Medicare Updates Processing Of Telehealth Claims; Will Allow Provider Organizations To Resubmit Some FFS Telehealth Claims

The Centers for Medicare & Medicaid Services (CMS) updated instructions to Medicare Administrative Contractors (MACs) for processing Medicare fee-for-service telehealth claims submitted for dates of service on and after October 1, 2025. As part of this update, CMS will return a subset of unpaid telehealth claims submitted between October 1 and November 10, 2025 to provider organizations for resubmission with more information to demonstrate the claim is eligible for payment.

CMS also instructed the MACs to pay claims CMS definitively confirmed are for behavioral and mental health services. CMS identified these claims using Healthcare Common Procedure Coding System . . .