Telehealth Requirements for a Medical Practice

Written By Astera Revenue Cycle Solutions .

Telehealth is no longer a niche offering; it’s an expected part of patient care. Whether your practice is expanding virtual services or refining existing workflows, understanding the regulatory landscape is critical. Below is a clear, structured overview of the major requirements that govern telehealth today.

1. Understanding What Telehealth Includes

Telehealth refers to delivering care through electronic communication technologies such as video visits, remote monitoring, store‑and‑forward imaging, and secure messaging. These tools allow providers to extend care beyond the clinic, improve continuity, and reduce travel burdens for patients.

2. HIPAA Compliance for Telehealth Technology

Practices must ensure that any telehealth platform used meets HIPAA privacy and security standards. This includes:

  • Secure, encrypted communication

  • Business Associate Agreements (BAAs) with technology vendors

  • Protection of patient data during transmission and storage

Federal guidance outlines how HIPAA applies to telehealth and what technologies are acceptable.

3. Licensure Requirements

Licensure rules vary widely:

  • Providers typically must be licensed in the state where the patient is located.

  • Some states offer special telehealth licenses or participate in interstate licensure compacts.

  • A few states allow limited cross‑state practice for infrequent telehealth encounters.

Practices must verify provider licensure for every patient encounter to avoid penalties.

4. Patient Consent

Many states require documented patient consent for telehealth services. Requirements may include:

  • Verbal or written consent

  • Verification of patient identity and location

  • Disclosure of telehealth limitations

  • Permission to share protected health information (PHI) with other clinicians

Consent must be recorded in the patient’s medical record.

5. Online Prescribing Rules

Prescribing via telehealth—especially controlled substances—varies by state:

  • Some states allow prescribing after establishing a patient‑provider relationship via telehealth.

  • Others require an in‑person evaluation within a specific timeframe.

  • The most restrictive states prohibit online prescribing of controlled substances entirely.

Practices must review state‑specific prescribing laws before issuing medications.

6. Medicare, Medicaid, and Payer Policies

Coverage and billing rules differ by payer:

  • Medicare defines eligible services, providers, and originating sites.

  • Medicaid policies vary by state and may include additional consent or documentation requirements.

  • Commercial payers may have their own telehealth coverage rules.

Understanding payer‑specific guidelines ensures accurate billing and reimbursement.

7. Documentation and Coding

Telehealth visits must be documented with the same rigor as in‑person visits. Key elements include:

  • Patient location and provider location

  • Technology used

  • Consent documentation

  • Clinical details of the encounter

  • Time spent, when relevant for coding

Accurate documentation supports compliance and proper reimbursement.

8. Technical and Operational Readiness

To deliver high‑quality telehealth, practices should ensure:

  • Reliable internet and video capabilities

  • Staff training on telehealth workflows

  • Clear patient instructions for accessing virtual visits

  • Contingency plans for technical failures

These operational steps help maintain a smooth patient experience.

Telehealth offers tremendous benefits: expanded access, improved continuity, and greater convenience. But it also requires careful attention to legal, clinical, and operational standards. By understanding and implementing these requirements, medical practices can confidently deliver compliant, high‑quality virtual care.

Sources:

HIPAA & Telehealth Technology

U.S. Department of Health and Human Services. (2024). HIPAA and telehealth. https://www.hhs.gov/hipaa/for-professionals/special-topics/telehealth/index.html

U.S. Department of Health and Human Services, Office for Civil Rights. (2024). Guidance on HIPAA and telehealth remote communications. https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/telehealth-guidance/index.html

Licensure & Cross‑State Practice

Federation of State Medical Boards. (2024). Telemedicine policies by state. https://www.fsmb.org/advocacy/telemedicine/

Interstate Medical Licensure Compact Commission. (2024). About the compact.

Patient Consent Requirements

Center for Connected Health Policy. (2024). State telehealth laws and reimbursement policies. https://www.cchpca.org

Online Prescribing & Controlled Substances

U.S. Drug Enforcement Administration. (2024). Telemedicine and controlled substances prescribing. https://www.deadiversion.usdoj.gov

Medicare, Medicaid & Payer Policies

Centers for Medicare & Medicaid Services. (2024). Telehealth services. https://www.cms.gov/medicare/medicare-general-information/telehealth

Centers for Medicare & Medicaid Services. (2024). Medicaid telehealth. https://www.medicaid.gov/medicaid/benefits/telehealth/index.html

Documentation & Coding

American Medical Association. (2024). Telehealth coding and billing tips. https://www.ama-assn.org/practice-management/digital/telehealth-coding-and-billing-tips

Astera Revenue Cycle Solutions .