Telehealth’s state-by-state regulatory patchwork means that healthcare providers must navigate a variety of regulations that govern which types of care can be provided by virtual means, and even what modalities can be used in different care settings.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
This does not constitute legal advice. All research contained herein should be verified prior to reliance thereon, and an attorney should be consulted to assess its applicability to any particular model of care. By accessing this site, you accept the terms of our privacy policy and you acknowledge your understanding that this tool is not a replacement for legal counsel. There is no guarantee that this research is up to date, as laws and regulations in this space continue to evolve.
Report last updated August 2021; note this report does not generally reflect waivers issued during the COVID-19 public health emergency, and this research does not reflect any requirements of health plans, including Medicaid programs, which may have their own modality requirements.
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AlaskaPhysicians:Alaska permits prescribing based on a telemedicine encounter (typically a secure two-way videoconference or use of “store-and-forward” technology). Prescribing solely on the basis of an online questionnaire or email without a prior physician-patient relationship does not constitute acceptable standard of care and is prohibited. It is also unprofessional conduct to prescribe based solely on a patient-supplied history that a physician licensed in this state received by telephone, facsimile, or electronic format.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
AlabamaPhysicians:Alabama permits prescribing based on a telemedicine encounter. There is no specific definition associated with “telemedicine” in statutes, regulations, or guidance. Accordingly, physicians are held to the same standard of care regardless of treatment modality. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
ArkansasPhysicians:A proper patient-provider relationship, which is required in order to prescribe, may be established via telemedicine using real-time audio and visual telemedicine technology. Prescriptions based solely in response to an internet questionnaire, an internet consultation, or a telephone are prohibited. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
ArizonaPhysicians:Arizona permits prescribing based on a telehealth encounter, including audio-only encounters. Based on 2006 guidance, prescribing on the basis of a questionnaire is not permitted.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
CaliforniaPhysicians:California permits prescribing on the basis of a telemedicine encounter, including based on a self-screening tool or questionnaire, as long as the licensee complies with the appropriate standard of care.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
ColoradoPhysicians:Colorado permits prescribing based on a telehealth encounter, held to the same standard of practice as in-person care. Prescribing on the basis of a questionnaire is not acceptable standard of care. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
WyomingPhysicians:Wyoming has a very broad definition of telemedicine, and it does not otherwise regulate remote prescribing of non-controlled substances.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
West VirginiaPhysicians:A physician-patient relationship may be established via a real-time audio-visual encounter, interactive audio-using store and forward technology, or audio-only conversations in real time. A physician-patient relationship may not be established through text-based communications such as e-mail, Internet questionnaires, text-based messaging or other written forms of communication.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
WisconsinPhysicians:Telemedicine is broadly defined to include services delivered via “electronic communications.” Before delivering treatment, the physician must conduct a patient evaluation. Issuing prescriptions based solely on a static questionnaire is not sufficient.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
WashingtonPhysicians:There are no statutes or regulations that govern professional standards for telemedicine services provided by physicians. guidance documents define “telemedicine” broadly and permit physicians to establish a practitioner-patient relationship via telemedicine. Patient completion of a questionnaire is insufficient to establish a practitioner-patient relationship.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
VermontPhysicians:Physician may prescribe after conducting an examination via telemedicine (defined to require a live audiovisual encounter) or with “the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically.” An electronic, online, or telephonic evaluation is inadequate for the patient’s initial evaluation.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
VirginiaPhysicians:Physicians may prescribe after conducting an examination with “the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically.” For the purpose of Schedule VI controlled substances, either “face-to-face interactive, two-way, real-time communications services” or store-and-forward technologies are acceptable to establish a bona-fide practitioner-patient relationship if, among other things, “the patient has provided a medical history that is available for review by the prescriber [and] (b) the prescriber obtains an updated medical history at the time of prescribing.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
UtahPhysicians:Providers can establish a proper provider-patient relationship via telehealth, which is defined to include both synchronous interactions and asynchronous store-and-forward technology. Prescribing solely on the basis of an online questionnaire or patient-generated medical history is prohibited.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
TexasPhysicians:A valid provider-patient relationship may be established via an audio-visual encounter or asynchronous store and forward technology, provided that the provider has access to (i) clinically relevant photographic or video images, including diagnostic images; or (ii) the patient’s relevant medical records, such as the relevant medical history. Telephone consults are permitted if used in conjunction with asynchronous store-and-forward technology, and the provider uses clinical information from images or medical records.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
