Barriers

Vermont requires out-of-state providers to register before delivering telehealth to Vermont patients. They must obtain either an Interim Telehealth Registration or a permanent telehealth license/registration.

Non-resident providers serving Utah Medicaid patients via telehealth must meet Utah DOPL licensing requirements and enroll as Utah Medicaid providers. Temporary licenses exist only if full licensure takes longer than 15 days.

Utah requires plans to reimburse network providers at a commercially reasonable rate, but does not mandate parity with in-person rates for general telemedicine. Only provider-to-provider telepsychiatric consults get an equivalence guarantee.

Out-of-state providers serving Texas patients via telehealth must be licensed or authorized in Texas and maintain a physical office in the state. This adds a presence requirement beyond licensure.

Texas Medicaid limits audio-only telehealth, requiring an established relationship for several services. Outpatient mental health and medication-assisted treatment via audio-only require an in-person or audiovisual visit within the prior six months.

Texas requires insurers to cover telemedicine but does not mandate paying it at the in-person rate. CCHP records no payment-parity reference, so commercial plans can reimburse telehealth below in-person care.

Tennessee insurers must cover telehealth but are not required to reimburse it at the in-person rate. State law specifies payers need not pay telemedicine encounters above the amount paid for the same in-person service.

Tennessee requires evidence of a prior in-person encounter between the provider and patient before a provider-based telemedicine visit. Behavioral health initial evaluations are exempt, but most other services are not.

South Dakota Medicaid requires periodic in-person, face-to-face visits for certain telehealth services. Applied Behavior Analysis and therapy services require an in-person visit within the first 30 days and every 90 days thereafter.

South Dakota law bars insurers from excluding a service just because it is delivered via telehealth, but it does not require them to pay telehealth at the same rate as in-person care. Private plans can reimburse telehealth below the in-person rate.

South Carolina requires physicians to hold a valid, current South Carolina medical license to treat patients in the state via telemedicine, with only narrow exceptions for care between in-person visits under an existing treatment plan.

South Carolina has no statute requiring commercial insurers to cover or pay for telehealth on par with in-person care. Private payers are free to decline telehealth coverage or reimburse it at lower rates.

Rhode Island's Board of Medical Licensure and Discipline prohibits prescribing controlled substances via telemedicine without an established in-person physician-patient relationship. Patients seeking controlled-substance treatment generally cannot start care through telehealth alone.

Pennsylvania's Act 42 of 2024 requires insurers to cover in-network telemedicine but does not require payment parity, so reimbursement can vary by contract and plan. Private payers may pay less for telehealth than for equivalent in-person care.

The Oregon Medical Board confirms that Oregon has not joined the Interstate Medical Licensure Compact or other physician licensure compacts. Out-of-state physicians generally must obtain full Oregon licensure to treat patients located in Oregon, with only narrow telemedicine exemptions for established patients.

Ohio requires health plans to cover telehealth on the same basis as in-person care, but the statute expressly states it does not require reimbursement at the same rate as in-person services. Private payers can therefore pay providers less for telehealth than for equivalent in-person visits.

North Dakota holds that an examination consisting only of a static online questionnaire or an audio-only conversation does not meet the standard of care for an initial diagnosis or treatment. This effectively limits which telehealth modalities can be used to establish care with a new patient.

North Dakota law requires commercial insurers to cover telehealth on the same basis as in-person care, but it explicitly leaves reimbursement rates to negotiation between insurer and provider. There is no payment parity, so private payers can reimburse telehealth at lower rates than in-person services.

North Carolina has no statute governing commercial insurer coverage of telehealth, meaning there is neither coverage parity nor payment parity for private payers. Private insurers are free to decline to cover telehealth services or to reimburse them at lower rates than in-person care.

New York has not joined the Interstate Medical Licensure Compact, so there is no expedited pathway for out-of-state physicians to become licensed in New York. Clinicians must hold a full New York license to treat patients located in the state.