The COVID-19 public health emergency ended on May 11, 2023. HHS's Office for Civil Rights ended its telehealth enforcement discretion with a 90-day transition period for providers to bring remote communication tools into HIPAA compliance. Medicare telehealth flexibilities, including physical therapists as telehealth practitioners, had been extended by the Consolidated Appropriations Act, 2023, through December 31, 2024, and were extended again later. For PT clinics, 2023 was the year to make virtual care compliant and clearly described.
During the pandemic, physical therapy clinics learned to treat patients by video. Exercise progressions, home program reviews and follow-ups moved online, often using whatever video tool was available. Temporary federal flexibilities made that possible. When the COVID-19 public health emergency ended on May 11, 2023, many clinics assumed those options would disappear.
They did not, at least not all at once. Congress had already extended key Medicare telehealth flexibilities, and the real changes in 2023 were about privacy compliance and clarity. For PT clinics, the year was a chance to turn improvised virtual care into a deliberate, well-described service.
This retrospective covers what happened and what it means today. It connects to our coverage of the 2024 Change Healthcare cyberattack, the 2025 Medicare pay cut and cash-pay PT and the 2025 Medicare telehealth lapse.
What actually happened in 2023
May 11: the emergency ended. The federal COVID-19 public health emergency expired on May 11, 2023, ending a range of temporary waivers and flexibilities that health care providers had relied on since early 2020.
HIPAA enforcement discretion ended. HHS’s Office for Civil Rights published a notice in the Federal Register on April 13, 2023, stating that its telehealth enforcement discretion would expire with the emergency. It gave covered providers a 90-calendar-day transition period to comply with HIPAA when using non-public facing remote communication technologies.
Medicare telehealth continued. The Consolidated Appropriations Act, 2023, extended many Medicare telehealth flexibilities through December 31, 2024. CMS’s CY 2024 physician fee schedule summary listed the expansion of telehealth practitioners to include physical therapists, occupational therapists, speech-language pathologists and audiologists through that date.
Home visits. The same summary noted continued coverage of telehealth with the patient at home, and said that starting in 2024, telehealth to patients in their homes would be paid at the non-facility rate.
Later extensions. Congress extended these flexibilities again after 2024. HHS’s telehealth policy page now says many Medicare flexibilities, including telehealth by all eligible Medicare providers, run through December 31, 2027.
Why it mattered for physical therapy clinics
For PT clinics, the end of the emergency removed the “anything goes” approach to video tools. Consumer apps that had been tolerated during the emergency were no longer covered by enforcement discretion after the transition period. Clinics needed HIPAA-appropriate platforms and agreements.
At the same time, the Medicare extension meant virtual care remained a viable service. Clinics that dropped telehealth entirely, assuming it had ended, gave up a convenient option some patients valued. Those that kept it, on compliant tools and with clear descriptions, could offer a hybrid model that combined hands-on care with the convenience patients had come to expect.
The uncertainty also created a marketing problem. Patients did not know whether virtual PT was still available or covered, and headlines about the end of the emergency suggested that everything had changed at once. Clinics that explained the situation clearly stood out, and front desk teams that could answer confidently kept patients from looking elsewhere.
What typical agencies did
Many agencies left outdated pandemic messaging on PT websites, such as “virtual visits available during COVID,” long after the emergency ended. Others removed telehealth pages entirely. Few updated content to explain current coverage and how virtual care fit with in-person treatment.
The better approach treated virtual care as a defined service with its own page, clear eligibility, accurate billing information and a compliant platform. It also meant checking that every tool in the patient journey, from scheduling to reminders, handled patient information appropriately.
What it means for a physical therapy clinic today
These steps keep virtual care useful, compliant and well marketed.
1. Use a compliant platform
Choose a video tool that supports HIPAA compliance and will sign a business associate agreement. Consumer chat and video apps that were tolerated during the emergency are not a safe default now. Confirm how recordings, chat logs and links are stored, and train staff to start sessions from the approved platform every time.
2. Define what virtual care covers
Explain which visits work well virtually, such as home program reviews, education, ergonomic assessments and progress checks. Be equally clear about what requires the clinic, such as manual therapy, certain evaluations and equipment-based treatment. Patients appreciate honesty about what a screen can and cannot do.
3. Be clear about coverage
Describe how virtual visits are billed for Medicare, commercial insurance and cash-pay patients, and update the page as rules change. Coverage varies by plan, so invite patients to confirm benefits with the front desk before booking a virtual session.
4. Remove outdated messaging
Delete pandemic-era banners, pop-ups and pages that no longer reflect how the clinic works. Outdated messaging makes a clinic look inattentive, and it confuses patients who are trying to understand their options.
5. Position hybrid care
Present telehealth as a complement to hands-on treatment, not a replacement. A plan that mixes in-clinic sessions with short virtual check-ins can keep patients engaged between visits without diluting the quality of care.
6. Watch for rule changes
Assign someone to track telehealth rules and update the website and front desk scripts. Medicare flexibilities have been extended several times on short deadlines, and a clinic that communicates changes calmly earns patient trust.
Hybrid care as a premium offer
Hands-on treatment remains central to physical therapy and always will, but many patients value the convenience of occasional virtual check-ins. Busy professionals, people recovering from surgery and patients who live farther from the clinic can stay on track between visits. A hybrid program that combines in-person sessions with scheduled virtual follow-ups can improve adherence and patient satisfaction.
