assignment of benefit and signature requirements for telehealth services

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Standards to Improve Virtual Care

The standards.

The new telehealth accreditation standards were developed upon review of our current standards and based on feedback from Joint Commission accredited organizations, multiple technical advisory panels, and external thought leaders.

The program requirements contain many of the standards similar to other Joint Commission accreditation programs, such as requirements for information management, leadership, medication management, patient identification, documentation, and credentialing and privileging. Requirements specific to the new telehealth program include:

• Streamlined emergency management requirements
• New standards for telehealth provider education and patient education about the use of telehealth platforms and devices
• New chapter focused on equipment, devices, and connectivity

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Get your standards questions answered.

Our Standards Interpretation Group provides information to help you interpret and apply Joint Commission standards to your processes.

Review the FAQs to see topics often raised by healthcare organizations or submit your own question via the electronic submission form.

• Why The Joint Commission
• Eligibility
• Learn the Application Process

Legal Requirements for Using Telehealth Services

Noncompliance with telehealth legal requirements can result in civil, criminal, and administrative penalties from state medical boards and other regulatory bodies. It is important that you consult state medical boards and other state-specific laws for updated and accurate information on telehealth legal requirements.

Learn about the key terms in legal requirements and view a summary how they apply in your state . For more detailed state-level information, visit The Center for Connected Health Policy .  

What are the legal requirements for telehealth?

Telehealth legal requirements vary by state. Always seek individual legal advice if your practice is unsure about aspects of licensure or legal requirements. Five key legal concepts in telehealth are consent, online prescribing, cross-state licensing, licensure compacts, and professional board standards.

Many states have created specific guidelines for how physicians and other medical professionals should obtain consent for telehealth services. Most states with telehealth consent guidelines require that medical professionals obtain and document verbal or written consent, documenting it in the patient’s medical record. Physicians may also need to verify the patient's identity and location, disclose the limitations of telehealth, and obtain consent to share protected health information (PHI) with other physicians and clinicians.

Online Prescribing

There is a lot of variation between how different states have approached online prescribing of controlled substances. The most flexible states require the establishment of a patient-physician relationship for online prescribing, and that relationship can be established via telehealth. Other states require an in-person evaluation within a specific timeframe for online prescribing to take place. The most restrictive states do not allow any online prescribing of controlled substances. Of note, Arkansas, Indiana, Iowa, Kansas, Kentucky, Montana, Oklahoma, South Carolina, South Dakota, Texas, and West Virginia have specific restrictions for online prescribing of abortion-inducing medication. 

Cross-state Licensing

The best practice for physicians seeking to practice medicine in a different state than the one where they reside is to obtain an official medical license from the state where the patient is located. However, some states have provided more flexibility to this process but 1) not requiring physicians to be licensed in different states for infrequent telehealth treatment if they are in good-standing with their home-state medical board 2) offering special telehealth licenses or 3) participating in interstate medical licensure compacts (IMLC).

Telehealth Collection: Resources on the basics, workflow, billing, and more

Licensure Compacts

Most states are participating in the Interstate Medical Licensure Compact (IMLC) and/or the Nurse Licensure Compact (NLC). These compacts provide a streamlined process for achieving medical or nursing licenses for multiple states at once, enabling the practice of medicine across state lines. This is the quickest way to ensure legal practice of telemedicine in multiple states. Learn more about the IMLC, including whether you qualify, what it costs, and how to apply, on the  IMLC website . 

Professional Board Standards

Most states do not have specific professional board standards for family physicians practicing telehealth. The limited number of states with any standards emphasized the importance of providing the same high standard of care as one would with in-person care.

Learn how telemedicine can help simplify your practice.

State-by-state legal requirements

Find your state to see high-level legal requirements. For more detailed information, visit The Center for Connected Health Policy .

• Requires informed consent that acknowledges the use of telehealth as an acceptable mode of delivery, including mode of communication and its limitations.
• Must be documented in patient’s medical record.
• Requires established relationship. Provider-patient relationship may be established via telehealth.
• Relationship established by verifying and authenticating patient’s identity and location, disclosure of provider identity and credentials, and informed consent.
• If patient is seen by the same physician or group more than four times in a 12-month period for the same condition without resolution, the patient must be seen in-person or referred to in-person care within 12 months.
• Controlled substances prescribed via telehealth require at least one in-person encounter within the previous 12 months, use of synchronous audio or audio-video communication technology, and a legitimate medical purpose (exception for prescription of controlled substances if for treatment of medical emergency). 

Cross-state Licensure

Interstate Medical Licensure Compact: Yes 

• Requires full and active license to practice medicine issued by the Medical Licensure Commission.
• Exception if services are provided on an irregular or infrequent basis (less than 10 days or fewer than 10 patients in a calendar year) or services are provided in consultation with a physician licensed to practice medicine in the state.

