Congress extended Medicare telehealth waivers through December 31, 2027 as part of the Consolidated Appropriations Act, 2026. Physical therapists, occupational therapists, and speech-language pathologists continue to qualify as distant-site practitioners under the temporary rules.

Eligible services include many of the timed therapy codes you already use in the clinic. The extension preserves the ability to furnish care when the patient is in their home. The home counts as an originating site without geographic restriction for the duration of the extension.

Modifier use differs between Medicare and some commercial payers. Medicare requires modifier 95 on telehealth claims during the public health emergency waivers. Some commercial plans still expect modifier GT. Verify the required modifier with each payer before submitting claims to avoid denials.

Audio-only services face tighter rules. Medicare generally requires audio-visual technology for therapy services. Audio-only encounters receive payment only when the patient lacks access to video-capable equipment and the therapist documents that limitation in the record.

Documentation requirements remain consistent with in-person care. The note must support medical necessity, include the same functional outcome measures, and record the technology used for the encounter. You must also note the patient’s location and confirm consent for telehealth delivery.

Commercial payer policies vary. Several large carriers aligned with Medicare’s extension and continue to cover telehealth physical therapy through at least the end of 2027. Others have announced earlier sunset dates. Maintain a payer-specific grid that lists current telehealth coverage status and required modifiers.

The 2028 cliff remains a planning consideration. Without further legislation, expanded practitioner eligibility ends on January 1, 2028. Physical therapists would no longer qualify as distant-site providers under the pre-pandemic statute. Practices that built telehealth volume may want to model revenue impact under both continuation and reversion scenarios.

You can reduce compliance risk by training therapists on platform selection that meets HIPAA standards and by running monthly audits of telehealth documentation completeness. Clear internal guidelines on when telehealth is appropriate versus when an in-person visit serves the patient better protect both clinical outcomes and claim integrity.

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