Alabama requires an established physician-patient relationship before telehealth treatment
Summary
Alabama generally requires an established physician-patient relationship (patient-initiated or by referral) before telehealth services. Repeated telehealth for the same unresolved condition also triggers an in-person visit requirement within 12 months.
CCHP's Alabama page states physicians must provide telehealth following the patient's initiation of a relationship or a referral. If a physician provides telehealth more than four times in 12 months for the same unresolved condition, the patient must be seen in person within 12 months. This affects new patients seeking to begin care entirely via telehealth and patients with chronic conditions managed remotely.
Source: Center for Connected Health Policy (CCHP), Alabama state telehealth policy page (2026).
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