Tessic Health

CA · STATE RULES

Telehealth rules in California

California lets a questionnaire serve as the exam, then adds rules none of its neighbours share: every prescription must be electronic, AI-written clinical messages need a disclaimer, and physicians need a full Medical Board of California license with no compact or telehealth-registration route. This page sets out those rules, the CURES check before controlled substances, the state's strict ban on corporate control of medicine, and how Tessic Health's providers work within them.

Book a DemoAll states
First visit
Async allowed
Physician license
Own license only, no compact
Controlled drugs
CURES check before Sched. II–IV
Nurse practitioners
Restricted practice

Rules checked September 2026 · 33 sources cited

ONLY IN CALIFORNIA

What is different about California

Each rule here is true of California and of none of the states that border it. Beside each one: what the neighbours do instead.

  1. 01 · Prescribing

    Every prescription is electronic

    Cal. Bus. & Prof. Code 688(d) requires every prescription, not only controlled substances, to be issued as an electronic data transmission prescription. Subdivision (e) allows narrow exceptions, such as a temporary technology or power failure and a prescription filled by a pharmacy outside California.

    Source: Cal. Bus. & Prof. Code 688

    Across the border

    • Oregon

      Oregon has no e-prescribing mandate. The Oregon Medical Board states prescribers are not required to send controlled substances electronically, and paper prescriptions for Schedule II–V drugs remain valid.

      Source: Oregon Medical Board: electronic prescribing

    • Nevada

      Nevada requires electronic transmission only for controlled-substance prescriptions (NRS 639.23535). Prescriptions for other drugs may still reach the pharmacy by the other methods NRS 639.2353 authorizes, including a written prescription.

      Source: NRS 639.23535

    • Arizona

      Arizona's mandate covers only Schedule II opioids, which A.R.S. 36-2525 says must be transmitted electronically. Non-opioid Schedule II drugs and non-controlled prescriptions may still be written on paper.

      Source: A.R.S. 36-2525

  2. 02 · Practice

    AI-written messages need a notice

    Under Cal. Health & Safety Code 1339.75 (AB 3030), a physician's office or clinic that uses generative AI to write messages about a patient's clinical information must add a disclaimer and instructions for reaching a human. The duty lifts only when a licensed provider reads and reviews the message first.

    Source: Cal. Health & Safety Code 1339.75

    Across the border

  3. 03 · Licenses

    No shortcut license for doctors

    Physicians treating patients located in California need a full license from the Medical Board of California, which states that telehealth to California patients requires California licensure. California has not joined the Interstate Medical Licensure Compact (IMLC, a fast-track multistate license) and offers no telehealth-only registration or special license.

    Source: Medical Board of California: telehealth

    Across the border

    • Oregon

      Oregon has also stayed out of the IMLC, but it issues a Telemedicine status license that lets a physician practicing entirely outside Oregon treat Oregon patients remotely (ORS 677.135 to 677.141).

      Source: Oregon Medical Board: telemedicine

    • Nevada

      Nevada ratified the IMLC in NRS chapter 629A and also issues a special purpose license so physicians licensed in another state can treat Nevada patients through telehealth (NRS 630.261).

      Source: NRS 630.261

    • Arizona

      Arizona belongs to the IMLC and lets out-of-state providers register with their Arizona licensing board to offer telehealth without a full Arizona license (A.R.S. 36-3606).

      Source: A.R.S. 36-3606

  4. 04 · Licenses

    Nurse practitioners earn independence in steps

    California is a restricted-practice state on the AANP map. Under AB 890, a '103 NP' completes three full-time years or 4,600 hours of transition to practice and works where physicians also practice (Cal. Bus. & Prof. Code 2837.103); only a '104 NP', after three more years in good standing, may practice outside those settings.

    Source: Cal. Bus. & Prof. Code 2837.103

    Across the border

    • Oregon

      AANP lists Oregon as a full practice authority state, where nurse practitioners evaluate, diagnose and prescribe under the board of nursing's licensure alone, with no physician agreement.

      Source: AANP: full practice authority brief

    • Nevada

      Nevada is a full practice authority state. An advanced practice registered nurse needs 2 years or 2,000 hours of experience, or a physician protocol, only to prescribe Schedule II drugs (NRS 632.237).

      Source: NRS 632.237

    • Arizona

      Arizona is a full practice authority state on AANP's list, and A.R.S. 32-1601 lets a registered nurse practitioner diagnose and prescribe, including controlled substances, within that scope.

