CMS walks back Medicare payment pause

By Erica Cerutti / October 16, 2025

CMS has clarified that only select Medicare claims will be held amid the ongoing federal government shutdown, walking back an earlier notice that suggested a broader payment pause.

“In light of the continuing government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for services impacted by the expired provisions,” the agency said in an Oct. 15 notice. “To date, no payments have been delayed as statute already requires all claims to be held for a minimum of fourteen days, and this recent hold is consistent with that statutory requirement. Providers may continue to submit claims accordingly.”

An earlier version of the notice stated that all payments under the Medicare Physician Fee Schedule, ground ambulance transport claims and all federally qualified health center claims would be temporarily held.

The updated notice specifies that only claims tied to lapsed legislative provisions — such as those for non-behavioral telehealth visits, hospital-at-home care and hospice face-to-face recertifications — will be affected by the hold.

Provisions for those programs expired Oct. 1 after Congress failed to pass a funding bill. The lapse has already led to service disruptions at hospitals and health systems across the country.

About 30% of hospitals have halted Medicare telehealth services amid the shutdown, according to estimates from the American Telemedicine Association. Many systems have also discharged or transferred hospital-at-home patients back to capacity-strained brick-and-mortar facilities as CMS reimbursement for the model lapsed.

The federal shutdown is now in its third week. A House-approved spending bill — which failed for the eighth time in an Oct. 14 Senate vote — would extend funding for telehealth flexibilities, hospital-at-home, and several rural hospital programs through Nov. 21. However, it excludes an extension of enhanced ACA premium subsidies, which Democrats have said must be included in any funding deal. Senate Democrats’ competing proposal, which includes an extension of the subsidies and would reverse Medicaid spending reductions passed under the One Big Beautiful Bill Act, has also stalled.