Barriers

Kentucky requires an in-person examination for the initial medical cannabis certification, though follow-up visits may occur via telehealth. This limits fully remote access to the medical cannabis program.

Kentucky requires private insurers to reimburse telehealth equivalent to in-person care, but providers and plans may contractually agree to a lower telehealth rate. Audio-only encounters default to the lower of the two applicable rates.

Kansas law expressly lets insurers set telehealth payment in the same manner as in-person services, with no parity guarantee. Commercial payers may reimburse telehealth at lower rates than equivalent in-person care.

Iowa rules generally require physicians to conduct an in-person medical interview and physical examination, or otherwise establish a provider-patient relationship, before treating via telehealth. Exceptions exist for emergencies, institutional settings, and consultations.

Out-of-state clinicians providing telehealth to Indiana patients must obtain an Indiana telehealth provider certification under IC 25-1-9.5-9. This registration step is an added administrative barrier for cross-state telehealth.

Indiana requires private insurers to cover telehealth using the same clinical criteria as in-person care, but imposes no payment parity. Insurers can reimburse telehealth services at lower rates than the equivalent in-person service.

Illinois currently requires private insurers to reimburse telehealth at the same rate as in-person care, but this payment parity provision becomes inoperative on and after January 1, 2028. Only mental health and substance use disorder services retain parity after that date.

Idaho's Virtual Care Access Act requires providers to first establish a provider-patient relationship meeting Idaho's community standard of care before delivering telehealth. Treatment based solely on a static online questionnaire is not acceptable.

Idaho has not enacted a private-payer telehealth statute. Commercial insurers are not required to cover telehealth, and there is no payment parity, so plans may reimburse telehealth below in-person rates or not at all.

Hawaii bars prescribing controlled substances via telehealth unless the prescriber is physically located in the state. An initial in-person consultation is also required before prescribing opioids or medical cannabis.

Hawaii Medicaid covers audio-only telehealth only for mental health, and only temporarily through 2027. Reimbursement is capped at 80% of the in-person rate and patients must have had an in-person or video visit within the prior six months.

Hawaii participates in the Interstate Medical Licensure Compact but is not a 'State of Principal Licensure.' Physicians whose primary license is in Hawaii cannot use it to enter the compact and obtain expedited licenses in other states.

Georgia requires out-of-state physicians providing telehealth to have an arrangement with a local physician who has admitting privileges or a local hospitalist. To prescribe controlled substances, providers must also obtain a separate Georgia DEA registration.

Georgia limits private-payer audio-only telehealth reimbursement to mental and behavioral health services. For all other services, insurers are not required to pay for audio-only (telephone) visits, disadvantaging patients without video access.

Florida's private-payer telehealth law does not mandate payment parity. Insurers and providers may agree to lower telehealth reimbursement than in-person rates, as long as the provider acknowledges the differential.

Under Florida Statute 456.47, a clinician not licensed in Florida may treat Florida patients via telehealth only after registering with the applicable board. Registrants must designate a Florida registered agent, carry liability coverage, and may not open an office or provide in-person care in the state.

Florida Medicaid stopped covering audio-only telehealth after the federal public health emergency ended. Patients who rely on telephone-only visits because they lack video access cannot have those visits reimbursed by Florida Medicaid.

Delaware requires out-of-state providers not covered by an applicable licensure compact to obtain an interstate telehealth registration from the Division of Professional Regulation before treating Delaware patients. This adds an administrative step despite strong coverage and parity rules.

California does not participate in the Interstate Medical Licensure Compact. Physicians licensed elsewhere cannot use the compact's expedited pathway and must complete California's full licensing process to treat California patients via telehealth.

Arkansas requires a professional relationship before telehealth, which can be established virtually only when the standard of care does not require an in-person encounter. Its private-payer law also does not require parity for services not comparable to in-person care.