Study: Virtual Care Visits Dropped During the Shutdown

The news comes as CMS reaffirms reimbursement during the shutdown and reverses a much-criticized policy on listing the provider's home as a telehealth site.

While healthcare leaders are awaiting long-term clarity on telehealth policy, they’re at least getting a little bit of good news from CMS.

At the same time, a new study finds that the waivers do have a significant impact on telehealth adoption, with a sharp drop reported in virtual care visits during the federal shutdown, when the waivers had expired.

In a FAQ issued earlier this month, CMS has affirmed that it will reimburse providers for telehealth services used during the shutdown, which lasted from October 1 through November 13. 

While first acknowledging that Medicare Administrative Contractors (MACs) were having problems separating claims submitted before the shutdown and during the shutdown, the agency eventually said it will now treat all claims “as if there hadn’t been a temporary lapse in the application of the telehealth flexibilities.” In addition, CMS said it will allow providers to resubmit claims that were denied by MACs during the shutdown.

[Also read: Healthcare Leaders Are Hamstrung by On-Again Off-Again Telehealth Waivers.]

And in an apparent response to complaints from several organizations over a change in policy in the 2026 Medicare Physician Fee Index, CMS also announced that it will allow providers to list their physical practice location when billing for telehealth services delivered from their home, while virtual-only providers must list their home address but can suppress specific details.

Telehealth advocates were grateful for the update.

“CMS’ guidance is a welcome, commonsense step that spares provider’s needless red tape,” Chris Adamec, Executive Director of the Alliance for Connected Care, said in an e-mail. “It enables the flexibility in how and when telehealth is delivered that is key to driving patient-centered care. We’re ready to help CMS take the next step and extend a similar approach to providers without physical practice sites.”

That said, long-term prospects for the telehealth and Hospital at Home waivers are still uncertain. Both were extended only until the end of January 2026.

Visits Plunged Without the Waivers

Researchers have found that the shutdown did severely affect telehealth services. In a research brief published by Ateev Mehrotra, Michael Barnett, Andrew Wilcock and Jared Perkins of thew Brown University School of Public Health’s Center for Advancing Health Policy Through Research, telehealth visits dropped by 24% for fee-for-service Medicare beneficiaries and 13% for Medicare Advantage beneficiaries during the first 17 days of October, with some larger states reporting declines of more than 40%.

This follows an up-and-down pattern since the waivers were first enacted in 2020 to support telehealth expansion and coverage during the COVID-19 pandemic. Those waivers were extended in December 2022, again in December 2024, and one more time in March 2025 before expiring at the end of September 2025.

“The resulting pattern of stopgap extensions created instability,” Mehrotra and his colleagues reported. “Providers have been forced to plan staffing, technology investments, and patient outreach around the possibility that telehealth could disappear with little notice. Beneficiaries, particularly those who rely on telemental health and chronic disease management services, face uncertainty about whether they should schedule their next appointment as a telehealth visit.”

This follows what many might consider a banner half-year for telehealth. According to the study, during the first six months of 2025, some 15% of all Medicare fee-for-service beneficiaries received at least one virtual care visit, totalling some 1,139,779 visits. And almost 30% of all clinicians in the US used telehealth during that time, with the most common uses being primary care services, visits by nurse practitioners and behavioral health services.

While the study’s authors said the decline in telehealth visits during the shutdown was caused by providers not being sure if they’d be reimbursed for telehealth services during the shutdown, it points to a continuing concern that virtual care will suffer if the waivers aren’t made permanent.

“Without Congressional action to reinstate telemedicine flexibilities, both beneficiaries and providers will continue to face disruptions in access to care, loss of critical services, and wasted investments in telehealth infrastructure,” they concluded.