TennesseePhysicians:A physician-patient relationship may be established via a telemedicine encounter whereby health information is transmitted via store and forward technology or video conferencing. It is impermissible to prescribe based “solely on answers to a set of questions” and prescriptions generally must be based on a “physical examination.” For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
South DakotaPhysicians:The definition of telehealth includes interactive audio-video, interactive audio with store and forward, and remote patient monitoring. Any health care professional who utilizes telehealth shall ensure that a proper health provider-patient relationship is established prior to prescribing.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
South CarolinaPhysicians:Telemedicine is broadly defined to incorporate the practice of medicine via “electronic communications.” An appropriate evaluation must be conducted before diagnosing and treating patients, which must meet the standard of care. A simple questionnaire without an appropriate evaluation is insufficient.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Rhode IslandPhysicians:Prescribing solely on the basis of an online questionnaire is considered unprofessional conduct. A “physical evaluation” is required, though this can be completed via telemedicine, which is defined as either two-way, audio-visual encounter or store-and-forward technology. Prescriptions cannot be issued solely on the basis of a questionnaire.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
PennsylvaniaPhysicians:There are no applicable laws, regulations, or guidance that govern telehealth or remote prescribing by physicians.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
OregonPhysicians:The Oregon Medical Board has issued guidance indicating that telemedicine “generally” includes “secure video conferencing.”For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
OklahomaPhysicians:Telemedicine encounters must provide equivalent information to what would have been provided in an in-person exam. Beginning in November, the definition of telemedicine will explicitly include synchronous and asynchronous mechanisms. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
OhioPhysicians:Physicians are permitted to prescribe without a “physical examination” as long as they satisfy certain, enumerated requirements and “use appropriate technology” to conduct all requirements as if the evaluation were in person. The Medical Board has said the rule is “silent” on whether a visual connection is required.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New YorkPhysicians:Telehealth is limited to telemedicine, store and forward technology, remote patient monitoring and audio-only telephone communication. Telemedicine is defined to require an audiovisual interaction. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
NevadaPhysicians:The term telehealth is defined to incorporate “information and audio-visual communication technology.” For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New JerseyPhysicians:Telemedicine services shall be provided using interactive, real-time, two-way communication technologies, but audio-only telemedicine combined with asynchronous store-and-forward is permissible if the provider accesses and reviews the patient’s medical records and concludes that the provider can “meet the same standard of care” as if the services were provided in person.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New HampshirePhysicians:Telehealth and telemedicine include the use of audio, video, or other electronic media. Providers must establish a provider-patient relationship via an audiovisual encounter in order to prescribe.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
NebraskaPhysicians:The definition for “telehealth” incorporates both synchronous and asynchronous modalities. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
North DakotaPhysicians:Licensees can prescribe on the basis of a telemedicine encounter, which is defined to include interactive patient encounters, as well as asynchronous store-and-forward technologies. An examination based solely on a static questionnaire or audio conversation is insufficient to meet the standard of care for treatment via telemedicine.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
North CarolinaPhysicians:The Board prohibits prescribing on the basis of answers to a questionnaire. It also states that a “physical examination” is “ordinarily” required, though it leaves open the possibility that prescriptions may be issued pursuant to a telemedicine encounter (which is broadly defined).For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MontanaPhysicians:The definition of “telemedicine” is broadly defined and incorporates videoconferencing, audio-only conversations, and “store-and-forward,” which is broadly defined to include electronic information that is reviewed by a health care provider at a later date. The definition of “telemedicine” excludes emails, instant messaging conversations, and fax.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MississippiPhysicians:Physicians must perform an examination prior to providing treatment, which does not need to be in-person if the technology provides the same information “as if the exam had been performed face-to-face.” In addition, a valid physician patient relationship requires a “physical examination.” Prescribing based solely on the answers to a set of questions is unprofessional conduct.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MissouriPhysicians:Prior to prescribing a drug via telemedicine, a physician must establish a valid physician patient relationship, which includes a “physical examination” (undefined). In addition, prescribing solely on the basis of an internet questionnaire is prohibited. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MinnesotaPhysicians:The term “telemedicine” is broadly defined, and includes interactive, audio-visual encounters and the use of store-and-forward technology. Store-and-forward technology is not specifically defined.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MainePhysicians:A 2021 statute defines telehealth to include both synchronous and asynchronous encounters. Current regulations applicable to physicians specify that a static questionnaire is insufficient to form the basis of a prescription. It distinguishes this with an “adaptive, interactive, and responsive online interview,” suggesting that the former is permissible. It is unclear whether telehealth regulations applicable to physicians will be revised in light of the new telehealth statute.