Act Now: Kidney Patients Could Lose Telehealth Coverage

On October 1, many COVID-era telehealth flexibilities ended. This may affect how some Medicare patients receive care. While most home dialysis patients and those in dialysis clinics can continue using telehealth, transplant recipients, people with kidney disease, and others may face new restrictions. Medicare may now require patients to be in a rural area and at an approved medical site for non-mental health care.

Table of Contents

• Telehealth for Home Dialysis Patients

• Telehealth in General

• When Patients May Notice Telehealth Disruptions

• Looking Forward

• Raise Your Voice

• ✅ Top 3 Takeaways

Telehealth for Home Dialysis Patients

For home dialysis patients, telehealth is still available, with some rules:

• Patients must have monthly in-person visits during the first three months of home dialysis.

• After that, virtual visits can be used to review treatment plans, adjust medications, and check access sites.

• Medicare still requires one in-person visit per quarter, reinstated after the COVID-19 Public Health Emergency ended in 2023.

This means home dialysis patients can continue to manage their care from home, while staying connected with their kidney care team.

Learn more about preparing for home dialysis.

Telehealth in General

For most other Medicare services, coverage is returning to pre-COVID rules:

• Patients usually must be in a rural area and at an approved medical site (not their home) for non-mental health care.

• Mental and behavioral health services remain covered via telehealth from any location.

• Certain clinicians in Accountable Care Organizations (ACOs) can still provide telehealth without geographic limits.

When Patients May Notice Telehealth Disruptions

Rule changes took effect on October 1, but it may take time to roll out. 

The Centers for Medicare and Medicaid Services (CMS) is temporarily holding telehealth claims for 10 days to see if flexibilities are extended. Claims filed during this time for eligible patients in approved settings will still be paid after the hold ends.

If flexibilities are not extended, Medicare may not cover certain telehealth visits. Eligible providers may then require patients to come to an approved medical site or ask them to sign an Advance Beneficiary Notice of Noncoverage (ABN), which explains that patients could be billed if Medicare denies coverage.

Patients should contact their provider or transplant program for guidance specific to their situation. Understanding these changes can help ensure telehealth continues to support ongoing care safely and effectively.

Looking Forward

There is broad, bipartisan interest in keeping Medicare’s telehealth flexibilities. Congress can act later this year to extend or restore many of these patient-friendly rules. The National Kidney Foundation (NKF) supports the CONNECT for Health Act, which would make COVID-19-era telehealth flexibilities permanent.

Learn more about the CONNECT for Health Act. 

Raise Your Voice

The bipartisan CONNECT for Health Act would make expanded telehealth flexibilities permanent. Without it, patients risk losing access to care they rely on.

Fill out NKF’s Action Alert to contact your senators today.

✅ Top 3 Take Aways

• Telehealth is essential for kidney patients, especially for rural patients and those with mobility issues or fatigue.

• The CONNECT for Health Act would make expand access and protect audio-only visits.

• You can help protect telehealth with NKF's Action Alert. 

© 2025 National Kidney Foundation, Inc.