Government Shutdown Resources

Government shutdown updates

Updated November 21, 2025

Strengthen the voice of neurology

on how the government shutdown impacted you. The AAN will use these stories to illustrate to policymakers the challenges and experiences our members faced during the shutdown while delivering neurologic care.

Shutdown update

A record 43-day US government shutdown ended Wednesday, November 12, when President Donald Trump signed a continuing resolution passed by the House and Senate to provide funding through January 30,2026.

Many of our members experienced serious negative impacts from the shutdown on their practice and their patients, and we’re pleased to see this difficult situation end. However, there is still far more work to be done.

As Congress continues to seek a longer-term funding agreement before January 30, we’ll remain persistent in our advocacy for our members and the patients they serve. Keep up to date on our advocacy—as well as opportunities to join us—by reading Capitol Hill Report, our biweekly advocacy newsletter.

Telehealth

The continuing resolution included an extension of Medicare telehealth flexibilities that were in place during the COVID-19 Public Health Emergency until January 30. Through this date, the Centers for Medicare & Medicaid Services (CMS) is permitted to pay for telehealth claims in all geographic originating sites, including a patient’s home and via audio-only modalities.

Congress retroactively restored telehealth payment provisions for services that were provided on or after October 1, 2025. CMS previously instructed Medicare Administrative Contractors to return a subset of held claims that were not payable under statute during the shutdown. Professional claims were returned with the following messages: CARC 16 and RARC M77. These claims are now payable, provided they meet all applicable Medicare requirements. Practitioners may resubmit returned and/or previously denied claims to CMS, as well as submit any other telehealth claims that were held in anticipation of possible Congressional action. CMS’s instruction to append the GY modifier on certain telehealth claims has been rescinded.

CMS also encourages practitioners to identify which beneficiaries were charged for telehealth services with dates of service on or after October 1, 2025, that are retroactively payable and instead submit applicable claims to Medicare, refunding any overpayment to beneficiaries.

The lapse in telehealth flexibilities during the shutdown created significant confusion for our members and the patients they serve. As part of our advocacy, we’ll inform congressional leadership that it’s unacceptable to allow these lapses in telehealth access and strongly advocate for a permanent or multi-year extension of these important flexibilities.

Fiscal year 2026 appropriations

Finally, the continuing resolution included three full-year appropriations bills that fund, among other things, the legislative branch, the Department of Veterans Affairs (VA), and the Food and Drug Administration (FDA). This means that these departments are fully funded for FY 2026 and would not be subject to a lapse in funding if an agreement is not reached on the other nine appropriations bills by January 30.

Notably, the AAN was able to secure a significant victory in the VA funding bill. Through our advocacy, we secured a 15% increase in funding for the VA Neurology Centers of Excellence. These centers allow our members to provide the best possible neurological care to veterans, and we appreciate Congress continuing to see the value they provide.

Neuroscience research

The continuing resolution provided funding for the National Institutes of Health (NIH) through January 30. Furloughed employees should be called back to work, and normal operations at the NIH should resume. If you are seeing any delays in funding from the shutdown, or seeing continued issues as the NIH reopens, please let us know. The AAN will continue to strongly advocate for full FY 2026 funding for the NIH through the Labor-H appropriations bill.

If you have any questions about the shutdown or our advocacy, please contact us at advocacy@aan.com.

View past government shutdown updates

Effects of a government shutdown

Congress failed to pass federal spending legislation by its September 30 deadline, causing the US government to shut down—meaning non-essential federal employees cannot report to work and many services have been paused until Congress reaches an agreement to fund the government. Some past shutdowns have lasted only a couple of days, while a handful of others—like the record 35-day shutdown that started in December 2018—have stretched for weeks. about how a government shutdown could impact you and your patients.

How the shutdown affects claims and reimbursements

The Medicare program will continue to reimburse claims through a shutdown; however government shutdown for any period of time could result in delays in claims processing, audits, and other administrative functions.

The Centers for Medicare and Medicaid Services (CMS) will continue to pay Medicaid reimbursement as long as funds allow without a reauthorization in appropriations. CMS will have sufficient funding for Medicaid to fund the first quarter of FY 2026, based on the advance appropriation provided for in the Full-Year Continuing Appropriations and Extensions Act, 2025. In addition, CMS employees who answer Medicare billing questions and process enrollment applications are paid through annual appropriations and could be affected by the shutdown.

The Department of Veterans Affairs (VA) is still requiring physicians to report to work and deliver clinical care, though there will be a delay in reimbursement and administrative functions. The VA will release guidance to people who are affected, and we will share more information once the VA releases its shutdown contingency instructions.

Telehealth extension

Congress previously extended the Medicare telehealth flexibilities that stemmed from the COVID-19 Public Health Emergency until September 30, 2025. These flexibilities permitted CMS to pay for telehealth claims in all geographic originating sites, including the patient’s home, and via audio-only modalities for non-mental health services. Congress was unable to pass legislation to continue these flexibilities, causing them to expire as of October 1.

This means that reimbursement for fee-for-service Medicare patients will be limited to certain rural areas and originating sites, such as a physician’s office. Medicare also will not reimburse additional practitioners, such as therapists, for telehealth services. In past shutdowns, whenever Congress passed legislation to reopen the government, it made the funding and policies retroactive to the effective date of the shutdown; however, there is no guarantee that Congress will do this for telehealth.

This explainer from the Alliance for Connected Care, of which the AAN is a member, gives more details on how a lapse in flexibilities could impact care, including information about patients enrolled in a Medicare Advantage plan. CMS has also updated its to reflect the impacts of the expired flexibilities in the context of previously finalized agency regulations for CY 2025.

Telehealth claims and reimbursement

Earlier in the shutdown, CMS instructed Medicare Administrative Contractors to hold telehealth claims for services provided on or after October 1, 2025 that are impacted by the expiring legislative flexibilities. However, due to system limitations, CMS has been unable to accurately identify all claims that are payable under current law. Therefore, that it will return to providers the subset of telehealth claims that were submitted on or before November 10, 2025, and are currently being held. Professional claims will be returned with the following messages: CARC 16 and RARC M77.

Practitioners who choose to submit telehealth claims that meet applicable requirements under current law should review the billing guidance outlined by CMS in the announcement. These services include those provided by clinicians in applicable Medicare Shared Savings Accountable Care Organizations (ACOs) and certain mental health and ESRD services.

In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to consider providing beneficiaries with an , as it is not guaranteed that Congress will approve retroactive payment for these services.

Lastly, if practitioners choose not to hold telehealth claims, CMS states they may submit them by appending the GY modifier to inform Medicare that the practitioner performed a telehealth service that is currently statutorily excluded from payment, and the claim will be denied, affording the beneficiary and practitioner with the rights of a denied service.

Medicare physician reimbursement fix

The reconciliation bill signed into law on July 4, 2025, included a 2.5% positive adjustment to physician reimbursement under Medicare in 2026. This congressional fix to cuts included in the Medicare Physician Fee Schedule (MPFS) usually happens concurrently with appropriations for the next fiscal year, but is not part of the current government funding conversation. The AAN will continue to work with policymakers to find long-term, structural changes to the MPFS that will help appropriately value the delivery of neurological care.

How does the shutdown affect NIH and research funding?

Current National Institutes of Health (NIH) grantees will continue to be able to draw from their award as long as no problems arise. If a drawdown of funds triggers an edit check or limit control, grantees cannot continue accessing funds, with assistance likely unavailable from the NIH. Any direct clinical care being provided through the NIH Clinical Center will continue, as well as medically necessary admittance of new patients.