CMS Lifts Claims Hold for FQHCs and RHCs
Claims Now Being Processed
CMS has instructed all Medicare Administrative Contractors (MACs) to lift the temporary claims hold for dates of service on or after October 1, 2025. This includes services paid under the Medicare Physician Fee Schedule, ground ambulance transport, and FQHC and RHC claims. Behavioral and mental health telehealth claims are also now being processed.
Telehealth Services Still on Hold
Claims for other telehealth services, such as primary care or chronic care management visits, remain on hold. Many of the telehealth flexibilities introduced during the COVID-19 Public Health Emergency expired on October 1, 2025, and require new Congressional action to be reinstated.
What This Means for Health Centers
For now, only behavioral and mental health telehealth visits are eligible for payment. Other telehealth visits are not payable unless they fall under special provisions, such as those available to participating Medicare Shared Savings Program ACOs.
FQHCs and RHCs that continue providing non-covered telehealth services may consider issuing an Advance Beneficiary Notice (ABN) so patients understand potential out-of-pocket costs. CMS has indicated that further updates will depend on Congressional action.
Key Takeaway
Most FQHC and RHC claims are now being processed, but non-behavioral telehealth remains on hold until further notice.