As the government shutdown continues to unfold, it’s important to understand how this situation impacts the home health and hospice community.
Since 2020, both home health and hospice have been permitted to conduct face-to-face encounters through telehealth under a waiver established during the public health emergency. Although that emergency has ended, the allowance for telehealth face-to-face visits continues to be extended.
It was anticipated that the telehealth allowance would receive another extension, potentially through December 31, if Congress had finalized budget or funding legislation for fiscal year 2026 by September 30. Since that did not happen, any face-to-face encounter dated October 1, 2025, or later must now be conducted in person for both home health and hospice.
For home health services, a face-to-face encounter must occur in a facility that either transfers or directly refers the patient to home health care. This encounter must be conducted by the certifying physician who will sign the home health plan of care, or by a nurse practitioner working in collaboration with that physician.
If a nurse practitioner or another non-physician practitioner authorized by your state is signing the home health certification, that practitioner must complete the face-to-face encounter, unless a qualifying encounter was already performed in a facility that directly referred the patient to home health.
For hospice, the face-to-face encounter must be conducted by the hospice medical director, a physician member of the interdisciplinary group (IDG), or a nurse practitioner who is an employee or volunteer of the hospice. Nurse practitioners that are contractors are not permitted to perform these encounters.
To reiterate, any face-to-face encounter dated October 1, 2025, or later must be conducted in person. Telehealth can no longer be used to complete these encounters.
If Congress later includes an extension in the finalized budget legislation, we’ll need to follow the new timeframes outlined there. It’s unlikely that any changes would apply retroactively, so any extension would most likely take effect from a future date specified in the legislation, if it is included at all.
Additionally, due to the government shutdown, there may be a minor delay in payments. Although payments were expected to continue, there was mention of a potential 10-day hold. Since home health payments already have a standard 14-day hold, you should not experience any significant disruption in payment processing by the Medicare MAC.
Finally, regarding surveys: if you are awaiting a recertification or an initial Medicare certification survey for home health or hospice, delays are expected unless the survey is being conducted by an accrediting body such as ACHC or CHAP. Accrediting organizations are expected to continue their survey schedules without interruption. However, surveys handled by state agencies will likely be delayed until the federal budget situation is resolved.
Healthcare Provider Solutions can support you in preparing for a survey or help clarify the face-to-face encounter requirements, we would be glad to assist. Don’t hesitate to reach out to us.
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