Texas Medicaid limits audio-only behavioral telehealth with an established-relationship rule

Texas Medicaid restricts audio-only telehealth: outpatient mental health and medication-assisted treatment delivered audio-only require at least one in-person or synchronous audiovisual service within the six months before the audio-only encounter, and many non-behavioral services exclude audio-only entirely. This affects low-income patients who lack reliable broadband or video-capable devices and cannot easily complete the prerequisite visit, a barrier for rural and underserved Texans relying on telephone care for mental health and addiction treatment.

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