On September 30, some of the federal COVID-era telehealth waivers expired, resulting in a rollback of coverage for several telehealth services under Medicare. This shift has left many providers and patients uncertain about what virtual care options would remain available.
“The good news: there was no opposition in the House to the bill/continuing resolution that included these waivers, so bipartisan support remains strong. Most are confident the flexibilities will be restored once Congress reaches a budget deal—hopefully sooner rather than later, and not as drawn out as the last shutdown,” Kathy Wibberly, PhD, Director of the Mid-Atlantic Telehealth Resource Center shared in a recent post.
Under new guidance released October 1, the Virginia Department of Medical Assistance Services (DMAS) confirmed that Virginia Medicaid telehealth flexibilities will remain in place. The DMAS guidance for providers stated:
“States have the flexibility to design its telehealth delivery methods and services, as long as it continues to meet the requirements of the overarching provisions in Title XIX of the Social Security Act (the Act), regulations, the federal policy framework of the covered Medicaid benefit, and the parameters of the state’s CMS-approved Medicaid state plan or a subsequent state plan amendment (SPA).
Virginia Medicaid will continue to cover all current Telehealth flexibilities at this time. The Telehealth Flexibilities that are projected to end on September 30, 2025, are in regard to Medicare.”
The provider guidance includes new updates to Virginia Medicaid’s Telehealth Services Supplement that broaden access and give providers more flexibility in delivering care to Medicaid members.
What’s Changing Under Virginia Medicaid:
- Remote patient monitoring (RPM): Coverage clarified for high-risk pregnant patients (including those with maternal diabetes and hypertension) and for patients with chronic or acute conditions.
- Provider requirements: Telehealth-only providers and provider groups no longer need a physical Virginia office address to enroll with Medicaid.
- Expanded covered services: More telehealth options—including audio-only, audio-video, virtual check-ins, and RPM—are now reimbursable.
- Administrative reminder: Providers must keep their enrollment, license, and contact information up to date in the PRSS portal to avoid claim disruptions.
Together, these updates reinforce Virginia Medicaid’s commitment to keeping telehealth accessible, even as Medicare’s coverage narrows.
Read the full DMAS bulletin for complete detail here: https://vamedicaid.dmas.virginia.gov/bulletin/telehealth-services-update-3.
Additional Resources:
- How to prepare for the telehealth cliff and the end of Medicare telehealth coverage
- The Telehealth Policy Cliff: Preparing for October 1, 2025 (MATRC)
- Medicare and Mental Health Coverage, a guide on telemental health in-person requirements now in effect (CMS)