CMS has begun paying most Medicare claims with dates of service (DOS) in October 2025, but there are exceptions. On October 21, 2025, CMS instructed Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with DOS of October 1, 2025 and later for services under the Medicare Physician Fee Schedule, ground ambulance transport, and Federally Qualified Health Center claims. CMS is also processing telehealth claims for behavioral health services.
However, CMS directed MACs to continue holding payments for certain categories—primarily non-behavioral health telehealth services and acute Hospital Care at Home claims—pending further Congressional action on expired payment provisions from the Full-Year Continuing Appropriations and Extensions Act, 2025. For services not impacted by the expired legislative provisions, claims are being processed and paid as usual
What Claims Are Now Being Paid?
The agency has instructed Medicare Administrative Contractors (MACs) to lift the payment hold for key categories:
- Services under the Medicare Physician Fee Schedule (PFS)
- Ground ambulance transport
- Claims for Federally Qualified Health Centers (FQHC)
- Behavioral health telehealth services
These types of claims are now processing and being paid for dates of service beginning October 1, 2025.
Which Claims Are Still On Hold?
Payments remain on hold for a few specialized categories:
- Non-behavioral health telehealth services
- Hospital Care at Home claims
These claims require additional Congressional action for legislative renewal of payment provisions and will be released once new directives are issued.
CMS October 2025 Payment Status Chart
See the quick reference chart below for the current payment status:
| Service Type | DOS in October 2025 | Payment Status |
|---|---|---|
| Physician Fee Schedule (in-person) | Yes | Paid/Processing |
| Ground Ambulance | Yes | Paid/Processing |
| Federally Qualified Health Center (FQHC) | Yes | Paid/Processing |
| Behavioral Health Telehealth | Yes | Paid/Processing |
| Non-behavioral Telehealth | Yes | Still on hold |
| Hospital Care at Home | Yes | Still on hold |
CMS Payment Status for October 2025 DOS Claims
Key Takeaways
- Most routine and behavioral health claims are being paid as of late October 2025.
- Some telehealth and specialty care claims remain on hold pending Congressional legislation.
- Providers can continue submitting claims; check with your MAC for guidance if your services are affected.
For up-to-date information, consult CMS bulletins and advocacy updates as payment policies may evolve quickly
