Medicare telehealth policy just got more complex and more consequential. As widely reported, the passage of HR 7148, the Consolidated Appropriations Act, 2026, extended Medicare telehealth waivers through December 31, 2027. But the extension is only part of the story. Embedded within HR 7148 are four additional telehealth-related provisions that introduce new requirements, expand coverage, and direct federal agencies to take specific actions in the years ahead.
Here’s a breakdown of what providers and organizations should be aware of.
New Billing Modifiers for Third-Party Virtual Platforms
By 2027, the Centers for Medicare and Medicaid Services (CMS) will be required to create billing modifiers that identify when telehealth services are delivered through a contracted third-party virtual platform, and when services are billed “incident to” another professional service. Today’s existing modifiers, such as 95 for synchronous audio-visual and 93 for audio-only, capture the modality of the service. The new modifiers will capture how care is being delivered and by whom, giving CMS greater visibility into the types of telehealth arrangements being used across Medicare. These new modifiers are expected to appear in CMS’s 2027 Physician Fee Schedule (PFS) proposals, which are typically released each summer and open for public comment before a November final rule.
Expanded Coverage for Cardiopulmonary Rehabilitation
Through the end of 2027, hospitals may furnish and bill Medicare for cardiopulmonary rehabilitation services delivered via live video to hospital outpatients in their homes. Previously, permanent policy only permitted reimbursement for physician office-based programs using telehealth, hospital outpatient departments were excluded. This temporary provision addresses that gap, enabling hospitals to extend supervised cardiac recovery programs to patients recovering at home. Notably, this waiver applies to live video only and does not include audio-only delivery.
Clinician Education on Medication-Induced Movement Disorders
CMS is required to educate Medicare clinicians by January 1, 2028 on screening for medication-induced movement disorders in at-risk patients, including best practices for conducting those screenings via telehealth and how to reflect them accurately in billing. Medications such as antipsychotics, antiemetics, and some antidepressants can cause involuntary motor symptoms including tremors and rigidity, and this provision charges CMS with making sure providers know how to assess for these conditions in a virtual setting. CMS may fulfill this requirement through a Medicare Learning Network fact sheet, an alert, or via the PFS, though given the January 2028 deadline, it may fall within the CY 2028 cycle rather than 2027.
Best Practices for Patients With Limited English Proficiency
Within one year of HR 7148’s enactment, the Department of Health and Human Services (HHS) must issue guidance on best practices for delivering telehealth services to patients with limited English proficiency (LEP). A 2024 JAMA study found that LEP patients reported poor telehealth experiences at a higher rate than English-proficient patients and were less likely to use video visits altogether, data that likely contributed to this directive. The guidance is intended to address those disparities and make virtual care more equitable across language barriers.
What to Watch
The CY 2027 Physician Fee Schedule, expected in July 2026, will likely be the primary vehicle CMS uses to implement several of these directives. For providers and healthcare organizations, that means now is a good time to review how telehealth services are currently documented, how third-party platforms factor into billing practices, and whether current workflows will need updating. SecureVideo will continue to monitor developments and share updates as new guidance is released. Stay tuned to future Telehealth Tuesday editions for the latest.