Professional Boards Standards

• A physician providing telehealth medical services shall owe to the patient the same duty to exercise reasonable care, diligence, and skill as would be applicable if the service or procedure were provided in person.
• No requirements for physicians.
• APRNs must document patient’s informed consent to use of telehealth technology.

Physician, physician assistant, or APRN may prescribe, dispense, or administer through telehealth if complying with state and federal law.

Interstate Medical Licensure Compact: No

Physicians licensed in another state may provide telehealth if they have an established physician-patient relationship and have previously had an in person visit OR the patient has been referred and the visit involves a life-threatening condition.

Physicians should follow the guiding principles for telemedicine practice in the American Medical Association (AMA).

Must follow applicable state and federal laws, rules and regulations for informed consent. 

Clinician-patient relationship must be established.

Relationship is established by previous in-person visit, personal relationship, treatment in consultation with another provider, or on-call coverage for patient’s regular provider. It cannot be established by internet questionnaire, email message, text, fax, or patient-generated medical history.

Requires appropriate medical evaluation and review of clinical history.

For abortion-inducing medication, initial administration must occur in the same room and physical presence of the prescribing physician.

Physicians licensed in another state may provide telehealth for episodic consultation services, consultation services to a medical school, services not available in the state, or with a physician physically seeing the patient in-persion.

APRNs must be licensed to practice nursing in Arkansas.

Must have an established professional relationship. 

Must provide healthcare services within the scope of practice of the healthcare professional. 

A licensing or certification board shall not permit the use of telemedicine in a manner that is less restrictive than the use of telemedicine authorized by the Arkansas State Medical Board.

Informed consent must be obtained either verbal or written from the patient or patient's health care decision maker. If verbal, clinician must document in the patient's medical record.

Consent does not apply for telehealth not involving physical presence of patient; in emergency situations when unable to give informed consent; or when diagnostic images or results are being transmitted.

Must first conduct a physical or mental health status examination or have a previously established physician-patient relationship to prescribe. This examination can be provided through telehealth.

Exceptions to this include: emergencies; clinicians working in consultation with patients regular treating health care professional; prescriptions for epinephrine auto-injectors written or dispensed for schools; or prescriptions for naloxone hydrochloride or other opioid antagonists approved by the FDA.

Clinicians not licensed in Arizona must register and pay registration fees with the state's applicable board or agency, register with the state controlled substances monitoring program, hold a current valid and unrestricted license in another state that is comparable to Arizona, comply with laws and rules of the state, maintain professional liability insurance, follow Arizona's standards of care, and annually update registration.

None specific to family medicine.

Informed consent may be verbal or written but must be filed in the medical record. 

Must conduct an appropriate prior examination, which may be achieved through a self-screening tool or questionnaire, provided the clinician complies with appropriate standards of care.

Physicians do not need to reside in California as long as they have a current California license.

Physicians are held to the same standard of care, and retain the same responsibilities of providing informed consent, ensuring the privacy of medical information, and any other duties associated with practicing medicine regardless of whether they are practicing via telehealth or face-to-face, in-person visits.

Informed consent may be verbal or written but must be filed in the medical record.

Patients should be informed that refusal of telemedicine services will not affect future right to treatment or care, and of confidentiality protections of the technology.

Clinician-patient relationship may be established via telehealth.

Relationship is established by verifying and authenticating patient’s identity and location, disclosure of provider identity and credentials, and obtained informed consent.

Clinician must be licensed in the state where the patient is located at the time telehealth technologies are used.

Referrals of Emergency Services: An emergency plan should be in place when care is provided by telehealth.

Medical Records: Patient records established during use of telehealth technologies must be accessible and documented in medical records.

Evaluation and Treatment, Privacy and Security of Patient Records & Exchange of Information, Parity of Professional and Ethical Standards: Same standard as traditional in person encounters.

Through June 30, 2024, at the time of telehealth provider’s first telehealth interaction with the patient, clinician must inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform.

Through June 30, 2024, each telehealth provider must, at the time of the initial telehealth interaction, ask the patient whether the patient consents to the telehealth provider’s disclosure of records concerning the telehealth interaction to the patient’s primary care clinician. If the patient consents, the telehealth provider must provide records of all telehealth interactions during such period to the patient’s primary care clinician, in a timely manner.

Through June 30, 2024, no telehealth provider may prescribe any schedule I, II, or III controlled substance using telehealth, except a schedule II or III controlled substance for the treatment of a person with a psychiatric disability or a person with a substance use disorder, including but not limited to, mediation-assisted treatment. 

Interstate Medical Licensure Compact: Yes

Appropriately licensed, certified or registered clinician in another state or territory of the United States or the District of Columbia may provide telehealth within such person’s scope of practice and in accordance with the standard of care applicable to the profession if they maintain professional liability insurance, or other indemnity against liability for professional malpractice, in an amount that is equal to or greater than that required for similarly licensed, certified or registered Connecticut providers. 

