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 January 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.
A diverse, global network of industry-leading talent committed to you and your vision.
1/6
As you confront the challenges and consequences of appealing a trial court decision, you can turn to our appellate team for the highest quality briefing, oral advocacy and strategic counseling at every step of the process. Combining unparalleled constitutional litigation experience with creative legal solutions, we are always ready to roll up our sleeves and tackle the complexities of appeals courts of all levels across the country—including the Supreme Court—on behalf of leading companies, individuals, business associations and other litigants.
2/6
To help your business navigate the unique, complex regulations around alcohol beverage licensing, permitting, production, taxation and more, we tap into our premier team’s collective legislative and regulatory experience and deep market knowledge. As the only Tier 1 Alcohol Regulatory Practice in the United States, and with experience in jurisdictions around the world, we can provide you with practical solutions and strategic advice to promote and safeguard your interests and help fuel your success.
3/6
Steering your company through the energy market’s regulatory landscape requires constant attention and a deep understanding of the unique legal issues you encounter. We make it easier for you to focus on your business objectives, providing coordinated legal counsel in jurisdictions around the world and leveraging our broad industry knowledge to help propel your success. You can turn to us for support with any of your transactional and regulatory needs in the power, oil and gas, renewable energy biofuels, renewable energy, agriculture, metals or derivatives markets, at home or abroad.
4/6
Your organization faces increasing pressure to ensure customers’ data privacy and stay ahead of the curve on cybersecurity regulations and risks. Our global team brings you sophisticated guidance on the complex statutory, regulatory and enforcement regimes that govern the collection, use and disclosure of data around the world. To help you think ahead, we constantly monitor industry trends and provide proactive counsel on global privacy compliance, catastrophic cyber incident response, best practices for implementing cutting-edge data strategies and beyond.
5/6
McDermott named the nation’s only Band 1 healthcare firm – Chambers USA
Moving at the pace of innovation, we provide legal acumen rooted in decades of experience, powered by unconventional thinking. With a deep bench that includes lawyers at the cutting edge of digital health, we partner with clients on the full range of industry issues, including PPM, healthcare litigation and the evolving regulatory landscape—both in the US and internationally. This range of specialty and experience allows us to skillfully advise all types of healthcare organizations—from multi-jurisdictional health systems, to payors, to investors and healthcare technology companies.
6/6
When companies and investors face business risks, our team is equipped to provide seamless, cross-border counsel around all aspects of distressed transactions. On behalf of debtors, creditors and distressed investors, we leverage our experience and track record to help you understand your best options and maximize the value of the business when faced with a business restructuring, insolvency proceeding or opportunity to acquire distressed assets.
Alaska
Physicians:
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.
Alabama
Physicians:
Alabama permits prescribing without a personal examination based on telemedicine encounters. There is no specific definition associated with “telemedicine” in statutes, regulations, or guidance. Accordingly, asynchronous solutions are not prohibited.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Arkansas
Physicians:
Prescriptions must be based on a face-to-face examination using real-time audio and visual telemedicine technology. Moreover, regulations explicitly provide that a questionnaire is not sufficient to create a professional relationship.
Arizona
Physicians:
Real-time audio-visual encounter required in order to prescribe. 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.
California
Physicians:
Prescribing on the basis of a questionnaire is permitted under California law 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.
Colorado
Physicians:
Colorado’s definition of telemedicine requires there to be an interactive element, and guidance from the Medical Board prohibits prescribing based solely on an online questionnaire.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Wyoming
Physicians:
Wyoming has a very broad definition of telemedicine, and it does not otherwise regulate remote prescribing. In the absence of any other limiting language, “electronic communication” could include dynamic questionnaires and audio-only telephone.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
West Virginia
Physicians:
A physician-patient relationship may be established via a real-time audio-visual encounter or interactive audio-using store and forward technology. A physician-patient relationship may not be established through audio-only communication; text-based communications such as e-mail, Internet questionnaires, text-based messaging or other written forms of communication; or any combination thereof.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Wisconsin
Physicians:
Prescriptions based solely on a static questionnaire are not sufficient, but this may be read to permit a dynamic questionnaire. A medical history, exam and diagnostic tests are required when appropriate. Consults solely by telephone are not permissible.
Washington
Physicians:
The insurance coverage requirements dictate that a valid physician-patient relationship must exist, which appears to require the use of audiovisual modalities for at least the initial visit. A dynamic questionnaire may be used if additional data or information is also provided to the provider (e.g., medical records, images, patient-reported health data).
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Vermont
Physicians:
Physician may prescribe after conducting an examination via telemedicine or with “the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically.”
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Virginia
Physicians:
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.
Utah
Physicians:
In 2020, Utah revised its Telehealth Act to explicitly prohibit prescribing solely on the basis of an online questionnaire or patient-generated medical history.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Texas
Physicians:
Dynamic questionnaires may be used to establish a valid practitioner-patient relationship if 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.
