North Dakota requires an in-person-equivalent exam before initial telehealth diagnosis or treatment

Under North Dakota physician practice rules, an examination must occur before an initial diagnosis or treatment, and an examination consisting only of a static online questionnaire or an audio conversation does not meet the standard of care. This means audio-only or questionnaire-based intake cannot establish a new patient relationship for diagnosis or treatment, constraining first-visit telehealth options, particularly for patients in rural or connectivity-limited areas who may only have telephone access.

Source: Center for Connected Health Policy (CCHP), North Dakota state telehealth page (2026).