Receipt of appropriate consent from a patient after disclosure regarding the delivery model and treatment method or limitations, including informed consent regarding the use of telemedicine technologies, is required to establish a clinician-patient relationship.

Clinician-patient relationship may be established by telehealth.

Relationship is established by verifying and authenticating patient's identity and location; disclosure of provider identity and credentials; obtained informed consent; discussion with patient of diagnosis; availability of follow-up care; and written visit summary provided to the patient.

Clinicians licensed in a state that has not adopted the interstate compact can obtain an interstate telehealth registration from the Division of Professional Regulation if they hold a valid/active license in another state and they are in good standing. 

A clinician using telemedicine must, prior to diagnosis and treatment, do at least one of the following: Provide an appropriate examination in person; require another DE-licensed provider be present with the patient; make a diagnosis using audio or visual communication; or meet the standard of service required by applicable professional society guidelines for establishing provider-patient relationship.

Must obtain consent and document patient consent, except when providing interpretive services.

A physician must perform a patient evaluation to establish diagnoses and identify underlying conditions or contraindications to recommended treatment options before providing treatment or prescribing medication for a patient utilizing the appropriate standards of care.

Real-time telemedicine can be used.

Must have license to practice medicine in DC.

No requirements

If a telehealth provider conducts a patient evaluation sufficient to diagnose and treat the patient, the telehealth provider is not required to research a patient’s medical history or conduct a physical examination of the patient before using telehealth to provide health care services including prescribing to the patient. 

May not use telehealth to provide controlled substances unless it is for treatment of a psychiatric disorder, inpatient treatment at a hospital, treatment of a patient receiving hospice services, or treatment of a resident of a nursing home.

Clinicians not licensed in FL may provide telehealth if they register with the applicable board or department if there is no board and have professional liability coverage for providing telehealth outside of the clinician's home state. 

A telehealth provider has the duty to practice in a manner consistent with his or her scope of practice and the prevailing professional standard of practice for a health care professional who provides in-person health care services to patients in this state.

Providing treatment via electronic or other means is considered unprofessional conduct unless a history and physical examination of the patient has been performed by a Georgia licensee. 

Does not authorize the prescription of controlled substances for the treatment of pain or chronic pain by electronic or other such means.

A licensed physician may prescribe Schedule II sympathomimetic amine drugs for the treatment of attention deficit disorder to a patient if they have conducted at least one in-person evaluation, are covering for another clinician, or the patient is being treated by or in the physical presence of a clinic/hospital/provider registered with the DEA.

Telemedicine licenses may be issued to clinicians who hold a full and unrestricted license in another state, will not practice physically in the state, and maintains records.

A physician-patient relationship may be established by telehealth interaction.

Treatment recommendations made via telehealth, including issuing a prescription via electronic means, shall be held to the same standards of practice as traditional settings that do not include a face-to-face visit but in which prescribing is appropriate, including on-call telephone encounters and encounters for which a follow-up visit is arranged.

Prescribing opiates or medical cannabis requires an in-person consultation to establish the physician-patient relationship.

A licensed out-of-state practitioner of medicine or surgery can utilize telehealth to consult with a Hawaii licensed physician or osteopathic physician as long as they don’t open an office or meet with patients in the state; the HI-licensed provider retains control of the patient; and the laws and rules related to contagious diseases are not violated.

Informed consent must be obtained including at a minimum verification of identity of patient and clinician credentials; telehealth determination; security measures information; and potential information loss disclosure.

Clinicians with an already established patient relationship may issue prescription medication orders using telehealth services provide that the prescription medication is not a controlled substance.

If a provider offering telehealth services does not have an established clinician-patient relationship with a person seeking such services, the clinician shall take appropriate steps to establish a relationship by use of two-way audio or audio-visual interaction.

Clinicians in good standing with no restrictions upon or actions taken against their license to practice in a state, territory, or district of the United States or Canada, are eligible for licensure by endorsement to practice medicine in Idaho.

No requirements specific to family medicine. 

A health care professional treating a patient located in this state through telehealth services must be licensed or authorized to practice in Illinois.

A health care professional may not be required to obtain a separate additional written health care consent for the provision of telehealth services.

A documented patient evaluation, including history and physical evaluation adequate to establish diagnoses and identify underlying conditions or contraindications to the treatment recommended or provided, must be obtained prior to issuing prescriptions electronically or otherwise.

Telehealth may not be used to provide any abortion prescriptions.

A prescription for a controlled substance can be issued if the prescriber has satisfied the standard of care, issuance is within their scope of practice, the prescription is not a opioid unless it is used for treating opioid dependence, and the prescription is not for an abortion-inducing medication.

The Telehealth Provider Certification is required by Indiana Code. In order for a practitioner to practice telehealth in Indiana, a copy of their individual certification and their employer’s certification must be filed with the Indiana Professional Licensing Agency.

