combined with clear explanation of impact on treatment engagement<\/li>\n\n\n\n<li>Evidence that telehealth treatment has been effective and client is clinically stable<\/li>\n<\/ul>\n\n\n\n<p>Always document that the client is safely managed via telehealth with no risks (suicidality, etc.) requiring in-person contact. Documenting the appropriateness for telehealth has been a requirement since the pandemic.<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_faff1c-37, .wp-block-kadence-advancedheading.kt-adv-heading42411_faff1c-37[data-kb-block=\"kb-adv-heading42411_faff1c-37\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_faff1c-37 mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_faff1c-37[data-kb-block=\"kb-adv-heading42411_faff1c-37\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_faff1c-37 img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_faff1c-37[data-kb-block=\"kb-adv-heading42411_faff1c-37\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_faff1c-37 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_faff1c-37\"><strong>What if I can&#8217;t see clients in person?<\/strong><\/h2>\n\n\n\n<p>Medicare will ask why. Expanding your practice geographically, for instance state-wide, or multi-state, is not a good enough answer. But there are some solutions with a little creativity:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sublet a colleague&#8217;s office as needed.<\/li>\n\n\n\n<li>Conduct in-home visits if the client is local and use POS 12 for location. (Yes, driving to a client\u2019s home is time consuming but I did home visits for 12 years and loved all but the time investment. You get a whole new appreciation for how a client lives.)<\/li>\n\n\n\n<li>Rent space from a medical practice and maybe develop a referral relationship.<\/li>\n<\/ul>\n\n\n\n<p><strong>Critical:<\/strong> Update your Medicare enrollment for any new service location, including &#8220;as-needed&#8221; offices or home visits. Medicare won&#8217;t pay for locations that are not on your enrollment profile. (Thank you, Susan Frager, for your billing expertise.)<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_d229cc-8e, .wp-block-kadence-advancedheading.kt-adv-heading42411_d229cc-8e[data-kb-block=\"kb-adv-heading42411_d229cc-8e\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_d229cc-8e mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_d229cc-8e[data-kb-block=\"kb-adv-heading42411_d229cc-8e\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_d229cc-8e img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_d229cc-8e[data-kb-block=\"kb-adv-heading42411_d229cc-8e\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_d229cc-8e wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_d229cc-8e\"><strong>What about Medicare Advantage?<\/strong><\/h2>\n\n\n\n<p>Advantage plans must cover telehealth for mental health\u2014it&#8217;s federal law (<a href=\"https:\/\/www.ecfr.gov\/current\/title-42\/chapter-IV\/subchapter-B\/part-422\/subpart-C\/section-422.101\">42 CFR \u00a7 422.101<\/a>). They must cover everything Original Medicare covers.<\/p>\n\n\n\n<p>However, in-person visit requirements are at each plan&#8217;s discretion. You can either call every plan (and spend hours on hold) or follow Original Medicare rules for all Advantage clients.<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_8691c2-2f, .wp-block-kadence-advancedheading.kt-adv-heading42411_8691c2-2f[data-kb-block=\"kb-adv-heading42411_8691c2-2f\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_8691c2-2f mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_8691c2-2f[data-kb-block=\"kb-adv-heading42411_8691c2-2f\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_8691c2-2f img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_8691c2-2f[data-kb-block=\"kb-adv-heading42411_8691c2-2f\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_8691c2-2f wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_8691c2-2f\"><strong>Can I keep seeing existing clients via telehealth?<\/strong><\/h2>\n\n\n\n<p><strong>Short answer:<\/strong> Probably, but not with 100% certainty.<\/p>\n\n\n\n<p>The <a href=\"https:\/\/www.apaservices.org\/practice\/reimbursement\/government\/medicare-inperson-telehealth-requirement\">APA<\/a> says you can continue with existing clients without an immediate in-person visit. <a href=\"https:\/\/www.federalregister.gov\/documents\/2022\/11\/18\/2022-23873\/medicare-and-medicaid-programs-cy-2023-payment-policies-under-the-physician-fee-schedule-and-other\">The 2023 Physician Fee Schedule Final Rule<\/a> supports this:<\/p>\n\n\n\n<p><em>From page 69464: &#8220;However, we clarify that we do not believe this requirement applies to beneficiaries who began receiving mental health telehealth services in their homes during the PHE (public health emergency).<\/em><\/p>\n\n\n\n<p>You&#8217;ll still need an in-person visit before September 30, 2026\u2014unless the rules change again. (Here\u2019s hoping!)