In a move that could significantly impact the future of behavioral health care, Congress is working through a $1.5 trillion federal funding bill that includes a critical mental telehealth policy delay. Specifically, the legislation would postpone the implementation of a controversial requirement that Medicare patients must be seen in person within six months of receiving mental health services via telehealth.
The Consolidated Appropriations Act of 2022, released Wednesday, outlines government spending through the end of the fiscal year in September and spans over 2,700 pages. While it touches on a wide range of federal programs and agencies, one of the more consequential provisions in the health care space involves the future of mental telehealth services.
Telehealth use surged during the COVID-19 pandemic, becoming a primary means of delivering behavioral health care. However, under rules finalized before the pandemic’s peak, Medicare beneficiaries were expected to return to in-person care standards—requiring face-to-face visits within six months of a virtual mental health appointment. If the new spending bill is passed, that requirement would be delayed until 152 days after the official end of the Public Health Emergency (PHE), offering a critical extension for both patients and providers.
What the Public Health Emergency Meant for Telehealth Access
The Public Health Emergency, first declared on March 13, 2020, by President Donald Trump, created a regulatory framework that allowed the federal government to respond swiftly and flexibly to the COVID-19 pandemic. One of the most significant actions taken during this time was the expansion of telehealth coverage, particularly under Medicare.
This emergency declaration, which has been renewed multiple times—including as recently as January 14—enabled behavioral health providers to conduct sessions with Medicare patients virtually, even via audio-only calls. The PHE is currently set to expire on April 14, unless renewed again. With the proposed mental telehealth policy delay, these expanded telehealth flexibilities would remain in place for 151 days beyond that expiration date.
During that grace period, providers would be able to continue serving Medicare beneficiaries without the added burden of meeting in-person requirements. This offers a temporary but much-needed reprieve as the country transitions out of pandemic-era health care protocols.
Telehealth’s Rapid Rise Among Medicare Patients
The behavioral health sector was one of the first to adopt telehealth at scale during the pandemic. In fact, the federal government recorded a 3,090% increase in the use of telehealth for behavioral health visits in 2020 compared to 2019. By the end of 2020, approximately 38% of all behavioral health visits were conducted virtually.
This surge not only reflected necessity but also patient preference. Many Medicare beneficiaries—particularly seniors, rural residents, and individuals with limited mobility—found virtual mental health services more accessible than traditional, in-person models. The mental telehealth policy delay reflects growing acknowledgment in Congress that this shift toward virtual care cannot simply be rolled back without serious consequences.
Lawmakers and stakeholders across the behavioral health field have expressed concern that reintroducing in-person mandates too quickly could create new barriers to care. The delay gives Congress and federal health agencies more time to assess the long-term policy framework for virtual behavioral health care.
In-Person Requirements: Why the Delay Matters
Before the pandemic, Medicare coverage for telemental health was already limited. It required patients to live in rural areas and travel to approved sites to access virtual care. The PHE allowed for widespread flexibility, including the ability to conduct telehealth appointments from a patient’s home. It also allowed for a broader set of technologies—including audio-only phones—to be used for these visits.
However, post-pandemic rules were set to reintroduce face-to-face visit requirements, mandating that all patients receiving telehealth mental health care under Medicare have an in-person appointment within six months of starting virtual treatment, with annual in-person check-ins thereafter.
The mental telehealth policy delay would temporarily hold off on enforcing this mandate. Supporters argue this delay is essential to prevent care disruptions for vulnerable populations. Critics of in-person mandates point out that requiring travel and in-person presence—especially for those dealing with severe mental illness or mobility issues—can create unnecessary burdens.
Telehealth Flexibilities Extended Across More Provider Types
The spending bill not only impacts mental health care—it also expands telehealth reimbursement for additional provider types. If passed, occupational therapists, physical therapists, speech-language pathologists, and audiologists will gain access to the same flexibilities behavioral health professionals currently enjoy. This broadens access across specialties, encouraging a more integrated, flexible health care delivery system.
As telehealth becomes a more permanent fixture in American health care, this move signals bipartisan support for extending virtual services across disciplines. It also reflects recognition that pandemic-era innovations in care delivery have long-term value beyond the immediate crisis.
Lawmakers Aim to Avoid Disruption in Care
The House of Representatives announced Wednesday that a deal had been reached to pass the spending bill, with a vote planned for the same day. However, given the slim Democratic majority and the looming funding deadline, lawmakers also prepared a stopgap measure to keep the government running should the bill stall in the Senate.
Inclusion of the mental telehealth policy delay has been widely seen as a win for behavioral health providers and advocates who have been calling for more time to adjust to regulatory changes. The five-month extension window ensures continuity of care for the millions of Americans relying on virtual behavioral health services—especially Medicare patients who may otherwise be at risk of losing access to their providers.
What Happens After the Delay?
While the delay offers temporary stability, questions remain about the long-term future of mental telehealth policy. Will Congress move to make pandemic-era telehealth flexibilities permanent? Will hybrid care models become the new standard of care for Medicare patients?
The mental telehealth policy delay gives lawmakers a critical window to gather data, engage with stakeholders, and craft thoughtful policy. It also allows time to measure patient outcomes, provider feedback, and infrastructure readiness before implementing stricter in-person rules.
For now, patients and providers can take comfort in the fact that access to mental health care via telehealth will continue uninterrupted—at least for the near future. But with the PHE expected to end soon and with regulatory uncertainty on the horizon, the behavioral health sector will be watching closely to see whether the delay turns into permanent policy reform.
A Turning Point for Behavioral Health Policy
The pandemic dramatically reshaped how mental health care is delivered in the United States. Telehealth, once a niche offering, has become a core component of care—especially for older adults and individuals in underserved areas.
The inclusion of a mental telehealth policy delay in the federal funding bill acknowledges this transformation. While the delay itself is temporary, it offers more than just a reprieve. It represents a critical turning point—a chance to rethink how we deliver behavioral health care in a way that is more accessible, equitable, and effective.