The Medical Licensing Board may adopt rules establishing guidelines for the practice of telehealth in Indiana. Adoption of rules may not delay the implementation and provision of telehealth services by a provider.

• None for physicians.

Physician assistants must obtain consent to use telemedicine and document it in the patient's medical record.

APRNs must obtain consent from the patient to receive services via telehealth.

The medical interview and physical examination may not be in-person if the technology utilized in a telemedicine encounter is sufficient to establish an informed diagnosis as though the medical interview and physical examination had been performed in-person. 

Clinicians must be physically present with the patient at the time an abortion-inducing medication is provided.

Kansas does not have consent requirements for telehealth.

Telemedicine may be used to establish a valid physician-patient relationship.

The same laws and regulations that apply to the prescribing of medications, including controlled substances, by means of in-person contact shall apply to the prescribing of medications, including controlled substances, by means of telemedicine.

 Interstate Medical Licensure Compact: Yes

A physician holding a license issued by the applicable licensing agency of another state may practice telemedicine to treat patients located in the state of Kansas, if such out-of-state physician holds a temporary emergency license granted by the state board of health arts.

The treating physician who delivers or facilitates the telehealth service shall obtain the informed consent of the patient before services are provided.

A practitioner-patient relationship may commence via telehealth. An in-person initial meeting shall not be required unless the clinician determines it is medically necessary to perform those services in person

The use of telehealth shall not be allowed in the performance of an abortion.

A provider must be licensed in Kentucky with the exception of persons who, being nonresidents of Kentucky and lawfully licensed to practice medicine in their states of actual residence, infrequently engage in the practice of medicine within this state, when called to see or attend particular patients in consultation and association with a Kentucky-licensed physician.

In addition to any informed consent and right to privacy and confidentiality that may be required by state or federal law or regulation, a physician shall insure that each patient to whom he or she provides medical services by telemedicine is informed of the relationship between the physician and patient and notified that they may decline to receive medical services by telemedicine at any time.

Telemedicine, including the issuance of any prescription via electronic means, shall be held to the same prevailing and usually accepted standards of medical practice as those in traditional, face-to-face settings.

Telemedicine can only be used to prescribe a controlled substance if there has been at least one in-person visit in the last year, the prescription is for a legitimate medical purpose, conforms with standards of care, and is permitted by state and federal laws and regulations.

The board shall issue a telemedicine license to allow the practice of medicine across state lines to an applicant who holds a full and unrestricted license to practice medicine in another state or territory of the United States.

A licensee who uses telehealth in providing health care shall ensure that the patient provides appropriate informed consent for the health care services provided, including consent for the use of telehealth to conduct a nursing assessment or physical examination, consultation, and diagnosis and treatment, and that such informed consent is timely documented in the patient’s telehealth record.

Insurers may not place any restriction on the prescribing of medication through telehealth by a provider whose scope of practice includes prescribing medication that is more restrictive than any requirement in state and federal law for prescribing medication through in-person consultation.

Prescribing to a patient based solely on an Internet request or Internet questionnaire is prohibited. 

A physician intending to provide consultative services in this state through interstate telehealth shall provide the board information on all active and previous licenses and negative licensing actions. They must also pay a fee of $500.

In establishing a relationship between a practitioner and patient through interactive or asynchronous telehealth, health care practitioners must obtain oral or written consent from the patient or from the patient’s parent or guardian.

Physician-patient relationship may be established by telehealth.

Relationship is established by verifying and authenticating patient's identity and location; disclosure of provider identity and credentials; and obtained informed consent.

Physicians may not prescribe controlled substances that are opiates for the treatment of pain through telehealth unless the patient is in a health care facility or the governor has declared a state of emergency due to a catastrophic health emergency.

A health care practitioner shall be licensed by the Board before the individual may practice medicine in Maryland.

Exceptions for consulting with physicians licensed in MD or licensed to practice medicine in an adjacent state prescribing home health services for patients who reside in MD.

No requirements.

The practice of medicine shall not require a face-to-face encounter between the physician and the patient prior to health care delivery via telemedicine.  

The standard of care applicable to the physician is the same whether the patient is seen in-person or through telemedicine.

A clinical visit is for an initial Certificate of Registration for the Cannabis Control Commission must be performed in-person.

Physicians must be licensed by the the Board in Massachusetts.

Consent for treatment must be obtained before providing a telehealth service and evidence of consent for treatment must be maintained in a client/patient’s medical record.

Must have a patient-clinician relationship.

A health professional providing telehealth service to a patient may prescribe the patient a medication if both the prescriber is acting within the scope of practice and if prescribing a controlled substance, they must meet the requirements for prescribing a controlled substance.

In limited circumstances, Michigan Public Health Code states that certain individuals are not required to have a license for practice of a health profession in Michigan (includes students in training and other less common circumstances).

A physician-patient relationship may be established through telehealth.