      Source: A.R.S. 32-1601

PRACTICE RULES

How telehealth works in California

Cal. Bus. & Prof. Code 2290.5 defines telehealth in California, and the Medical Board of California holds it to the same standard of care as an office visit. Consent, AI-written messages and the corporate-practice ban each carry California-specific rules.

  1. 01

    Consent comes first

    Before care by telehealth begins, Cal. Bus. & Prof. Code 2290.5(b) requires the provider to tell the patient that telehealth will be used and obtain verbal or written consent, and the consent must be documented. The section counts both real-time visits and asynchronous store and forward as telehealth.

    Source: Cal. Bus. & Prof. Code 2290.5

  2. 02

    How the AI notice works

    Cal. Health & Safety Code 1339.75 sets the format: written messages open with the disclaimer, chat and video show it throughout, and audio states it at the start and the end. Scheduling, billing and other clerical messages are exempt, and violations by physicians go to the Medical Board of California.

    Source: Cal. Health & Safety Code 1339.75

  3. 03

    Doctors control the medicine

    Cal. Bus. & Prof. Code 2400 gives corporations 'no professional rights, privileges, or powers', and section 2052 makes unlicensed practice a crime. The Medical Board of California lists choices only a California physician may make, including diagnostic tests, referrals, coding and billing, and ownership of patient records.

    Source: Medical Board of California: corporate practice

  4. 04

    Limits on investor control

    Since January 1, 2026, Cal. Health & Safety Code 1190 and 1191 (SB 351) bar private equity groups and hedge funds from interfering with clinical judgment or controlling records, coding and billing, or payer-contract terms. Clauses stopping a clinician from competing after leaving, or from criticizing the practice's quality of care, are void.

    Source: SB 351, Chapter 409

  5. 05

    Deals need 90 days' notice

    AB 1415 extended Office of Health Care Affordability notice duties to management services organizations on January 1, 2026. An MSO, private equity group or hedge fund must give the office written notice at least 90 days before a transaction that transfers control or a material amount of assets of a California provider or MSO.

    Source: AB 1415, Chapter 641

FIRST VISIT

Can a first visit happen without a live call in California?

Yes

Yes. Cal. Bus. & Prof. Code 2242(a) states that an appropriate prior examination 'does not require a synchronous interaction' and may use a self-screening tool or questionnaire, provided the prescriber meets the standard of care.

California writes async permission into the Medical Practice Act itself. The limits come from the standard of care and from the separate internet-prescribing statute, which carries its own fines.

  1. 01

    A questionnaire can be the exam

    Prescribing a dangerous drug without an appropriate prior examination and medical indication is unprofessional conduct under Cal. Bus. & Prof. Code 2242. Since AB 1264, the statute says that exam may happen through telehealth, including a self-screening tool or questionnaire, when the licensee meets the appropriate standard of care.

    Source: Cal. Bus. & Prof. Code 2242

  2. 02

    Online sales need a real exam

    Cal. Bus. & Prof. Code 2242.1 bars any person or entity from prescribing, dispensing or furnishing dangerous drugs or devices on the Internet for delivery in California without an appropriate prior examination and medical indication. Fines or civil penalties reach $25,000 per occurrence, and the Attorney General can enforce.

    Source: Cal. Bus. & Prof. Code 2242.1

  3. 03

    Same standard as the office

    The Medical Board of California states that 'the standard of care is the same whether the patient is seen in-person, through telehealth or other methods.' An async intake for a California patient is judged against what an in-person physician would need, and the 2290.5 consent still applies.

    Source: Medical Board of California: telehealth

PRESCRIBING

Prescriptions and controlled drugs in California

California adds two statewide duties to the federal DEA rules: every prescription is electronic, and CURES, the state's prescription-monitoring database, must be checked before controlled substances. Federal DEA telemedicine flexibilities, which apply in California as elsewhere, run through December 31, 2026.

  1. 01

    No paper prescriptions

    Cal. Bus. & Prof. Code 688(d) covers non-controlled drugs such as GLP-1s as well as controlled substances, and controlled-substance e-prescriptions must also meet the DEA's EPCS rules in 21 CFR Part 1311. The listed exceptions include a temporary system or power failure and a prescription filled outside California.