Tennessee
Physicians:
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 Dakota
Physicians:
The definition of telehealth excludes audio-only telephone. In addition, a face-to-face, audio-visual examination is required in order diagnose and treat the patient, if face-to-face would otherwise be required in order to deliver the same service without telehealth. Because prescriptions are traditionally provided following a face-to-face visit in person, this would appear to require an audio-visual examination.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
South Carolina
Physicians:
While a simple questionnaire is not sufficient, a dynamic questionnaire may be permissible if it allows the physician to accurately diagnose and treat the patient in conformity with the applicable standard of care.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Rhode Island
Physicians:
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.
Pennsylvania
Physicians:
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.
Oregon
Physicians:
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.
Oklahoma
Physicians:
Telemedicine encounters must provide equivalent information to what would have been provided in an in-person exam, and relevant definitions explicitly exclude website questionnaires. Two modalities appear to be sufficient: either a two-way, audio-visual encounter or store-and-forward technology that incorporates photographs.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Ohio
Physicians:
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 previously stated that this does not require a visual connection, but has since updated the FAQ to state that the rule is “silent” on this point. While this may be interpreted to be permissive, it is not clear whether a dynamic questionnaire alone could be read to satisfy this standard.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New York
Physicians:
Telemedicine is defined to mean either synchronous, audio-visual communications, or store-and-forward technologies that incorporate the exchange of images or videos. A dynamic questionnaire without video or images likely does not satisfy these definitions. There are otherwise no specific requirements that apply to remote prescribing.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Nevada
Physicians:
The term telehealth is defined to incorporate “information and audio-visual communication technology.” A dynamic questionnaire does not satisfy this definition.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New Jersey
Physicians:
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 Hampshire
Physicians:
A physician-patient relationship must be established using two-way, audio-visual technology.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Nebraska
Physicians:
The definition for “telehealth” incorporates both synchronous and asynchronous modalities. It would include a dynamic questionnaire.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
North Dakota
Physicians:
An examination based solely on an online questionnaire is insufficient to meet the standard of care for treatment via telemedicine, but a dynamic questionnaire may suffice.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
North Carolina
Physicians:
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.
Montana
Physicians:
The definition of “telemedicine” incorporates “store-and-forward,” which is broadly defined to include electronic information that is reviewed by a health care provider at a later date. This could include dynamic questionnaires.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Mississippi
Physicians:
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.” It may be difficult to meet these standards without an audio-visual interaction.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Missouri
Physicians:
Prescribing solely on the basis of an internet questionnaire is prohibited. In addition, a valid physician patient relationship requires a “physical examination.” It may be difficult to meet these standards without an audio-visual interaction.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Minnesota
Physicians:
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.
Maine
Physicians:
Applicable regulations 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. A dynamic questionnaire could satisfy this standard, though the term “interview” is unclear.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
New Mexico
Physicians:
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.
Maryland
Physicians:
A 2020 law permits prescriptions to be issued on the basis of synchronous (defined solely as “real time”) or asynchronous encounters. A dynamic questionnaire likely satisfies the definition of asynchronous to the extent that it includes “a patient’s medical information” and “self-reported medical history.” However, 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.
Massachusetts
Physicians:
The most recent telemedicine guidance available from the Board of Registration in Medicine indicates that a face-to-face encounter is not required. The telemedicine guidance suggests that providers can use their discretion in delivering care via telemedicine, as long as it comports with the standard of care. Recent updates specifically contemplate the use of various types of modalities.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Louisiana
Physicians:
Telemedicine is defined to require interactive audio and video telecommunications, or audio-only under certain circumstances. A dynamic questionnaire is insufficient.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Kentucky
Physicians:
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.
Kansas
Physicians:
Kansas pharmacy laws prohibit prescriptions based on an online questionnaire. Moreover, the term “telemedicine” is defined to require interactive modalities.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Indiana
Physicians:
Questionnaires are explicitly excluded from the definition of “telemedicine,” and accordingly 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.
Illinois
Physicians:
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. Accordingly, a dynamic questionnaire is likely sufficient to prescribe.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Idaho
Physicians:
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.
Iowa
Physicians:
Applicable regulations 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. A dynamic questionnaire could satisfy this standard, though the term “interview” is unclear.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Hawaii
Physicians:
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.
Georgia
Physicians:
Physicians must perform a “physical examination,” which requires them to use technology and peripherals that are equal or superior to an in-person exam. A dynamic questionnaire alone is likely insufficient to meet this standard.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Michigan
Physicians:
Physicians are permitted to prescribe via telehealth, which is defined broadly. It includes telemedicine, which is specific to real-time encounters but is not limited to such encounters. Accordingly, a dynamic questionnaire is arguably sufficient under the definition of telehealth.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Florida
Physicians:
Telehealth providers may perform patient evaluations via telehealth, which is defined to include asynchronous telecommunications. A dynamic questionnaire likely meets this definition and is therefore sufficient to prescribe.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Delaware
Physicians:
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.
District of Columbia
Physicians:
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. A dynamic questionnaire is insufficient.
For our full Rules Governing Telehealth Modalities and Patient-Provider Relationships Report click below to download.
Connecticut
Physicians:
Providers are permitted to deliver telehealth services via store-and-forward technologies, which is broadly defined. 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.