Prescriptions must be based on documented patient evaluation adequate to establish diagnosis and identify underlying conditions and contradictions for controlled substances, muscle relaxants, centrally acting analgesics with opioid activity, drugs containing butalbital, and phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction. 

A written certification of a qualifying condition for medical cannabis cannot be performed by telehealth.

 A physician licensed in another state can provide telehealth services to a patient in Minnesota if their license has never been revoked or restricted in any state, they agree to not open an office in Minnesota, not meet with patients in Minnesota or receive calls in Minnesota from patients, and they annually register with the state’s board.

The provider using any form of telemedicine should obtain the patient’s informed consent before providing care via telemedicine technology. 

In addition to information relative to treatment, the patient should be informed of the risk and benefits of being treated via a telemedicine network, including how to receive follow-up care or assistance in the event of an adverse reaction to treatment or if there is a telemedicine equipment failure.

Clinicians using telemedicine technologies to provide medical care to patients located in Mississippi must provide an appropriate examination prior to diagnosis and treatment of the patient. However, this exam need not be in person if the technology is sufficient to provide the same information to the physician as if the exam had been performed face-to-face.

Any physician utilizing the automated dispensary will be responsible for the proper maintenance and inventory/accountability requirements as if the physician were personally dispensing the medications to the patient from his or her stock in their personal practice and may not use it to dispense controlled substances.

Only clinicians holding a valid Mississippi license are allowed to practice any form of telemedicine in Mississippi.

• Nurses and physician assistants must obtain consent to use telemedicine and document it in the patient's medical record.

Prior to providing treatment, including issuing prescriptions, a physician who uses telemedicine shall interview the patient, collect, or review relevant medical history, and perform an examination sufficient for diagnosis and treatment of the patient. A questionnaire completed by the patient, whether via the telephone or internet, does not constitute a medical interview and examination for provision of treatment via telemedicine.

• In order to treat participants in this state through the use of telemedicine, health care clinicians shall be fully licensed to practice in this state and shall be subject to regulation by their respective professional boards.

Exceptions for informal or episodic consultations with clinicians licensed and located in another state.

No requirements for family medicine.

The licensee using telemedicine in patient care may prescribe Schedule II drugs to a patient only after first establishing a physician-patient relationship through an in-person encounter which includes a medical interview and physician examination.

 None specific to family medicine.

None specifc to family medicine.

Only requirements are for Medicaid: Written or email consent is required before initial service delivery must include alternative care options, existing laws and protections, whether telehealth will be recorded, and identification of all parties who will be present. Must be documented in medical record.

Any credential holder under the Uniform Credentialing Act may establish a clinician-patient relationship through telehealth.

Any credential holder under the Uniform Credentialing Act who is providing a telehealth service to a patient may prescribe the patient a medication if the credential holder is authorized to prescribe under state and federal law.

 No specific information available. 

None required.

To prescribe via telehealth, the clinician must hold a valid license or certificate in Nebraska, establish a clinician-patient relationship, perform an evaluation and risk assessment, establish a diagnosis and treatment plan, document in the medical record, and obtain informed consent if a controlled substance.

The Board may issue a special-purpose license to a physician who is licensed in another state by using equipment that transfers information concerning the medical condition of a patient in this state electronically, telephonically, or by fiber optics, including, without limitation, through telehealth, from within or outside this State or the United States.

Patient consent is required prior to forwarding medical records to the patient's primary care or treating clinician.

Must have a physician-patient relationship which can be established during a telemedicine exam to prescribe.

Cannot prescribe through telemedicine a controlled medication, except substance use disorder (SUD) treatment other than methadone hydrochloride.

 An out-of-state healthcare professional providing services by means of telemedicine or telehealth shall be required to be licensed, certified, or registered by the appropriate New Hampshire licensing body if the patient is physically located in New Hampshire at the time of service.

Patients must be clearly advised if telemedicine will be with a provider who is not a physician and allow for the patient to specifically request to be scheduled for the telemedicine visit with a physician.

Prior to using telemedicine, must provide the client the opportunity to sign a consent form that authorizes the licensee to release client records of the encounter to the client’s primary care licensee or other health care professional identified by the client.

Diagnosis, treatment, and consultation recommendations, including discussions regarding the risk and benefits of the patient’s treatment options, which are made through the use of telemedicine or telehealth, including the issuance of a prescription based on a telemedicine or telehealth encounter, shall be held to the same standard of care or practice standards as are applicable to in-person settings.

The prescription of Schedule II controlled dangerous substances through the use of telemedicine or telehealth shall be authorized only after an initial in-person examination of the patient and a subsequent in-person visit with the patient shall be required every three months with the exception of stimulants prescribed to a minor patient.

A health care practitioner may initially authorize any qualifying patient for the medical use of cannabis using telemedicine or telehealth, provided that the use of telemedicine or telehealth, rather than an in-person visit, is consistent with the standard of care required for assessment and treatment of the patient’s condition.