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New MexicoPhysicians:Physicians may only prescribe via a telehealth encounter that incorporates face-to-face, videoconferencing technology. In addition, prescribing based solely on an online questionnaire is expressly identified as insufficient.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MarylandPhysicians:A 2020 law permits prescriptions to be issued on the basis of synchronous (defined solely as “real time”) or asynchronous encounters. The Board of Medicine has historically had regulations that are more strict than the provisions in the new statute (including requiring an audio-visual encounter), although these are arguably superseded by the new law. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MassachusettsPhysicians:Telehealth is defined to include the use of synchronous and asynchronous modalities, as well as audio-only telephone and online adaptive interviews. Based on recent guidance from the Board of Registration in Medicine, a face-to-face encounter is not required.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
LouisianaPhysicians:Telemedicine is defined to include electronic communications, information technology, asynchronous store-and-forward transfer technology, or technology that facilitates synchronous interaction between a physician at a distant site and a patient at an originating site, or audio-only under certain circumstances. Email and text messages that are not HIPAA-compliant do not constitute “telemedicine.” In addition, based on current regulations, an online, electronic or written mail message does not satisfy the standards of appropriate care.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
KentuckyPhysicians:Telehealth is defined to include “interactive audio, video, or other electronic media.” An electronic, online, or telephonic questionnaire is considered insufficient for the initial evaluation of a patient or any follow-up evaluation.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
KansasPhysicians:The term “telemedicine” is defined to require interactive modalities. In addition, Kansas pharmacy laws prohibit prescriptions based on an online questionnaire. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
IndianaPhysicians:Providers can prescribe on the basis of a telehealth encounter, which is defined to include both videoconferencing and store and forward technologies. Certain technologies are explicitly excluded from the definition of “telemedicine,” including emails, instant messaging, fax, questionnaires, and internet consultations. Accordingly, these technologies may not be relied upon as the sole basis to issue prescriptions.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
IllinoisPhysicians:Health care professionals are broadly permitted to use telehealth to perform services, which includes telemedicine. Telemedicine, in turn, is defined broadly in the Medical Practice Act to include “telephonic” and “electronic” means.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
IdahoPhysicians:A provider-patient relationship must be established using two-way, audio-visual technology. Moreover, treatment based solely on an online questionnaire does not constitute an acceptable standard of care.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
IowaPhysicians:Physicians may establish a provider-patient relationship and prescribe via telemedicine, which is defined to include audio-visual communications and asynchronous store-and-forward technologies. A static questionnaire is insufficient to form the basis of a prescription, in contrast to an “adaptive, interactive, and responsive online interview,” suggesting that the former is permissible.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
HawaiiPhysicians:Based on language in the commercial coverage statute, a provider-patient relationship may be established via telehealth. In addition, prescribing on the basis of a telehealth encounter is permissible provided that the standard of care is met. Prescribing solely on the basis of an online questionnaire is prohibited without a prior physician-patient relationship. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
GeorgiaPhysicians:Georgia permits prescribing through electronic means. Such treatment is permissible if the physician has previously personally seen and examined the patient, is providing medical care on behalf of another provider that has personally seen the patient, or is able to examine the patient using technology or peripherals that are equal or superior to personal examination within the provider’s standard of care.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
MichiganPhysicians:Physicians are permitted to prescribe via telehealth, which is defined broadly. It includes telemedicine, which is defined to include interactive audio or video, as well as online messaging.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
FloridaPhysicians:Florida permits prescribing based on a telehealth encounter, which includes synchronous and asynchronous communications. Audio-only calls, email messages, and fax transmissions are excluded from the definition of telehealth. For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
DelawarePhysicians:Providers may establish a provider-patient relationship via telemedicine. Diagnoses must be based on an encounter using audio and visual communication. Prescribing solely on the basis of an online questionnaire, Internet consult, or telephone consult is prohibited without a prior physician-patient relationship.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
District of ColumbiaPhysicians:Physicians are required to use real-time telemedicine to establish a provider-patient relationship if they have not conducted a prior in-person examination with the patient. Real-time is defined to require “near immediate feedback.”For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
ConnecticutPhysicians:Connecticut permits prescribing based on a real time, two-way interactive communications or store-and-forward technologies. Fax, audio-only phone, texting, and email are excluded from the definition of “telehealth.” Telehealth providers must also have access to the patient’s medical history and medical record.For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.