Clinics can describe that hybrid model as a feature of premium care: more continuity, more attention and more support between appointments. Our physical therapy marketing guide covers how to present those programs.
Cash-pay clinics and virtual services
Cash-pay and hybrid PT clinics have more flexibility in how they offer virtual care. They can create virtual packages, remote programming for athletes and follow-up plans without depending on insurance rules. The marketing should be clear about price, what each virtual session includes and when an in-person visit is necessary. We explore the cash-pay shift in our 2025 Medicare pay cut retrospective.
Privacy beyond the video tool
The end of enforcement discretion focused attention on video platforms, but PT clinic privacy extends further. Websites with advertising pixels on booking pages, intake forms that send data to third parties and email tools that share patient lists all deserve review. The FTC and HHS raised those issues directly in their July 2023 tracking letters.
Remote monitoring and home programs
Virtual care for PT clinics is broader than live video. Many clinics use home exercise apps, progress tracking and secure messaging to support patients between visits. These tools can improve adherence and give therapists better information, but they also handle health data. Clinics should confirm that each tool is appropriate for patient information, describe how it is used and avoid overstating what remote monitoring can do. When billing rules for remote services apply, they should be checked carefully rather than assumed. On the website, a short description of how the clinic supports patients at home can be a meaningful differentiator, especially for patients recovering from surgery who want to know they will not be left alone between appointments.
Making virtual care easy to book
Many clinics offer virtual visits but bury them. Patients cannot tell from the booking page whether a visit is in person or online, and the confirmation email does not explain how to join. Small friction points like these reduce use of a service that patients would value.
A clear virtual option in the online scheduler, a short explanation of what to prepare and a reliable link in the confirmation make virtual care feel professional. Our booking engine service covers how to design that experience so patients can choose the right visit type without calling.
Preparing patients for a good session
Virtual PT works best when patients know what to expect. A short guide can explain how to set up the camera so the therapist can see movement, what clothing to wear, how much floor space is needed and which equipment, such as bands or a chair, to have nearby. Clinics that provide this preparation get better sessions and fewer technical delays.
The same guide doubles as useful website content. It answers common questions, shows that the clinic has thought carefully about virtual care and gives search engines and AI assistants clear, specific information to reference.
Front desk scripts
When rules change, front desk staff hear the questions first. After May 2023, patients called to ask whether virtual visits were still allowed and whether their insurance would pay. Clinics with clear, current scripts answered confidently. Those without them gave inconsistent answers that eroded trust.
A simple script covers what the clinic offers, how coverage generally works, how to confirm benefits and when a patient should come in person. Updating it whenever the rules change is a small task that protects the patient experience. Our guide to call handling and lead leakage explains why those first conversations matter.
Search visibility for virtual PT
Patients search for terms like “virtual physical therapy” and “online PT near me,” and AI assistants answer questions about whether telehealth physical therapy is covered. A clinic with a clear, current virtual care page has a better chance of appearing in those results. Keeping that page accurate and dated helps both patients and search engines trust it.
A strong Google Business Profile also helps, because many patients confirm a clinic’s location and hours before booking even a virtual visit. Our approach to Maps and AI search visibility covers how to keep those details consistent.
What 2023 does not tell us
We do not have reliable data on how many PT clinics kept or dropped telehealth after May 2023, or how patients used it. The rules have also changed several times since, so 2023 details are not a guide to current billing. What 2023 does show is the documented end of the emergency, the HIPAA transition and the Medicare extension. Clinics should treat current CMS and HHS guidance as the source of truth and review it at least once a year.
The premium practice advantage
Premium PT clinics offer care that fits patients’ lives. Visit our physical therapy marketing service, our services, who we help and our approach to Google Maps and AI search visibility. Our team works from Austin with practices nationwide.
The bottom line
The 2023 end of the public health emergency did not end telehealth for PT clinics, but it did end improvised tools. Clinics that offer compliant, clearly described hybrid care give patients more support and a reason to choose them. The details are simple, but they add up to an experience that feels organized, modern and trustworthy.
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Frequently asked questions
When did the COVID-19 public health emergency end?
The federal COVID-19 public health emergency ended on May 11, 2023.
Did telehealth end with the public health emergency?
No. The Consolidated Appropriations Act, 2023, had extended many Medicare telehealth flexibilities, including for physical therapists, through December 31, 2024. Later legislation extended them further.
What changed for HIPAA and video tools?
HHS's Office for Civil Rights ended its telehealth enforcement discretion when the emergency expired and gave providers a 90-calendar-day transition period to comply when using non-public facing remote communication technologies.
Can physical therapists still bill Medicare for telehealth?
According to HHS's telehealth policy page, recent legislation extended many Medicare telehealth flexibilities, including telehealth by all eligible Medicare providers, through December 31, 2027. Check current CMS guidance before relying on any rule.
Should PT clinics market virtual visits?
Yes, where clinically appropriate and compliant. Describe what virtual care involves, who it suits, how it is billed and which platform protects privacy.
What is the biggest marketing lesson from 2023?
Describe virtual care accurately, keep tools compliant, and present telehealth as a complement to hands-on treatment rather than a replacement.