During a system upgrade from Friday, Dec. 5, through Sunday, Dec. 7, the AAFP website, on-demand courses and CME purchases will be unavailable.
Federal government shutdown: What family physicians need to know—and do
Updated Oct. 16, 2025, News Staff—Congress has failed to pass a full slate of appropriations bills before the Sept. 30 end of fiscal year 2025, resulting in a shutdown of the federal government. Lapsed funding for HHS means potential disruption to health care programs and procedures affecting family physicians.
New guidance from CMS says clinicians may continue to submit claims, but the agency notes that it has suspended payment for telehealth and other expired programs. The AAFP is in touch with CMS and will keep members updated.
Lapsed funding as of Oct. 1
Programs whose funding has lapsed include
- the Teaching Health Center Graduate Medical Education (THCGME) program,
- the Community Health Center (CHC) Fund (which is responsible for about 70% of the federal money supporting community health centers) and
- the National Health Service Corps.
The Academy in recent weeks pushed Congress to ensure uninterrupted funding for these health-extender programs, and long-term stability for all three has been a top AAFP policy priority for years.
In an Oct. 1 letter to the Health Resources and Services Administration (HRSA), the AAFP warned that any disruption to THCGME and CHC funding would affect patient care and jeopardize the future primary care workforce.
“It is critically important HRSA clarify that, even in the event of a government shutdown, these programs will be able to maintain their recruitment schedule and keep training the next generation of U.S. primary care physicians uninterrupted,” the Academy said.
Potential Medicare payment decrease
Also expired as of Sept. 30: the 1.0 floor for work geographic practice cost indices (GPCIs), which adjust relative value units in Medicare payment to reflect regional differences in the cost of physician services. Congress has routinely renewed GPCI as part of the formula for Part B reimbursement; without it, some clinicians could see a decrease in reimbursement. Congress must extend the GPCI provision again to stave off such a cut.
Tell Congress to invest in crucial primary care programs and preserve Medicare telehealth
Because the federal shutdown means that congressional staff aren’t monitoring email inboxes, the AAFP urges members to call their lawmakers’ offices. This Speak Out includes a phone script.
Expired: Medicare telehealth flexibilities
Because Congress has not extended the Medicare telehealth flexibilities enacted during the pandemic (which expired Sept. 30), millions of Medicare beneficiaries face losing access to essential care. The shutdown brings an immediate halt to
- expanded originating sites,
- many audio-only services and
- delayed in-person requirements for virtual mental health services.
Federally qualified health centers (FQHCs) and rural health clinics (RHCs) can continue to provide most telehealth services as distant-site providers through Dec. 31.
What the AAFP is doing to secure permanent telehealth coverage
The AAFP continues to call on Congress to enact legislation that would make Medicare telehealth flexibilities permanent, arguing that they have transformed care delivery, especially for older adults as well as patients with mobility limitations and in rural or underserved communities. Past extensions have shown that telehealth flexibilities have broad bipartisan support.
Medicare beneficiaries who can still receive telehealth services
Medicare telehealth is now limited to patients
- at an eligible originating site and within specific geographic area or
- receiving mental/behavioral health services (that meet the criteria below).
Medicare telehealth for mental/behavioral health services do not need to meet the originating and geographic site requirements (meaning they can remain at home) if the patient
- is being treated for substance use disorder and a co-occurring mental health condition or
- had an in-person visit with the telehealth physician or clinician within six months prior to the initial telehealth visit and every 12 months thereafter. (The in-person visit may be with another physician or clinician in the same subspecialty within the same group practice if the original physician or clinician is unavailable.)
The originating site must be in
- a rural health professional shortage area,
- a county that is not in a Metropolitan Statistical Area or
- within a federal telehealth demonstration project.
Eligible originating sites include physician offices, FQHCs, RHCs, critical access hospitals and hospitals. To see if an address is an eligible site, use the Medicare Telehealth Payment Eligibility Analyzer.
Audio-only telehealth is limited to the treatment of mental/behavioral health conditions when the patient is at home.
For additional detailed guidance about telehealth during the shutdown and absent Medicare flexibilities, consult the National Consortium of Telehealth Resource Centers’ webpage.
Other payers’ telehealth policy
The flexibilities that expired on Sept. 30 apply only to traditional Medicare (Part B) patients. Medicaid, Medicare Advantage and commercial policies will vary by state and payer. Contact your state Medicaid and provider relations representatives to get their policies.
Affected federal health care agencies include HHS and CMS
The Office of Management and Budget has cautioned that permanent reductions in force across federal agencies could occur, delaying regulatory reviews and appeals.
HHS and its subagencies (including CMS) staff on a contingency basis during shutdowns, which may slow rulemaking and other agency decisions and actions.
Clinicians can continue seeing and billing Medicare patients during the shutdown, but CMS oversight of contractors may be suspended, potentially affecting complaint resolution. Routine CMS surveys and certifications are suspended.
What happens next?
In past shutdowns, legislation passed to reopen the government has generally made funding and policies retroactive to the closure’s first day.
The AAFP will continue to provide timely updates on the shutdown’s status.
This article was originally published Oct. 1, 2025. It was updated on Oct. 16 with information about new payment guidance from CMS.