    Source: Cal. Bus. & Prof. Code 688

  2. 02

    Check CURES first

    Under Cal. Health & Safety Code 11165.4, a prescriber must review the patient's past 12 months in CURES no earlier than 24 hours, or the previous business day, before a first Schedule II, III or IV prescription. The check repeats at least every six months while the drug stays part of treatment.

    Source: Cal. Health & Safety Code 11165.4

  3. 03

    When CURES can be skipped

    Section 11165.4(c) lists narrow exemptions, including a terminally ill patient, a CURES outage, and a nonrefillable supply of seven days or less when timely CURES access is impossible or would harm the patient. An ongoing telehealth prescription for a controlled substance is not on that list.

    Source: Cal. Health & Safety Code 11165.4

  4. 04

    Sign up for CURES

    Cal. Health & Safety Code 11165.1 requires every California practitioner authorized to prescribe Schedule II–V drugs to apply for CURES access on receiving a DEA registration. Without that access a prescriber cannot run the 11165.4 check.

    Source: Cal. Health & Safety Code 11165.1

  5. 05

    Pharmacies need a California license

    A pharmacy outside California that ships drugs to California patients needs a nonresident pharmacy license under Cal. Bus. & Prof. Code 4112; the version operative July 1, 2026 also requires a California-licensed pharmacist-in-charge. Sterile compounded drugs, such as injectable GLP-1 preparations, need a separate nonresident sterile compounding license under section 4127.2.

    Source: Cal. Bus. & Prof. Code 4112

Federal rules apply on top of every state's. Prescribing controlled substances by telehealth without an in-person visit runs on DEA flexibilities currently extended through December 31, 2026, with a permanent rule still pending.

LICENSES

Who can treat patients in California

The Medical Board of California licenses every physician who treats a patient located in the state, with no compact or registration alternative. Nurse practitioners and physician assistants each practice under limits set in the California Business and Professions Code.

  1. 01

    Doctors need a California license

    The Medical Board of California states that 'physicians using telehealth technologies to provide care to patients located in California must be licensed in California.' Treating a California patient without that license is unlicensed practice under Cal. Bus. & Prof. Code 2052, a crime carrying fines up to $10,000.

    Source: Medical Board of California: telehealth

  2. 02

    The '104 NP' still has duties

    A '104 NP' may practice outside physician settings after at least three years in good standing, but Cal. Bus. & Prof. Code 2837.104 still requires a referral plan for complex cases and emergencies, physician consultation when warranted, and professional liability insurance. Until then, a '103 NP' must work where physicians practice.

    Source: Cal. Bus. & Prof. Code 2837.104

  3. 03

    PA agreements and ratios

    California physician assistants practice under a written practice agreement, signed by the PA and a physician, that sets services, supervision and drug furnishing (Cal. Bus. & Prof. Code 3502.3). Section 3516 caps supervision at eight physician assistants per physician at any one time.

    Source: Cal. Bus. & Prof. Code 3502.3

  4. 04

    A one-time pain course

    Cal. Bus. & Prof. Code 2190.5 requires California physicians to complete 12 hours of continuing education in pain management and care of terminally ill patients within four years of initial licensure, including the addiction risks of Schedule II drugs. Pathologists and radiologists are exempt.

    Source: Cal. Bus. & Prof. Code 2190.5

ADVERTISING

Marketing to patients in California

California governs health-care marketing through Cal. Bus. & Prof. Code 651, the Confidentiality of Medical Information Act (CMIA) and the state's automatic renewal law. Separate California statutes reach the brand name on the storefront and any AI chat tool.

  1. 01

    Prices must be exact

    Cal. Bus. & Prof. Code 651 bans false or misleading health-care advertising. Price ads must be exact, without phrases such as 'as low as', 'and up' or 'lowest prices'; testimonials may not omit material facts; and a 'board certified' claim must name the certifying board.

    Source: Cal. Bus. & Prof. Code 651

  2. 02

    A brand name needs a permit

    A California physician practice that operates under any name other than its physicians' own needs a fictitious-name permit from the Medical Board of California (Cal. Bus. & Prof. Code 2415). The board issues it only when licensees wholly own and control the practice and the name is not misleading.

    Source: Cal. Bus. & Prof. Code 2415

  3. 03

    AI cannot pose as a clinician

    Since January 1, 2026, Cal. Bus. & Prof. Code 4999.9 (AB 489) bars AI systems from using terms, letters or phrases, in advertising or in the product itself, that imply care or advice comes from a licensed professional. Each prohibited term is a separate violation that the relevant California licensing board can enjoin.

