Community health centers across Connecticut are no longer receiving Medicare reimbursements for virtual telehealth visits, except for mental health and limited other exceptions.
The provision ended Sept. 30, a day before the federal government shut down, after Congress was unable to reach an agreement to extend Medicare telehealth put in place during the COVID-19 pandemic.
As a result, telehealth under Medicare is now back to pre-pandemic reimbursement policies.
“It is a victim of bad timing,” said Melissa Meyers, CEO of Generations Family Health Center, a federally qualified health center in Willimantic. “It is very likely that the longer the shutdown continues, the longer this service will be disrupted.”
In a social media post Oct. 1, Generations notified patients that Medicare would cease to cover tele-medical and virtual medication management visits from home. Those consultations must be now held in person, or from an approved location that is either a clinic or a hospital.
Patients with mental illness can still be seen virtually under Medicare, but they must have made an in-person visit within six months prior to their first telehealth visit.
Federal Medicare reimbursements for telehealth services were put in place during the pandemic, and in 2024, Congress passed a six-month extension through its 2025 funding bill. Another extension was passed through Sept. 30, 2025.
“Easier access to telehealth services granted during the COVID-19 public health emergency allowed hundreds of thousands of Medicare patients in rural areas to obtain virtual care in the privacy of their homes, saving them the time, money, and the risk of getting an infection in traveling to a distant medical facility to receive it,” according to the American Medical Association. “At the same time, patients in urban, suburban and underserved areas gained access to telehealth services for the first time.”
At UConn Health, Dr. Christopher M. Morosky, associate professor of obstetrics and gynecology, said he and his colleagues are engaged in conversations on billing for virtual mental health consultations.
“The question that we're having right now is, are non-psychiatrists, providers such as OB-GYN [for Medicare patients, and] primary care physicians, who do participate in mental health management, able to continue those visits?” he asked.
The confusion is compounded by delays for so-called global billing – a single, bundled payment for all services provided by a medical provider – including mental health care.
“Are we still able to do telehealth visits [with global billing]? Because we're not really individually charging for those visits,” he said.
On the policy front, U.S. Sen. Richard Blumenthal, a Connecticut Democrat, is co-sponsor of a bipartisan bill that would permanently expand telehealth access.
The Centers for Medicare & Medicaid Services said practitioners who choose to perform telehealth services that are not payable by Medicare after Oct 1, should consider notifying beneficiaries in advance that the services may not be covered.
CMS also said practitioners should monitor Congressional action and “may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action. Additionally, Medicare would not be able to pay some kinds of practitioners for telehealth services.”