<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_f20c52-5e, .wp-block-kadence-advancedheading.kt-adv-heading42411_f20c52-5e[data-kb-block=\"kb-adv-heading42411_f20c52-5e\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_f20c52-5e mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_f20c52-5e[data-kb-block=\"kb-adv-heading42411_f20c52-5e\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_f20c52-5e img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_f20c52-5e[data-kb-block=\"kb-adv-heading42411_f20c52-5e\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_f20c52-5e wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_f20c52-5e\"><strong>What To Do If Meeting In-Person Is Not An Option<\/strong><\/h2>\n\n\n\n<p>During your first October telehealth visit:<\/p>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>Document clearly and specifically why an in-person session wasn&#8217;t conducted. If you already had your first October telehealth sessions and documented them, you can write an addendum to your progress notes.<\/li>\n\n\n\n<li>Have the client sign an <a href=\"https:\/\/www.cms.gov\/medicare\/forms-notices\/beneficiary-notices-initiative\/ffs-abn\">Advanced Beneficiary Notification<\/a> (ABN) form. This allows the client to make cash payments for non-covered services.<\/li>\n<\/ol>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_66c6e3-c1, .wp-block-kadence-advancedheading.kt-adv-heading42411_66c6e3-c1[data-kb-block=\"kb-adv-heading42411_66c6e3-c1\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_66c6e3-c1 mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_66c6e3-c1[data-kb-block=\"kb-adv-heading42411_66c6e3-c1\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_66c6e3-c1 img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_66c6e3-c1[data-kb-block=\"kb-adv-heading42411_66c6e3-c1\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_66c6e3-c1 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_66c6e3-c1\"><strong>Claims, Payments, and Audits<\/strong><\/h2>\n\n\n\n<p><strong>Claims:<\/strong> Medicare Administrative Contractors (MACs) have been directed to temporarily hold claims for 10 business days for dates of service that start on October 1, 2025. Holding claims avoids the need to re-process claims should Congress, when it resumes session, decide to extend the waiver again or make it permanent.<\/p>\n\n\n\n<p><strong>Payments:<\/strong> Unfortunately, the temporary withholding of claims means there will likely be some delay in Medicare payments. At the same time, this also indicates that there is a good chance that these restrictions will be reversed when the government shutdown ends. NASW and the APA have been lobbying to have these restrictions permanently lifted.<\/p>\n\n\n\n<p><strong>Audits:<\/strong> Medicare typically avoids conducting audits during periods when policy is in flux\u2014like right now. Hopefully, we\u2019ll have more clarity and good news when the government resumes sessions.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has--font-size\"><strong>Does This Requirement Also Apply to Medicaid and Commercial Insurance, and Out of Network Providers?<\/strong><\/h2>\n\n\n\n<p>Officially, the in-person requirement applies only Medicare. BUT, Medicaid and some commercial insurance companies may decide to follow their lead. Medicare is Federal law and sets the standards that most insurance companies follow. Given who Medicaid serves, it&#8217;s hard to believe that it would be so restrictive. But Medicaid is staring down the barrel of budget cuts and commercial insurances are staring down the barrel of rate increases. Requiring the first visit to be in-person, may be one of the restrictions they use to limit access to care and save money. <\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_be76f9-26, .wp-block-kadence-advancedheading.kt-adv-heading42411_be76f9-26[data-kb-block=\"kb-adv-heading42411_be76f9-26\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_be76f9-26 mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_be76f9-26[data-kb-block=\"kb-adv-heading42411_be76f9-26\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_be76f9-26 img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_be76f9-26[data-kb-block=\"kb-adv-heading42411_be76f9-26\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<p class=\"kt-adv-heading42411_be76f9-26 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_be76f9-26\"><strong>How the question applies to out of network providers is a bit more complex. <\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p>Out of network providers (OONs) who provide super bills so clients can get reimbursed for services, are subject to the same requirements to justify medical necessity. Yes, OON providers are audited. It&#8217;s not as often but it does happen. When the insurance company pays the bill, the provider has to follow the rules. However, the billing structure is a different story. The client pays you and gets reimbursed by their  insurance company.