Medicare Telehealth Coverage for SLPs Has Expired — Here’s What That Means and What Comes Next
I woke up on October 1, 2025 to dozens of messages from SLPs across the country asking the same question:
“Can I still see my Medicare patients via telehealth?”
Unfortunately, the answer right now is no.
At midnight, the temporary Medicare telehealth extension for speech-language pathologists, along with other health providers like PTs and OTs, officially expired. Not because Congress voted against it, but because they failed to make a decision at all. When the government shut down, the bill that included telehealth provisions simply didn’t get passed, and so our coverage lapsed.
Here’s what you need to know about where things stand, what it means for your patients, and what we can do together next.
What This Change Actually Means
As of now, Medicare Part B no longer covers telehealth services provided by SLPs.
This affects traditional Medicare beneficiaries only… not Medicare Advantage, Medicaid, or private insurance plans (at least not yet). But because Medicare sets the standard, this decision could have a ripple effect if it isn’t fixed soon.
If you’re wondering about your patients in skilled nursing facilities, the situation isn’t much better. While some facilities can technically choose to use telehealth as a tool, CMS no longer recognizes it as a valid substitute for in-person care.
In short: this decision limits access to care for thousands of patients. Especially those who are homebound, rural, immunocompromised, or managing chronic neurological conditions.
What You Can (and Can’t) Do Right Now
If you serve Medicare Part B patients, you have a few options:
Convert telehealth sessions to in-person when possible. Medicare will still cover in-person services.
Temporarily hold telehealth sessions and let patients know you’ll update them as soon as there’s news.
Private pay is an option, but only with an Advance Beneficiary Notice (ABN). Because Medicare no longer covers telehealth, it is temporarily considered a non-covered service. This means patients can choose to pay privately after signing the ABN.
Just be cautious here: if Congress reinstates telehealth and applies it retroactively, we’ll be required to refund those payments and submit the claims. So this is not the time to launch a “cash telehealth practice.” For now, it’s a waiting game.
Why This Matters
This isn’t just a billing issue. It’s an access to care issue.
Across the country, patients who rely on telehealth for safety, transportation, or health reasons suddenly lost that option overnight. Clinicians who have built hybrid models, or even full telehealth caseloads, were forced to cancel sessions and scramble to find solutions.
It’s 2025. The technology exists. The need exists. And yet, due to political gridlock, we’re being asked to return to a system that ignores both.
This doesn’t just impact SLPs; it affects PTs, OTs, dietitians, and most importantly, the people we serve.
What You Can Do
This is where advocacy matters. Here’s how you can take action right now:
Call your Congressional representatives.
Let them know that the Medicare telehealth lapse is limiting access to care and harming patients. You can find their contact info through the Telehealth Advocacy Toolkit.Educate your team.
Make sure your clinic, supervisors, and administrators understand this change affects traditional Medicare only, not Medicare Advantage or Medicaid. Don’t let employers make blanket “no telehealth” policies out of confusion or fear.Stay informed.
Check reliable sources, not Facebook rumors. You can always find the latest updates from Medicare for SLPs and Fix SLP.Keep your patients informed.
Be transparent about why sessions are changing, and reassure them that we’re advocating for their right to access care.
Why I’m Speaking Up
I’ve been advocating for telehealth coverage for years now, building tools and resources to make it easier for SLPs to reach out to Congress and take action. But this moment feels especially important.
Because this isn’t just about reimbursement… It’s about the future of our profession and the people we serve.
Telehealth has become an essential part of modern healthcare, especially for adults with neurological conditions, rural communities, and those with mobility challenges. Losing it sets us back years.
So yes, I’m frustrated. But I’m also hopeful because every time our community has been faced with a barrier like this, we’ve stepped up and done something about it.
Join the Advocacy Effort
If you’re ready to take action, download my Telehealth Advocacy Toolkit for call scripts, email templates, and step-by-step instructions to contact your representatives.
Check out the podcast episode that Jeanette, from Fix SLP, and I put out with the latest information.
It’s going to take all of us, clinicians, leaders, and advocates, to make sure Congress understands what’s at stake.
Let’s fix this together.
Katie Brown, MA, CCC-SLP
Katie is the owner of Neuro Speech Solutions, a private practice in Buffalo, NY that helps adults with neurological communication and cognitive disorders. She is also the founder of Medicare for SLPs, where she supports private practice speech-language pathologists navigate Medicare Part B with less stress and more confidence.