    Source: AB 489, Business and Professions Code 4999.8 to 4999.9

  4. 04

    Health data stays out of ads

    Under California Civil Code 56.10, part of the CMIA, a provider or its contractor may not disclose medical information without authorization, or use it for marketing, unless the patient expressly authorizes it. The CCPA separately lets consumers limit a business's use of their sensitive personal information (Civil Code 1798.121).

    Source: Cal. Civil Code 56.10

  5. 05

    Subscriptions need a cancel button

    California's automatic renewal law, Cal. Bus. & Prof. Code 17602 as amended by AB 2863, requires clear renewal terms and affirmative consent before charging, an online cancellation button, an annual reminder for yearly plans, and 7 to 30 days' notice before a price change.

    Source: Cal. Bus. & Prof. Code 17602

TESSIC HEALTH IN CALIFORNIA

How Tessic Health's providers cover California

Tessic Health's providers treat California patients under the brand's name, through an MSO and a physician-owned professional corporation built around Cal. Bus. & Prof. Code 2400. Each step below follows from a California statute or Medical Board of California rule cited above.

  1. 01

    California-licensed clinicians

    Every clinician who treats a patient located in California holds a California license, and the friendly PC that employs them is owned by a California-licensed physician. Decisions on the Medical Board of California's physician-only list, from test selection to coding and billing, stay with the PC rather than the MSO or the brand.

  2. 02

    CURES, then EPCS

    Before a first Schedule II–IV prescription, Tessic Health's providers review the patient's 12-month CURES history within the prior 24 hours and repeat the review at least every six months. Every California prescription is sent electronically, and controlled substances go through EPCS.

  3. 03

    Consent and the board notice

    Each first California visit records the patient's verbal or written telehealth consent in the chart under section 2290.5. Patients also receive the notice required by 16 CCR 1355.4: 'Medical doctors are licensed and regulated by the Medical Board of California,' with the board's contact details.

  4. 04

    AI drafts get a human read

    Where a brand's patient messaging drafts clinical content with generative AI, a licensed provider reads and reviews each message before it reaches a California patient. A message sent without that review would have to carry the AB 3030 disclaimer and instructions for reaching a human.

  5. 05

    California-licensed pharmacies

    Prescriptions for California patients ship at 0% markup, with cold-chain packing where needed, from pharmacies licensed by the California State Board of Pharmacy, including nonresident licenses under section 4112. Sterile compounded drugs come only from pharmacies holding a California nonresident sterile compounding license.

COMMON QUESTIONS

Questions about telehealth in California

  • Yes. Cal. Bus. & Prof. Code 2242(a) lets a self-screening tool or questionnaire serve as the prior exam if the prescriber meets the standard of care, and the patient's telehealth consent must still be documented under section 2290.5.

  • No, not without a California license. The Medical Board of California requires one for telehealth to patients located in California, and the state offers no IMLC compact license, telehealth registration or special-purpose license instead.

  • Yes, when generative AI writes messages about a patient's clinical information and no licensed provider reviews them first. Cal. Health & Safety Code 1339.75 then requires a disclaimer and a way to reach a human; scheduling and billing messages are exempt.

  • No. Under Cal. Bus. & Prof. Code 2400 a corporation has no professional rights, so a physician-owned professional corporation employs the clinicians while an MSO runs the business side. Since January 1, 2026, SB 351 limits investor control and AB 1415 requires 90 days' notice to the Office of Health Care Affordability for covered deals.

  • Not at first. Under AB 890, a California nurse practitioner completes 4,600 hours or three full-time years of transition to practice, then practices as a '103 NP' alongside physicians; only a '104 NP', after at least three more years in good standing, may practice outside those settings.

  • Clear renewal terms, the patient's affirmative consent before the first charge, and an online way to cancel. California's automatic renewal law, Cal. Bus. & Prof. Code 17602, also requires an annual reminder for yearly plans and 7 to 30 days' notice before a price change.

SOURCES

Rules checked September 2026 · 33 sources cited. A planning summary, not legal advice. Statutes, board rules and enforcement priorities change; a brand's own counsel should review its model and marketing before launch.

OTHER STATES

Rules in other states

Each state page is researched from that state's own statutes and board rules.

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