<\/p>\n\n\n\n<p>While out-of-network providers aren&#8217;t bound by Medicare&#8217;s billing requirements, your clients may find their insurance company won&#8217;t reimburse them for telehealth services that don&#8217;t meet this in-person requirement. So the requirement could still affect whether your clients can get reimbursed, even though it doesn&#8217;t legally bind you as the provider. Confusing, I know. Time will tell what happens. <\/p>\n\n\n\n<p>I hate to say it, but it&#8217;s best to check with the individual insurance companies. Maybe they will be proactive and publish something on their provider portal. But I&#8217;m not holding my breath. <\/p>\n\n\n\n<p>Here&#8217;s hoping that when the shutdown ends (may it be soon) that the waiver is permanent.<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading42411_dbeec1-2e, .wp-block-kadence-advancedheading.kt-adv-heading42411_dbeec1-2e[data-kb-block=\"kb-adv-heading42411_dbeec1-2e\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_dbeec1-2e mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_dbeec1-2e[data-kb-block=\"kb-adv-heading42411_dbeec1-2e\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_dbeec1-2e img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_dbeec1-2e[data-kb-block=\"kb-adv-heading42411_dbeec1-2e\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 class=\"kt-adv-heading42411_dbeec1-2e wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_dbeec1-2e\"><strong>Can I do nothing, and hope Congress retroactively extends the waiver?<\/strong><\/h2>\n\n\n\n<p>You could if you are not risk averse. But as hopeful as I am, I wouldn\u2019t hold my breath banking on a good outcome. It doesn\u2019t take that much to comply with the current rules for existing clients. Clear documentation about why you can\u2019t see clients in person will suffice. However, for those of us who only offer telehealth sessions, seeing new clients in-person is a challenge and will take some creativity. Since I am risk averse, I believe it\u2019s best to follow the rules as best you can and document thoroughly, particularly when you can\u2019t.<\/p>\n\n\n\n<p>Unfortunately, the current in-person requirement can act as another barrier for clients seeking services, reducing, yet again, access to care. You can help reverse this trend by writing to your member of congress about the benefits of a permanent waiver.<\/p>\n<\/div><\/div>\n\n\n<style>.kadence-column42411_95f45c-42 > .kt-inside-inner-col,.kadence-column42411_95f45c-42 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column42411_95f45c-42 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column42411_95f45c-42 > .kt-inside-inner-col{flex-direction:column;}.kadence-column42411_95f45c-42 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column42411_95f45c-42 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column42411_95f45c-42{position:relative;}@media all and (max-width: 1024px){.kadence-column42411_95f45c-42 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column42411_95f45c-42 > 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2rem);grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id42411_8ae63b-f8 alignnone kt-row-has-bg wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-2-columns kt-row-layout-right-golden kt-tab-layout-row kt-mobile-layout-row kt-row-valign-top\">\n<style>.kadence-column42411_7a759d-66 > .kt-inside-inner-col,.kadence-column42411_7a759d-66 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column42411_7a759d-66 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column42411_7a759d-66 > .kt-inside-inner-col{flex-direction:column;}.kadence-column42411_7a759d-66 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column42411_7a759d-66 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column42411_7a759d-66{position:relative;}@media all and (max-width: 1024px){.kadence-column42411_7a759d-66 > 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1024px){.wp-block-kadence-image.kb-image42411_b2113c-34:not(.kb-specificity-added):not(.kb-extra-specificity-added){margin-top:-128px;margin-bottom:0px;margin-left:0px;}}@media all and (max-width: 767px){.wp-block-kadence-image.kb-image42411_b2113c-34:not(.kb-specificity-added):not(.kb-extra-specificity-added){margin-top:-64px;margin-bottom:0px;margin-left:0px;}}<\/style>\n<figure class=\"wp-block-kadence-image kb-image42411_b2113c-34 kb-image-is-ratio-size\"><div class=\"kb-is-ratio-image kb-image-ratio-port34\"><img decoding=\"async\" src=\"https:\/\/tewconsulting.com\/dw\/wp-content\/uploads\/2025\/01\/beth-rontal-author-box.jpg\" alt=\"Beth Rontal, LICSW and Documentation Wizard\" class=\"kb-img wp-image-39231\"\/><\/div><\/figure>\n<\/div><\/div>\n\n\n<style>.kadence-column42411_ac9099-6e > .kt-inside-inner-col,.kadence-column42411_ac9099-6e > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column42411_ac9099-6e > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column42411_ac9099-6e > .kt-inside-inner-col{flex-direction:column;}.kadence-column42411_ac9099-6e > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column42411_ac9099-6e > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column42411_ac9099-6e{position:relative;}.kadence-column42411_ac9099-6e, .kt-inside-inner-col > .kadence-column42411_ac9099-6e:not(.specificity){margin-left:var(--global-kb-spacing-lg, 3rem);}@media all and (max-width: 1024px){.kadence-column42411_ac9099-6e > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 1024px){.kadence-column42411_ac9099-6e, .kt-inside-inner-col > .kadence-column42411_ac9099-6e:not(.specificity){margin-left:0px;}}@media all and (max-width: 767px){.kadence-column42411_ac9099-6e > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column42411_ac9099-6e\"><div class=\"kt-inside-inner-col\"><style>.kb-row-layout-id42411_79803e-2b > .kt-row-column-wrap{align-content:start;}:where(.kb-row-layout-id42411_79803e-2b > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:start;}.kb-row-layout-id42411_79803e-2b > .kt-row-column-wrap{column-gap:var(--global-kb-gap-lg, 4rem);row-gap:var(--global-kb-gap-md, 2rem);padding-top:var(--global-kb-spacing-sm, 1.5rem);padding-bottom:var(--global-kb-spacing-sm, 1.5rem);grid-template-columns:minmax(0, 1fr);}.kb-row-layout-id42411_79803e-2b > .kt-row-layout-overlay{opacity:0.30;}@media all and (max-width: 1024px){.kb-row-layout-id42411_79803e-2b > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}@media all and (max-width: 767px){.kb-row-layout-id42411_79803e-2b > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id42411_79803e-2b alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-1-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top\">\n<style>.kadence-column42411_db1e80-82 > .kt-inside-inner-col,.kadence-column42411_db1e80-82 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column42411_db1e80-82 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column42411_db1e80-82 > .kt-inside-inner-col{flex-direction:column;}.kadence-column42411_db1e80-82 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column42411_db1e80-82 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column42411_db1e80-82{position:relative;}@media all and (max-width: 1024px){.kadence-column42411_db1e80-82 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column42411_db1e80-82 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column42411_db1e80-82\"><div class=\"kt-inside-inner-col\"><style>.wp-block-kadence-advancedheading.kt-adv-heading42411_f1f21f-12, .wp-block-kadence-advancedheading.kt-adv-heading42411_f1f21f-12[data-kb-block=\"kb-adv-heading42411_f1f21f-12\"]{font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading42411_f1f21f-12 mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading42411_f1f21f-12[data-kb-block=\"kb-adv-heading42411_f1f21f-12\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading42411_f1f21f-12 img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading42411_f1f21f-12[data-kb-block=\"kb-adv-heading42411_f1f21f-12\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<p class=\"kt-adv-heading42411_f1f21f-12 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading42411_f1f21f-12\"><a href=\"https:\/\/tewconsulting.com\/dw\/about\/\"><strong>Beth Rontal, LICSW<\/strong><\/a><strong>,&nbsp;<\/strong>a private practice therapist and the Documentation Wizard\u00ae is a nationally recognized consultant on mental health documentation. Her&nbsp;<a href=\"https:\/\/tewconsulting.com\/dw\/online-workshop\/\">Misery and Mastery\u00ae&nbsp;trainings<\/a>&nbsp;and accompanying&nbsp;<a href=\"https:\/\/tewconsulting.com\/dw\/master-forms\/\">forms<\/a>&nbsp;are developed to meet strict Medicare requirements. Beth\u2019s&nbsp;Documentation Wizard&nbsp;training program&nbsp;helps clinicians turn their clinical skill and intuition into a systematic review of treatment that helps to pass audits, protect income, maintain professional standards of care, reduce documentation anxiety and increase self-confidence. Beth\u2019s forms have been approved by 2 attorneys, a bioethicist, and a billing expert and have been used all over the world. She mastered her teaching skills with thousands of hours supervising and training both seasoned professionals and interns when supervising at an agency for 11 years. Her newest initiative,&nbsp;<a href=\"https:\/\/tewconsulting.com\/dw\/membership-circle\/\">Membership Circle<\/a>, is designed to&nbsp;empower psychotherapists to master documentation&nbsp;with expert guidance, efficient strategies, and a supportive community.<\/p>\n<\/div><\/div>\n\n<\/div><\/div><\/div><\/div>\n\n<\/div><\/div><\/div><\/div>\n\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>On March 2, 2025, I wrote a blog on the future of telehealth. In March, we still hoped that the Medicare requirement to see telehealth clients once a year would be permanently eliminated. That might happen but not now. 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