Medicare Update: Government Shutdown Impact

With the 2025 federal government shutdown now underway, CMS has issued several important updates that affect providers:

Claims Hold – Medicare Administrative Contractors (MACs) have been directed to hold certain claims for up to 10 business days. This precaution helps avoid reprocessing if Congress restores funding or extends flexibilities. Expect payment delays.

Telehealth Services – Many temporary Medicare telehealth flexibilities expired on October 1, 2025. Without congressional action, providers may need to consider Advance Beneficiary Notices (ABNs) for telehealth services not covered under permanent law.

Essential Services Continue – Medicare and Medicaid payments are expected to continue, since these programs are not tied to annual appropriations. However, processing may be delayed due to reduced staffing.

Non-Essential Activities Paused – CMS is scaling back non-critical activities (e.g., some surveys, oversight, and policy development). If you are waiting on a Medicare survey, expect delays.

We’re monitoring CMS and congressional updates closely and will keep our clients informed. For now, no action is required, but planning for possible delays is wise.

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