 Any health care professional who uses telemedicine or engages in telehealth while providing health care services to a patient shall be validly licensed, certified, or registered in the State of New Jersey.

Must have physician-patient relationship which may be established by telehealth where a medical history and informed consent are obtained and a medical record is generated.

Exceptions for clinicians on call for another health care professional, prescriptions written to prepare patients for special examinations or laboratory testing, or treating partners with STDs.

Diagnosis via telehealth with a debilitating medical condition can be used to qualify a patient for medical cannabis certification.

 The board shall issue a licensed physician a telemedicine license to allow the practice of medicine across state lines to an applicant who holds a full and unrestricted license to practice medicine in another state or territory of the United States. 

A telemedicine license shall be issued for a period not to exceed three years and may be renewed upon application and payment of fees.

No requirements for family medicine. 

Buprenorphine requires a preliminary face-to-face evaluation.

No requirements for family medicine

No requirements specific to family medicine

 No requirements specific to family medicine

A licensee who has performed a telemedicine examination may prescribe medications according to the licensee’s professional discretion and judgment. 

Opioids may only be prescribed through telemedicine if done so as an FDA-approved medication-assisted treatment for opioid use disorder. Opioids may not be prescribed through a telemedicine encounter for any other purpose.

 None specific to family medicine

Prescribing is allowed when a patient is remote for non-controlled substances if clinicians establish patient's identity and location, obtain informed consent, forward records to primary care physician, conduct an appropriate evaluation, establish diagnosis and treatment plan, document in the medical record, provide follow-up care, and use appropriate technology.

Prescribing controlled substances remotely can be done for active patients who has had evaluation performed in the last 24 months which can be done by telemedicine.

Telehealth can be used to conduct examinations to prescribe medical marijuana.

 None specifc to family medicine

Must have physician-patient relationship which may be established by telehealth where patients identity and location are confirmed and physician's identity and professional credentials are provided to the patient.

Exceptions for clinicians on call for another clinician, treating patients and partners with STDs, and licensed clinicians ordering opioid antagonists.

Abortion-inducing medications shall not be provided directly to the patient through telemedicine.

Physicians treating patients in Oklahoma through telemedicine must be fully licensed in Oklahoma.

 Oregon medical board requires a "Telemedicine Active" license to practice medicine across state lines. Physicians must hold a full, unrestricted license to practice medicine in any other state of the United States, have not been the recipient of a professional sanction by any other state of the United States, and otherwise meets the standards for Oregon licensure.

Pennsylvania issues extraterritorial licenses that allow practice in Pennsylvania to physicians residing or practicing with unrestricted licenses in an adjoining state, near the Pennsylvania boundary, and whose practice extends into Pennsylvania.

An informed consent agreement should be employed and discussed with the patient that includes types of transmissions permitted, circumstances when telehealth or office visits should be used, security measures, a hold harmless clause, and requirements for express patient consent to forward PHI to a third party.

Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in face-to-face settings.

Physicians licensed to practice in another state or states but not Rhode Island can be consulted on a singular occasion by a physician in Rhode Island.

None specific to family medicine. 

A licensee who establishes a physician-patient relationship solely via telemedicine shall adhere to the same standard of care as a licensee in-person.

Schedule II and III prescriptions are not permitted except as specifically authorized by the board.

Prescribing abortion-inducing medication is not permitted.

 The physician must be licensed in South Carolina; however, they do not need to reside in South Carolina.

A health care professional using telehealth shall follow any applicable state or federal statute or rule for informed consent.

Exceptions for providers on call for another provider or consultation with another provider.

Mifepristone and misoprostol must be prescribed and dispensed by a licensed physician in a licensed abortion facility. 

Any health care professional treating a patient in the state through telehealth shall be fully licensed to practice in the state or employed by a licensed health care facility, an accredited prevention or treatment facility, a community support provider, a nonprofit mental health center, or a licensed child welfare agency and subject to any rule adopted by the applicable South Dakota licensing body.

The consent by the patient may be expressed or implied consent; however, the clinician-patient relationship is not created simply by the receipt of patient health information by a provider unless a prior clinician-patient relationship exists.

Clinician must perform an appropriate history and physical exam, make a diagnosis, formulate a therapeutic plan, and ensure availability of follow-up can in order to prescribe or dispense any drug.

A health care professional who is authorized to prescribe buprenorphine under federal law shall not prescribe via telehealth a buprenorphine product, as for use in recovery or medication-assisted treatment, unless they are employed or contracted with a licensed facility or treatment network.

No person shall engage in the practice of medicine, either in person or remotely using information transmitted electronically or through other means, on a patient within the state of Tennessee unless duly licensed by the Board in accordance with the provisions of the current statutes and rules.  

Must obtain informed consent of the patient, or another appropriate individual authorized to make health care treatment decisions for the patient, is obtained before telemedicine services are provided.

