Tessic Health

MA · STATE RULES

Telehealth rules in Massachusetts

Massachusetts schedules every prescription drug. Schedule VI holds everything not already placed in Schedules I through V, so a state controlled substances registration stands behind an ordinary hair or weight prescription exactly as it stands behind an opioid. The definition of telehealth runs the other way and is unusually open, naming the online adaptive interview among the modalities it covers, which leaves the first visit to clinical judgment rather than to a modality rule.

Book a DemoAll states
First visit
Async allowed
Physician license
No medical compact; own license
Controlled drugs
All drugs are Schedule VI
Nurse practitioners
Full practice

Rules checked September 2026 · 26 sources cited

ONLY IN MASSACHUSETTS

What is different about Massachusetts

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

  1. 01 · Prescribing

    Every drug is a scheduled drug

    Schedule VI consists of all prescription drugs not included in any other schedule, so the state controlled substances act reaches finasteride and semaglutide on the same terms as a narcotic. A practitioner registers with the Department of Public Health to prescribe across Schedules II through VI, which means a state registration stands behind any prescription at all.

    Source: 105 CMR 700.002

    Across the border

    • New Hampshire

      New Hampshire keeps the five federal schedules and puts its distinctive limit on time instead, expecting a telemedicine prescriber of controlled drugs to repeat an in-person examination at least once a year.

      Source: Center for Connected Health Policy: New Hampshire

    • Vermont

      Vermont's regulated drug list follows the federal schedules and adds no catch-all tier beneath them, so a prescription for an unscheduled drug carries no state registration duty whatever.

      Source: Center for Connected Health Policy: Vermont

    • New York

      New York moves one drug rather than all of them, listing testosterone in Schedule II above its federal placement while leaving unscheduled products outside the controlled substances article entirely.

      Source: N.Y. Public Health Law 3306

    • Connecticut

      Connecticut mirrors the federal schedules by default, so a drug outside Schedules I through V is simply not a controlled substance there and carries no extra state consequence.

      Source: Conn. Gen. Stat. 21a-243

    • Rhode Island

      Rhode Island ties its added duties to the federal schedules too, requiring electronic transmission and a monitoring review for Schedules II through V and leaving other drugs untouched.

      Source: 216-RICR-20-20-4, Sec. 4.4

  2. 02 · Practice

    The law names the online interview

    The statutory definition lists interactive audio-video technology, remote patient monitoring devices, audio-only telephone and online adaptive interviews. A structured intake that branches on what the patient reports therefore sits inside the legal meaning of telehealth rather than beside it as an unregulated substitute.

    Source: M.G.L. c.118E Sec. 79

    Across the border

    • New Hampshire

      New Hampshire defines telehealth by the medium, covering audio, video and other electronic media used synchronously or asynchronously, without naming any questionnaire format among its listed modalities.

      Source: Center for Connected Health Policy: New Hampshire

    • Vermont

      Vermont splits the vocabulary: telemedicine means live interactive audio and video over a secure connection, and store and forward is treated as a separate category of asynchronous transmission.

      Source: Center for Connected Health Policy: Vermont

    • New York

      New York lists four modalities in its public health law, store and forward transmission among them, but describes each one by how the data travels rather than by the format of the interview.

      Source: N.Y. Public Health Law 2999-cc

    • Connecticut

      Connecticut permits store and forward transfer as a delivery technology and then attaches a condition, requiring the provider to hold the patient's history and health record before care proceeds.

      Source: Conn. Gen. Stat. 19a-906

    • Rhode Island

      Rhode Island's medicine board rejects the idea outright, calling an evaluation without a contemporaneous real-time exchange inappropriate and questionnaire-only prescribing unprofessional conduct.

      Source: 216-RICR-40-05-1, Sec. 1.5.9

  3. 03 · Prescribing

    Registry checks cover more drugs

    Participants must use the prescription monitoring program each time a prescription for a narcotic in Schedule II or III is issued, and each time a prescription for a benzodiazepine is issued. The trigger is the drug class and the act of prescribing, not a supply threshold or a first fill.

    Source: M.G.L. c.94C Sec. 24A

    Across the border

    • New Hampshire

      New Hampshire's monitoring statute binds dispensers to submit information and leaves the prescriber's lookup duty to rules adopted by the licensing boards, so the trigger is fixed by rule rather than by statute.

      Source: N.H. Rev. Stat. 126-A:91

    • Vermont

      Vermont attaches its queries to pain: an opioid first written for chronic pain, a Schedule II to IV drug begun for ninety days or more of pain therapy, and an annual look after that.

      Source: 18 V.S.A. 4289

    • New York

      New York runs on a clock, calling for the registry to be consulted within twenty-four hours before a Schedule II, III or IV prescription, with named exceptions for hospice and short emergency supplies.

