Teletherapy continues to be an essential part of mental health care across the U.S. As federal rules shift and COVID-era flexibilities expire, therapists and clients should stay informed about what’s changing — and what remains available.
Here are the latest updates:
1. Updated Medicare Rules for Tele-Mental-Health
Many pandemic-era telehealth flexibilities have now expired, and Medicare requirements are shifting as a result. Beginning January 31, 2026, Medicare beneficiaries who want to use tele-mental-health from home will face new conditions:
- New Medicare tele-mental-health patients must have an in-person, non-telehealth visit within the previous 6 months before starting virtual therapy.
- To continue virtual care, all Medicare patients must have an annual in-person visit with their provider.
- Established patients (those who were already receiving tele-mental-health before these rules take effect) are generally exempt from the “6-month prior visit,” but still require yearly in-person visits.
- Audio-only sessions will remain covered, but only if the provider is capable of video sessions and the patient is unable or declines to use video. Documentation is required.
Sources:
CMS Telehealth FAQ (updated Nov 2025)
CMS Telehealth Guidance
What this means
- Therapists who accept Medicare must update their workflows, intake forms, and scheduling to track in-person visit requirements.
- Clients using Medicare should confirm whether they are considered “new” or “established” tele-mental-health patients and plan ahead for required in-person visits.
2. Teletherapy Use Remains High — for Mental Health
Even as regulations tighten, demand for teletherapy remains strong.
- A May 2025 Los Angeles Times report found that more Californians receive therapy via video or phone than exclusively in person, reflecting a sustained preference for remote care.
- National digital-health analyses show that mental health remains the #1 telehealth specialty by volume nationwide heading into 2026.
Sources:
Los Angeles Times (May 2025)
Agents of Change (2025)
What this means
- Therapists offering virtual appointments are meeting ongoing client demand.
- Clients should expect widespread availability of online therapy, even as insurance coverage rules evolve.
- Hybrid or private-pay options may become increasingly common.
3. Legislative Moves to Expand Telehealth Permanently
Not all news is restrictive — federal lawmakers continue to push for long-term telehealth reform.
- The CONNECT for Health Act of 2025, introduced with bipartisan support, seeks to permanently remove Medicare’s geographic restrictions and allow home-based telehealth without in-person requirements.
Whether this bill (or similar legislation) passes will significantly shape teletherapy access in the coming years.
Source: American Medical Association (2025)
What this means
- Therapists should monitor legislative updates — permanent reforms could dramatically improve access and reimbursement stability.
- Clients may see teletherapy become a long-term, fully supported care option if Congress codifies these expansions.
4. Temporary Disruptions and Continuing Resolutions
During the 2025 federal government shutdown, some CMS telehealth operations and claims processing were temporarily delayed. Shortly afterward:
- A continuing resolution passed in November 2025 extended critical Medicare telehealth flexibilities through January 30, 2026.
This helped ensure continuity for beneficiaries and providers while Congress debated long-term policy solutions.
Source: ACC News Story (2025)
What this means
- Therapists should stay aware of deadlines and temporary extensions affecting billing or coverage.
- Clients should confirm with their providers whether their teletherapy visits remain covered under current Medicare timelines.
Bottom Line
Teletherapy is here to stay — but the rules surrounding coverage, in-person requirements, and audio-only visits continue to evolve.
For therapists:
- Stay updated on Medicare policy.
- Adjust workflows to ensure compliance with annual and initial in-person visit rules.
- Consider offering private-pay options for patients who prefer consistent virtual care.
For clients:
- Teletherapy remains widely accessible and highly effective.
- Medicare users should check whether they fall under “new” or “established” tele-mental-health rules.
- Private-pay or hybrid care may offer more flexibility if insurance coverage becomes restrictive.
As 2026 approaches, teletherapy remains one of the most widely used and trusted formats for mental health support — and ongoing legislative actions may further shape its future.
