Update on Medicare Payments Following the Recent Government Shutdown
The recent federal government shutdown created significant uncertainty for physician practices nationwide, primarily due to the temporary hold placed on some Medicare claims by the Centers for Medicare & Medicaid Services (CMS). We are pleased to report a major step toward resolving these cash-flow issues.
The Impact of the Hold
In response to the funding lapse, CMS had instructed Medicare Administrative Contractors (MACs) to temporarily pause the processing of certain claims with dates of service on or after October 1. While the statutory 14-day payment floor for electronic claims provided an initial buffer, a prolonged hold had the potential to severely impact the financial stability of many practices reliant on timely Medicare reimbursement. Specific areas, such as certain telehealth services, experienced a more complex hold due to the expiration of pandemic-era flexibilities.
Good News: Payments Are Moving!
PracticeForces have confirmed that CMS has instructed MACs to lift the holds on most claims paid under the Medicare Physician Fee Schedule (PFS).
- Crucially, PracticeForces are now seeing the positive results of this decision, with payments starting to be released. Practices should have begun receiving payments as of October 28, 2025 and with more payments expected to follow rapidly.
- This swift action helps restore predictable cash flow for essential medical services and provides immediate relief to the physician community.
What You Should Do Now
- Monitor Payments: Closely track your incoming CMS payments to ensure they align with your expected billing cycles.
- Check MAC Updates: For any remaining payment questions or specific claim types (like certain telehealth services, which may still be subject to a hold), refer to your individual Medicare Administrative Contractor’s website for the latest official guidance.
- Advocate: The recent instability underscores the need for a stable, predictable, and functional federal government to support the healthcare infrastructure.
The resumption of these critical payments is a welcome development for physicians who have continued to provide essential care throughout this period of political uncertainty. We will continue to monitor the situation for any further updates, especially concerning those services that remain affected.
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Physician Payment Update: Cash Flow Relief is Here!
The recent government shutdown caused significant financial stress for physician practices with the temporary CMS claims hold on payments under the Medicare Physician Fee Schedule (PFS). This pause created uncertainty and cash flow concerns across the nation.
The good news is here!
CMS has lifted the hold on most PFS claims. PracticeForces are now seeing the direct impact: Medicare payments have started rolling in again, beginning around October 28, 2025, with a surge of payments expected over the coming days and weeks!
