Protecting Rural Telehealth Access Act
Sponsored By: Representative Pappas, Chris [D-NH-1]
Introduced
Summary
Expands rural telehealth access by removing location and technology limits and creating new payment rules for rural providers.
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- Rural patients would be able to receive Medicare telehealth from home and from any originating location beginning Jan 1, 2027. The bill also removes the Alaska and Hawaii store-and-forward restriction.
- Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), and Rural Health Clinics (RHCs) would get new payment rules. CAHs could be paid 101 percent of reasonable costs for distant-site telehealth unless they opt for another method, and FQHCs and RHCs would receive a separate telehealth rate set by the Secretary starting Jan 1, 2027.
- Audio-only calls would count as telehealth for specified services beginning Jan 1, 2027 and must be paid at parity with other telehealth methods. The Secretary would assess clinical appropriateness, require any needed in-person visits, and review audio-only use after five years.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Broader Medicare telehealth access
If enacted, the bill would expand where Medicare telehealth can be delivered. From enactment through December 31, 2026, an individual’s home could be an originating site but only for certain covered telehealth purposes. Beginning January 1, 2027, the home could be an originating site more broadly and the law’s geographic originating-site limits for telehealth would be removed for services on or after that date. The bill would also remove a rule that limited "store-and-forward" telemedicine to an Alaska or Hawaii demonstration program, allowing broader use upon enactment.
Medicare payment for audio-only visits
If enacted, starting January 1, 2027, certain audio-only phone calls would count as telehealth under Medicare for specified services. Qualified clinicians and facilities would be able to furnish those services by audio-only when clinically appropriate, subject to any initial in-person visit rule the Secretary sets. Payment would be the same as if the service used other telecommunication systems. The Secretary would review audio-only use and policy not later than five years after enactment and could add or remove services and billing codes.
Separate telehealth pay for community clinics
If enacted, Medicare would set a separate telehealth payment rate for Federally Qualified Health Centers and Rural Health Clinics. The Secretary would make a rate method that considers geography, allowable telehealth costs, and full telehealth delivery costs, and would create billing codes that reflect services. These rules take effect upon enactment, but beginning January 1, 2027, Medicare payment for certain telehealth services would only be allowed if the FQHC or RHC is a "qualified provider" with an established patient relationship as defined by the State. The Secretary may implement these changes by instruction or interim rule.
Medicare pay boost for Critical Access Hospitals
If enacted, Critical Access Hospitals (CAHs) could serve as distant-site telehealth providers and be paid by Medicare for telehealth they furnish. Payment to a CAH would generally equal 101 percent of the CAH’s reasonable costs for the telehealth services unless the CAH elects the alternate payment method in current law. Telehealth furnished by a CAH would count toward the CAH’s productivity measure. These rules would take effect upon enactment and apply when the CAH has an established patient relationship and the telehealth complements in-person care.
Sponsors & CoSponsors
Sponsor
Pappas, Chris [D-NH-1]
NH • D
Cosponsors
Rep. Nunn, Zachary [R-IA-3]
IA • R
Sponsored 2/9/2026
Roll Call Votes
No roll call votes available for this bill.
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