      Source: N.Y. Public Health Law 3343-a

    • Connecticut

      Connecticut sets a supply threshold instead, calling for a review before a controlled substance is written for more than seventy-two hours and at least once a quarter while treatment continues.

      Source: Conn. Gen. Stat. 21a-254

    • Rhode Island

      Rhode Island writes its trigger around opioids, asking for a review before an opioid is first prescribed and a recheck at least every three months for anyone on continuous therapy.

      Source: 216-RICR-20-20-4, Sec. 4.4

  4. 04 · Licenses

    No compact license works here

    The medical compact was never joined, and the nurse compact that was enacted is not yet issuing multistate licenses while the board rewrites its licensure, discipline and fee regulations. Every clinician treating a patient in the state holds a full license from the relevant board.

    Source: Mass.gov: the Nurse Licensure Compact

    Across the border

PRACTICE RULES

How telehealth works in Massachusetts

No telemedicine regulation comes from the medical board and no standalone practice act governs remote care. The duties that exist were written into the public assistance and insurance chapters, which is where the definition, the consent expectation and the standard-of-care rule all sit together.

  1. 01

    Four named modalities

    The definition covers synchronous and asynchronous audio, video, electronic media and other telecommunications technology, then names interactive audio-video, remote patient monitoring devices, audio-only telephone and online adaptive interviews.

    Source: M.G.L. c.118E Sec. 79

  2. 02

    The same standard as an office

    Services delivered this way conform to the standards of care applicable to the provider's own profession and specialty. That is the only conduct test the section sets, and it is the one discipline applies.

    Source: M.G.L. c.118E Sec. 79

  3. 03

    Privacy standards travel with the visit

    Remote care also has to meet applicable federal and state health information privacy and security standards together with the standards for informed consent, so the consent conversation is folded into the same provision.

    Source: M.G.L. c.118E Sec. 79

  4. 04

    Some services stay in person

    Coverage rules keep particular work off every telehealth modality, naming surgery, laboratory, radiology, ambulance and hearing aid services, and requiring live video for a comprehensive therapy evaluation or re-evaluation.

    Source: Center for Connected Health Policy: Massachusetts

FIRST VISIT

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

Yes

Yes. No statute or board rule requires a live exam before a first prescription for an unscheduled drug, and the statutory definition of telehealth expressly covers the online adaptive interview, so an asynchronous review is a named modality rather than a workaround.

The first visit is a clinical question here rather than a regulatory one. The statute describes what telehealth is and holds the clinician to the standard of care, and it is that standard, not a modality rule, that decides whether a review went deep enough.

  1. 01

    The questionnaire is in the statute

    Because the definition lists online adaptive interviews, a branching intake that adapts to what the patient reports is a described way of delivering care, which few state definitions state out loud.

    Source: M.G.L. c.118E Sec. 79

  2. 02

    Consent and revocation

    The patient is told how information will be handled and that consent may be revoked, and may choose an in-person appointment at any point without losing access to care.

    Source: Center for Connected Health Policy: Massachusetts

  3. 03

    The standard still bites

    A thin review is judged against the standard of care for the profession and the specialty, so an intake that gathers too little to support the decision is a conduct problem even where the modality is lawful.

    Source: M.G.L. c.118E Sec. 79

  4. 04

    The registration comes first

    Whatever the modality, the prescriber holds the state controlled substances registration before writing anything, because the drug being prescribed is scheduled in this state even when it carries no federal schedule.

    Source: 105 CMR 700.004

PRESCRIBING

Prescriptions and controlled drugs in Massachusetts

Two features shape every prescription. The state schedules all prescription drugs, which pulls ordinary products into the controlled substances act, and the monitoring duty is written around drug classes rather than around days of supply.

  1. 01

    Register before prescribing

    A practitioner registers with the Department of Public Health, and that registration covers prescriptions and medication orders across Schedules II through VI, which is to say across every prescription drug.

    Source: 105 CMR 700.004

  2. 02

    Check on each occasion

    The monitoring program is consulted every time a narcotic in Schedule II or III is prescribed and every time a benzodiazepine is prescribed, and the department may extend the duty to other drugs commonly misused.

    Source: M.G.L. c.94C Sec. 24A

  3. 03

    Electronic is the ordinary route

    Prescriptions are issued electronically under the controlled substances act, and because the state schedules reach every prescription drug, electronic transmission is the normal path rather than a special case for scheduled products.

    Source: M.G.L. c.94C Sec. 23

  4. 04

    Testosterone follows the federal list

    The state may schedule only what the federal act covers or what state findings support, and its statutory drug classes name no anabolic steroid, so testosterone is handled on its federal Schedule III placement.