Must have a physician-patient relationship which can be established by telehealth.

Telemedicine medical services used for the treatment of chronic pain with scheduled drugs by any means other than via audio and video two-way communication is prohibited

Telemedicine medical services may be used for the treatment of acute pain with scheduled medications, unless otherwise prohibited under federal and state law.

Prescribing an abortifacient or other medication or device to terminate a pregnancy cannot be done via telehealth.

 1A telemedicine license may be issued for out of state providers. 

An out-of-state telemedicine license to practice medicine across state lines shall be limited exclusively to the interpretation of diagnostic testing and reporting results to a physician fully licensed and located in Texas or for the follow-up of patients where the majority of patient care was rendered in another state, and the license holder shall practice medicine in a manner so as to comply with all other statutes and laws governing the practice of medicine in the state of Texas. 

Informed consent must be obtained prior to each patient encounter or at least annually and must include: additional fees for telehealth, to whom protected health information (PHI) may be disclosed, rights of patients with respect to PHI, appropriate uses and limitations, telehealth security and privacy standards, warning about technical failures, and disclosure of website provider.

Must have physician-patient relationship which may be established by telehealth where patient’s identity and location are confirmed, and physician's identity and professional credentials are provided to the patient.

Clinicians are held to the same standard of practice for telehealth prescribing as in-person.

An out-of-state physician may practice without a Utah license if they are licensed and in good standing in another state and services are provided as a public service and no fee or other consideration of value is charged.

A health care professional delivering health care services or dental services through telemedicine must obtain and document a patient’s oral or written informed consent. 

Audio-only services informed consent must include that the patient has the option to choose to receive services another way, is not precluded from receiving services another way in the future, describe the opportunities and limitations of audio-only, inform the patient of any other participating individuals, the implications of audio-only for insurance reimbursement, and informing them that not all audio-only services are covered by all health plans.

Providers may prescribe, dispense, or administer drugs or medical supplies, or otherwise provide treatment recommendations to a patient after having performed an appropriate examination of the patient in person, through telemedicine, or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically.

Health care professionals who hold an out-of-state license and provide services through telehealth to patients located in the state of Vermont will be required to obtain an Interim Telehealth Registration.

A practitioner who uses telemedicine should ensure that the patient provides appropriate informed consent, whether oral or written, for the medical services provided.

Prior to providing treatment, including issuing prescriptions, a practitioner who uses telemedicine should interview the patient to collect the relevant medical history and perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. 

Following an in-person physical examination to authorize the use of marijuana for medical purposes, the health care professional may determine and note in the patient’s medical record that subsequent physical examinations for the purposes of renewing an authorization may occur through the use of telemedicine technology if the health care professional determines that requiring the qualifying patient to attend a physical examination in person to renew an authorization would likely result in severe hardship to the qualifying patient because of the qualifying patient’s physical or emotional condition.

There is no prohibition against the consultation through telemedicine by a practitioner, licensed by another state or territory in which he or she resides, with a practitioner licensed in Washington who has responsibility for the diagnosis and treatment of the patient within Washington.

With the exception of the practice of pathology and radiology, a telehealth provider shall obtain the patient’s consent to receive telehealth services.

In order to prescribe via telehealth, a clinician-patient relationship must be formed by a clinician serving a patient’s medical needs, examining, diagnosing or treating a patient, or agreeing to examine, diagnose or treat a patient.

A physician or podiatrist may not prescribe any pain-relieving controlled substance listed in Schedule II of the Uniform Controlled Substance Act as part of a course of treatment for chronic non-malignant pain solely based upon a telemedicine encounter.

A physician or health care professional may not prescribe any drug with the intent of causing an abortion.

By registering to provide interstate telehealth services to patients in this state, a health care practitioner is subject to the laws of the state and jurisdiction of the state licensing board.

Informed consent required.

A physician-patient relationship may be established through telemedicine.

Physicians may issue a prescription via telehealth if they are licensed in the state, their contact information is provided to the patient, informed consent is received, a patient evaluation is performed, and a health record is maintained.

 A Wisconsin medical license is required.

Evidence documenting appropriate patient informed consent for the use of telehealth technologies must be obtained and maintained. Consent must include identification of the patient and provider with their credentials, types of technology used, clinician determination that telehealth is appropriate, and details security measures.

A documented physician-patient relationship is required to initially prescribe a controlled substance through the telehealth.

Any physician rendering medical diagnosis and/or treatment to a person physically present in this state must have a license issued by the board, regardless of the physician’s location.

Exception when consulting with in-state licensed physician.

Copyright © 2024 American Academy of Family Physicians. All Rights Reserved.

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HIPAA Rules for telehealth technology

Find out about HIPAA Rules and guidance on compliance for telehealth.

On this page:

Technology considerations, hipaa-compliant technology.

