2025-11-21 - Update on Processing of Medicare Claims Impacted During the Government Shutdown
AI Summary
Congressional action retroactively restored Medicare telehealth payment provisions effective October 1, 2025 through January 30, 2026. Previously returned telehealth claims can now be resubmitted, and the requirement to use GY modifiers on certain telehealth claims has been rescinded.
Action Required
Immediately: 1) Resubmit all telehealth claims that were returned with CARC 16 and RARC M77 messages between October 1-November 10, 2025. 2) Remove GY modifiers from previously denied telehealth claims and resubmit. 3) Identify patients charged for telehealth services from October 1, 2025 forward and submit claims to Medicare, refunding any patient overpayments. 4) Resume normal telehealth claim submission for home-based services. Claims processing should return to normal operations within days.
Plan Types
Traditional Medicare
Specialties
all-specialties