decisionhealth Newsletters, Part B News - 2025 Issue 12 (December)
Submit or resubmit telehealth claims for services during the shutdown
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Article Overview
This premium coding update reviews a Medicare telehealth policy extension under the Continuing Appropriations and Extensions Act, 2026 and a related CMS notice on claims affected by the shutdown. It is aimed at billing and coding staff, practice managers, and Medicare providers who need a high-level understanding of what types of telehealth claims may be submitted or resubmitted, what kinds of remittance feedback to look for, and how the update affects related telehealth billing practices. The article also notes broader categories of services that are not treated as telehealth in CMS guidance and highlights privacy and security considerations tied to telehealth delivery.
Why This Topic Matters
It helps practices identify which shutdown-period telehealth claims may need attention, understand why certain denials occurred, and stay aligned with current Medicare billing guidance.
Article Sections
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Billing
Overview of the Medicare telehealth policy extension, the shutdown-related claim timing issue, and CMS guidance affecting submission and resubmission of affected telehealth claims.
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Resources
Reference links to the legislative text and CMS notice cited in the article.
What You Will Learn
- How the temporary telehealth policy extension affects shutdown-period claims
- What CMS says about denied or held telehealth claims
- Which general categories of services CMS distinguishes from telehealth
- What billing and compliance topics practices should review before submitting affected claims
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Medicare providers
- Revenue cycle teams
Codes Discussed
Modifiers Discussed
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