Barriers

New York's law requiring commercial insurers to reimburse telehealth at the same rate as in-person care is temporary and sunsets on April 1, 2026. After that date, private payers can pay providers less for a telehealth visit than for the equivalent in-person visit, even though coverage parity remains.

New Mexico enacted the Interstate Medical Licensure Compact in February 2026, but the medical board is still writing rules and the expedited multistate pathway is not expected to launch until late 2026 or early 2027. Until then, out-of-state physicians must obtain full New Mexico licensure the traditional way.

Under New Jersey's telehealth parity rules, audio-only physical health services are exempt from full payment parity and may be reimbursed at as little as 50% of the in-person rate. Audio-only visits for physical health care are therefore financially disadvantaged compared with in-person or video visits.

A telemedicine or telehealth organization operating in New Jersey must register annually with the state Department of Health before providing services. This registration requirement adds an administrative barrier for telehealth providers and out-of-state organizations serving New Jersey patients.

New Hampshire generally requires a prior in-person, face-to-face visit before delivering primary care or remote patient monitoring via telehealth, with limited exceptions for certain facility settings. This established-relationship requirement limits new-patient telehealth.

In New Hampshire, a clinician prescribing Schedule II-IV controlled substances by telehealth must conduct an in-person exam at intervals appropriate to the patient, but no less than annually. This in-person requirement limits fully remote controlled-substance prescribing.

Nebraska Medicaid limits audio-only (telephone) telehealth to behavioral health and crisis services, and only for established patients. Phone-based visits for other services and for new patients are generally not covered, and store-and-forward telehealth is not covered at all.

Montana law requires service parity (telehealth coverage equivalent to in-person) but explicitly does not require payment parity. Private payers may reimburse telehealth visits at lower rates than in-person care.

To deliver telehealth to Missouri Medicaid patients, out-of-state providers must be fully licensed to practice in Missouri and separately enrolled as a MO HealthNet provider. This dual requirement creates an administrative barrier for out-of-state clinicians.

Missouri requires carriers to cover telehealth on the same basis as in-person care but does not require them to reimburse at the same rate. Private payers may pay telehealth visits at lower rates and need not reimburse site origination fees.

Mississippi Medicaid does not cover physician or practitioner telehealth visits for non-established patients, so a prior relationship is generally required. Audio-only services are not part of standard coverage and are allowed only during declared emergencies.

Mississippi requires private insurers to cover telehealth to the same extent as in-person care but does not require equal payment rates. Insurers may reimburse telehealth visits at lower rates than in-person visits.

Minnesota's Medicaid program covers audio-only (telephone) telehealth only on a temporary basis through July 1, 2027. After that date, audio-only will no longer count as covered telehealth except for narrow emergency mental health and substance use exceptions.

Michigan law requires private insurers to cover telehealth services but does not require them to pay at the same rate as in-person care. Insurers can therefore reimburse telehealth visits at lower rates than equivalent in-office visits.

Massachusetts guarantees telehealth reimbursement at the in-person rate only for behavioral health services. For other services, private payers are not required to pay telehealth at parity, so medical and specialty telehealth visits can be reimbursed below in-person rates.

Massachusetts has not joined the Interstate Medical Licensure Compact, so out-of-state physicians cannot use the compact's expedited pathway to get licensed in Massachusetts. They must instead apply through the standard, slower state process.

Maryland Medicaid requires telehealth providers to hold active Maryland licenses, aside from recognized interstate compacts and limited exceptions. This in-state licensure requirement is a cross-state barrier for out-of-state clinicians.

Maine requires providers to be appropriately licensed, certified, or registered in the state where the member is located during a telehealth service. A 2026 bulletin warns that noncompliance can lead to claim denials or recoupment.

Maine bars insurers from denying coverage for telehealth that would be covered in person, but has no payment parity requirement. Carriers may reimburse telehealth below in-person rates and impose identical cost-sharing.

Louisiana's private-payer telehealth law sets the originating-site physician reimbursement floor at no less than 75% of the reasonable and customary in-person amount. This allows reimbursement below the full in-person rate for those services.