The HIPAA Rules establish standards to protect patients’ protected health information. All telehealth services provided by covered health care providers and health plans must comply with the HIPAA Rules. Covered health care providers and health plans must use technology vendors that comply with the HIPAA Rules and will enter into HIPAA business associate agreements in connection with the provision of their video communication products or other remote communication technologies for telehealth.

More information:

• Guidance on HIPAA and Audio-Only Telehealth – Office for Civil Rights
• Resource for Health Care Providers on Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies for Telehealth – Office for Civil Rights
• Privacy and Security Tips for Patients – Office for Civil Rights
• HIPAA and Telehealth – Office for Civil Rights
• Telehealth Privacy Tips for Providers (PDF) – Health Resources and Services Administration

Telehealth policy

Federal legislation continues to expand and extend telehealth services.

Medicare and Medicaid policies

Expanding telehealth care for Medicare and Medicaid patients.

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Changes to MBS items – Assignment of benefit and signature requirement

Changes to Services Australia’s website page – Changes to MBS items - Assignment of benefit and signature requirements – went live on Thursday 21 September 2023. The changes that have been made are aimed to provide guidance for health professionals to fulfill the legal requirements under the Health Insurance Act 1973 to obtain and record a patient’s verbal agreement to assign their Medicare benefit for bulk billing purposes.

Read the attached Frequently Asked Questions for more information.

Attached Files

• Telehealth Verbal AoB FAQs 20 Sept 2023.pdf 142.09 KB

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GPs urged to contact MPs about assignment of benefit concerns

The RACGP has issued a letter template for members, which includes a request to make verbal consent to bulk bill telehealth a permanent feature.

GPs are being urged to express their ‘deep concern and frustration’ about extra bureaucracy introduced to the telehealth bulk billing process by writing to their local MPs.   A newly released template letter is now available through the RACGP’s advocacy resources in response to changes requiring GPs to obtain written consent to bulk bill a patient for a telehealth appointment, or complete a form documenting verbal consent.   It warns that genuine improvements and health system reforms are being undermined by ‘unnecessary, outdated and inefficient bureaucratic requirements’.    ‘These requirements will make it cumbersome and administratively unviable for GPs to bulk bill telehealth appointments and further contribute to declining rates of bulk billing,’ the letter reads.   ‘This is a 20th century approach to 21st century healthcare that is inefficient and cumbersome.’   According to the college, the forms introduced by Services Australia that are now required to complete the bulk billing process for telehealth do not integrate with existing practice software.   In its template, the RACGP states that obtaining verbal consent for telehealth should be made permanent, with a digital solution to recording patient consent integrated with existing clinical information systems described as ‘a sensible way forward’.   MPs who receive the correspondence from GPs will be asked to raise the issue directly with the Federal Health and Aged Care Minister Mark Butler to ‘ensure a quick resolution’ and allow continue access to bulk billed telehealth.   RACGP President Dr Nicole Higgins said she hopes as many GPs as possible will join the college’s advocacy efforts.   ‘The change to assignment of benefit requirements, which was introduced without any proper consultation, has caused entirely predictable and unnecessary stress – and is already having an effect on patients,’ she told newsGP .   ‘I have expressed my views directly to the Minister and it is to his credit that he has responded to address our worries.   ‘I encourage my GP colleagues to make it clear just how widespread our concerns are in general practice, and to keep the impetus going for a speedy solution.’   In response to outcry about the changes last week, Minister Butler moved to dampen down the controversy .   ‘I have asked my department to provide options to address concerns about the assignment of benefit for Medicare bulk billed claims, including legislative amendments,’ he said.   ‘My department has advised me that until these changes are made, there are no plans to pursue any broad punitive actions on this issue, unless it relates to fraudulent claims against Medicare.’   There has not yet been any timeframe put on potential legislative changes, although Minister Butler said the RACGP will be consulted on proposed amendments before any are put in place.   The most recent poll run on the newsGP website showed an overwhelming majority of readers are likely to move to private billing if the extra paperwork requirements remain in place.   Anecdotally many general practices have said they have already cut down on bulk billing telehealth as a result, with some saying they have stopped altogether.   There is no public data yet available to verify the impact.     Next month will mark the start of a flagship health measure from the 2023–24 Federal Budget, with the introduction of a bulk billing incentive that is triple the current rate.   Weighted in favour of the most remote areas, the incentive is funded by $3.5 billion over five years, with the initiative expressly intended to address the recent decline in bulk billing .   It will apply to all bulk billed level B telehealth consultations lasting 6–20 minutes, while longer consultations will require the patient to be part of MyMedicare.   When telehealth was widely introduced shortly after the onset of the pandemic in Australia in 2020, verbal consent for bulk billed appointments was permitted to be recorded in the patient notes.   However, a critical report by the Australian National Audit Office (ANAO) published in January this year highlighted concerns about that approach’s ‘failure to manage legal risk’.   More information on assignment of benefit and signature requirements can be found on  the RACGP website .   Log in below to join the conversation.  

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