Medicare Telehealth for PT, OT, and SLP: The 2026 Rules

The answer first, because most of what ranks for this question is out of date: as of August 2026, physical therapists, occupational therapists, and speech-language pathologists are eligible Medicare telehealth practitioners, and the authority runs through December 31, 2027. The patient’s home is a valid originating site, there is no rural restriction, and the therapy codes you’d expect are on the Medicare Telehealth Services List.

What that paragraph hides is that the authority is still temporary. It has lapsed twice, been restored retroactively twice, and now rides on Section 6209 of the Consolidated Appropriations Act, 2026 (H.R. 7148, enacted February 3, 2026). The next cliff is January 1, 2028. This guide covers the current rules and the mechanics, with everything dated, because in this corner of Medicare the date on your source is the whole game.

How we got here: the extension treadmill

Therapists were added as telehealth practitioners by pandemic-era authority, and Congress has been extending that authority in shrinking increments ever since. The full sequence, each law amending Social Security Act §1834(m):

Both lapses were erased retroactively. During the shutdown lapse, CMS had contractors hold and then return affected telehealth claims; after the November restoration, CMS confirmed the flexibilities applied “as if there hadn’t been a temporary lapse” and told practices to resubmit returned claims and refund any beneficiaries charged for retroactively payable services. The February 2026 law amended the prior end date itself, so the four-day January gap closed with no statutory hole, though CMS published less gap-specific guidance for that window.

The operational lesson from both episodes: when an extension deadline approaches without a signed law, hold telehealth claims rather than submitting them into a denial, because retroactive restoration has been the pattern and resubmitting held claims is cheaper than working denials.

CMS’s therapy services page now reflects the current state: PTs, OTs, and SLPs may furnish telehealth services, including telephone assessment and management codes 98966 to 98968, through December 31, 2027.

Where the patient and therapist can be

Through December 31, 2027, the pre-pandemic geography rules stay suspended (§1834(m)(2)(B)(iii) and (4)(C)(iii), as amended):

• The patient’s home is a valid originating site, and no rural or health professional shortage area requirement applies. No originating-site facility fee is paid when the patient is home.
• The therapist can furnish telehealth from home. Practitioners with an enrolled practice location do not need to add their home address to their Medicare enrollment, and the CY 2026 rule added a PECOS option to suppress a home address from public display (MLN901705, Dec. 2025 edition).

If Congress does nothing before 2028, the baseline that returns is the pre-2020 framework: rural facility originating sites only, home ineligible for therapy, and PT/OT/SLP off the practitioner list entirely.

Which codes are on the telehealth list

The CY 2026 Medicare Telehealth Services List includes the core outpatient therapy codes: therapeutic exercise (97110), neuromuscular re-education (97112), gait training (97116), therapeutic activities (97530), self-care/home management training (97535), PT evaluations and re-evaluation (97161 to 97164), OT evaluations and re-evaluation (97165 to 97168), plus 97129/97130, 97542, 97750, 97755, 97760, and 97761, and the common SLP codes (92507, 92521 to 92524, 92526).

A structural change worth knowing: the CY 2026 Physician Fee Schedule final rule (CMS-1832-F) eliminated the “provisional” versus “permanent” distinction on the list. The therapy codes, formerly provisional, are now simply on the list, and CMS considers listed services permanent. So the annual suspense about whether 97110 survives the list review is over. The binding constraint is no longer the code list; it’s the statutory practitioner eligibility date of December 31, 2027.

Billing mechanics

For therapists in private practice billing professional claims, current as of August 2026 (MLN901705):

• Place of service tells Medicare where the patient was. POS 10 for telehealth in the patient’s home; POS 02 for telehealth anywhere else. The distinction is not cosmetic: POS 10 pays the full non-facility PFS rate, while POS 02 pays the lower facility rate. Miscoding home visits as POS 02 quietly underpays you.
• Audio-only gets modifier 93 (more below).
• Everything else about therapy billing still applies. The 8-minute rule governs timed-code units exactly as in the clinic. Discipline modifiers (GP, GO, GN) are still required, assistant-furnished minutes still take CQ/CO, and accrual still counts toward the $2,480 KX threshold. A telehealth visit is a normal therapy visit that happens to be remote.

Hospital outpatient departments, rehab agencies, CORFs, and SNFs billing Part B put modifier 95 on the therapy line of institutional claims instead; payment runs at PFS rates. This institutional pathway rests on CMS guidance layered onto the same statutory extension, and it shares the same 2027 end date. One boundary: therapy bundled into a Part A SNF stay is consolidated billing and can’t be carved out as telehealth.

Audio-only, and its limits for therapy

Two rules stack here. The statute extends audio-only telehealth authority through December 31, 2027. Separately, a permanent regulation (42 CFR 410.78(a)(3), effective January 1, 2025) allows any telehealth service to be furnished audio-only when the patient is at home and either can’t use or doesn’t consent to video, provided the practitioner is capable of video. You attest to those conditions by appending modifier 93; no additional documentation is required.

In practice, most 97-series interventions presuppose seeing the patient move, so audio-only sessions of therapeutic exercise are a clinical and audit stretch even where technically permitted. The purpose-built audio vehicle is the telephone assessment and management set, 98966 to 98968, which therapists can bill through December 31, 2027.

Supervision went remote too

Two changes adjacent to telehealth matter for staffing models:

• Since January 1, 2025, Medicare requires only general supervision of PTAs and OTAs in private practice, matching the institutional standard, so the supervising therapist no longer needs to be in the suite. State practice acts can be stricter and often are.
• Where direct supervision is still required, the CY 2026 rule made virtual direct supervision permanent: immediate availability can be met through real-time two-way audio-video (audio-only doesn’t count).

Medicare Advantage plays by different rules

Everything above is fee-for-service. Medicare Advantage plans have had separate authority since 2020 (42 CFR 422.135) to cover any Part B service via telehealth as a basic benefit, at the plan’s discretion, using contracted providers. An MA patient’s telehealth coverage depends on their plan’s benefit design, not on the congressional extension cycle. Verify per plan; don’t assume FFS rules in either direction.

What to do with a 2027 expiration date

Treat telehealth as a real service line with a known regulatory horizon. Three concrete moves:

1. Bill it correctly now. POS 10 versus 02, modifier 93 where it applies, and normal therapy modifiers on every claim. Sloppy telehealth claims are the ones that get relitigated when rules churn.
2. Watch for the new platform modifiers. Section 6209(g) requires HHS, by January 1, 2027, to mandate claim modifiers for telehealth furnished through third-party virtual platforms and incident-to arrangements. Expect implementation guidance in the CY 2027 rulemaking.
3. Plan for January 1, 2028 as a real cliff. Congress has extended five times, but twice now the extension arrived after the deadline. If telehealth is material revenue, know which patients and visit types you’d transition, and have the claims-hold playbook ready.

Telehealth billing is ordinary therapy billing with three extra fields that are easy to get wrong. PrismEHR includes telehealth in the platform rather than as a bolt-on, and the same billing rules that enforce the 8-minute rule and modifier requirements at the point of documentation apply to remote visits, so a POS or modifier problem surfaces while the note is open, not on a remittance. See how it fits physical therapy practices, or start with the denial-prevention guide for the rest of the claims picture.