    Source: M.G.L. c.94C Sec. 3

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 Massachusetts

Licensing runs board by board, with no compact route into the state that presently works. A clinician treating a patient here is licensed here, and the paperwork a compact would otherwise save has to be done again.

  1. 01

    Full license, every time

    No telehealth registration exists and no compact license is available to a physician, so extending coverage into the state means a full application to the board that governs the profession.

    Source: Center for Connected Health Policy: Massachusetts

  2. 02

    The nurse compact is pending

    Legislation joining the nurse compact passed, but multistate licenses are not being issued while the board revises its licensure, discipline and fee regulations and rebuilds the systems behind them.

    Source: Mass.gov: the Nurse Licensure Compact

  3. 03

    Nurse practitioners prescribe on their own

    The American Association of Nurse Practitioners places the state in the full practice column, and the controlled substances rules let a nurse practitioner issue prescriptions and medication orders across Schedules II through VI.

    Source: AANP: full practice authority brief

  4. 04

    Two credentials per prescriber

    A prescriber holds the state controlled substances registration alongside any federal registration, and the state one is needed even where the federal one is not, because of how the schedules are drawn.

    Source: 105 CMR 700.004

How Tessic Health's providers are licensed in Massachusetts

ADVERTISING

Marketing to patients in Massachusetts

There is no comprehensive consumer privacy act here, so marketing answers to the consumer protection act, the attorney general's regulations and the medical board's advertising rule, which is more specific than most.

  1. 01

    Keep the ad for three years

    A physician advertising through print or electronic media maintains a complete, accurate and reproducible version of the audio and visual content for three years and supplies copies to the board on request, bearing the cost.

    Source: 243 CMR 2.07

  2. 02

    No cures, no superiority

    Advertising that is false, deceptive or misleading is prohibited, as is advertising that guarantees a cure, exerts undue pressure, or claims a professional superiority the licensee cannot substantiate.

    Source: 243 CMR 2.07

  3. 03

    The consumer protection act

    Unfair or deceptive acts in trade are unlawful under the consumer protection act, which supports attorney general enforcement and a private claim alike, and that is where an overstated outcome claim is tested.

    Source: M.G.L. c.93A Sec. 2

  4. 04

    Mind the word uncontrolled

    Because every prescription drug is scheduled in this state, copy that contrasts a treatment with controlled substances misdescribes the state's own classification and should be rewritten for this market.

    Source: 105 CMR 700.002

TESSIC HEALTH IN MASSACHUSETTS

How Tessic Health's providers cover Massachusetts

Schedule VI is the fact that changes the build here. Registration rather than modality is the gate, and a brand treating a state registration as an opioid concern will find its ordinary prescriptions blocked.

  1. 01

    Registered for every prescription

    A provider treating patients in this state holds the state controlled substances registration before writing anything, including products that carry no federal schedule, because the state's own schedule takes them in.

  2. 02

    Asynchronous intake is used as written

    A structured intake that adapts to the patient's answers is used for a first visit here, because that format is named in the statutory definition, and the review is still sized to what the standard of care needs.

  3. 03

    The registry is queried by drug class

    Where a narcotic in Schedule II or III or a benzodiazepine is involved, the monitoring program is consulted on each occasion rather than on a cycle tied to days of supply.

  4. 04

    Licensing is done the long way

    Coverage in this state comes from clinicians holding a full license from the relevant board rather than a compact credential, which is planned for in advance because no shortcut exists.

  5. 05

    Pricing and shipping

    Medication for patients here leaves the pharmacy at 0% markup, with cold-chain packaging for any product that needs it, and prescriptions travel electronically as the state's rules contemplate.

COMMON QUESTIONS

Questions about telehealth in Massachusetts

  • Yes. Schedule VI takes in all prescription drugs not placed in another schedule, so a prescriber needs the state controlled substances registration to write any prescription at all. A federal registration does not answer this question.

  • It can. The statutory definition of telehealth names online adaptive interviews as a covered modality, and no rule requires a live exam before a first prescription for an unscheduled drug. The review still has to meet the standard of care for the specialty.

  • Each time a narcotic in Schedule II or III is prescribed, and each time a benzodiazepine is prescribed. The duty attaches to the drug class and to the act of prescribing rather than to a supply length or a first fill.

  • No. The medical compact was never joined. The nurse compact has been enacted but is not yet issuing multistate licenses, so every clinician treating a patient here holds a full license from the relevant board.

  • Three years. A physician who advertises through print or electronic media keeps a complete, accurate and reproducible version of the audio and visual content and provides copies to the board on request.

  • In the public assistance and insurance chapters rather than in a medical board regulation. The definition, the standard-of-care duty and the privacy and consent expectations sit together in one statutory section.

SOURCES

Rules checked September 2026 · 26 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.

All state pages →