CMS Shutdown: What Physicians Need to Know and Why Advocacy Matters

During the current federal funding lapse, CMS has confirmed that Medicare and Medicaid will continue. However, with reduced staffing and expired program extensions, physicians should prepare for significant disruptions.

Impact on Physicians and Practices
The funding lapse has significant implications for physician practices. As outlined by the American Medical Association (AMA):
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• Medicare Telehealth Flexibilities: These have lapsed for most patients, except those receiving care for mental health or substance use disorders. For others, telehealth reverts to pre-pandemic restrictions—limited to rural areas and not available to patients in their homes.
• Audio-Only Services: The ability to provide audio-only care to Medicare patients has expired.
• Acute Hospital Care at Home: This program is no longer active.
• Other Program Expirations: Funding for community health centers, the National Health Service Corps, and teaching health centers with graduate medical education (GME) programs expired on September 30, 2025. Extensions for the work geographic practice cost index (GPCI) floor, special diabetes programs, certain hospital payment adjustments, and low-income outreach programs have also lapsed.
• Claims Processing: Medicare Administrative Contractors (MACs) have been instructed to hold claims for 10 business days. While this should have minimal impact due to the 14-day payment floor, delays are possible.

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Physicians experiencing issues tied to reduced CMS staffing or MAC delays are encouraged to contact AMA advocacy staff at [email protected] with the subject line “Medicare Payment Delay.”

NANS Advocacy
For neuromodulation specialists, these policy changes jeopardize timely access to care and disrupt training pipelines. That is why NANS continues to advocate on behalf of our members and the patients they serve. We are working alongside national partners, including the AMA, to safeguard physician practice stability, protect patient access, and ensure that neuromodulation therapies remain available when they are needed most.