Tessic Health

OH · STATE RULES

Telehealth rules in Ohio

Ohio lets a first telehealth visit happen by video, store-and-forward review or a phone call that covers every element of a bona fide visit, provided it meets the in-person standard of care set by ORC 4743.09 and OAC 4731-37-01. The strict points are in prescribing: an in-person exam before a new patient's first Schedule II drug, OARRS checks, a BMI and weight-loss test for phentermine, and electronic Schedule II scripts. Ohio is an Interstate Medical Licensure Compact state.

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First visit
Async allowed
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Controlled drugs
Schedule II needs in-person exam
Nurse practitioners
Reduced practice

Rules checked September 2026 · 28 sources cited

ONLY IN OHIO

What is different about Ohio

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

  1. 01 · Prescribing

    E-prescribing is required for Schedule II only

    Ohio's e-prescribing mandate stops at Schedule II. ORC 3719.06 requires every Schedule II prescription to be electronic, with written scripts allowed for listed exceptions, including prescribers who issue 50 or fewer a year; Ohio law sets no electronic mandate for Schedule III–V.

    Source: ORC 3719.06 (electronic Schedule II prescriptions)

    Across the border

    • Pennsylvania

      Pennsylvania's Act 96 reaches every Schedule II–V controlled substance, so a phentermine or testosterone script that Ohio lets go on paper must be electronic in Pennsylvania.

      Source: Pennsylvania Department of Health: electronic prescribing (Act 96)

    • West Virginia

      West Virginia's code now marks its former controlled-substance e-prescribing section, W. Va. Code 60A-4-403a, as repealed, and its Controlled Substances Act contains no Schedule II-only electronic duty like Ohio's.

      Source: W. Va. Code 60A-4-403a (repealed)

    • Kentucky

      Kentucky's KRS 218A.182 requires electronic prescribing for Schedule II–V controlled substances, with hardship and technology waivers of up to one year handled under 902 KAR 55:130.

      Source: 902 KAR 55:130

    • Indiana

      Indiana requires every controlled-substance prescription to be electronic and allows written, faxed or oral orders only under the exceptions and board waivers listed in IC 25-1-9.3-8.

      Source: IC 25-1-9.3-8

    • Michigan

      Michigan's MCL 333.17754a is broader than any Schedule II rule: prescribers must transmit every prescription electronically, controlled or not, subject to exceptions such as technology failures and department waivers.

      Source: MCL 333.17754a

  2. 02 · Prescribing

    Phentermine needs BMI 30 and 5% loss

    OAC 4731-11-04 limits Schedule III–IV weight-loss drugs such as phentermine to patients with a BMI of 30, or 27 with a comorbidity, and allows continued use only if the patient loses 5% of starting weight in the first three months.

    Source: OAC 4731-11-04 (controlled substances for obesity)

    Across the border

    • Pennsylvania

      Pennsylvania has no weight-loss drug rule; phentermine falls under the general 49 Pa. Code 16.92 standard of a history and physical exam before any controlled substance, with no BMI floor.

      Source: 49 Pa. Code 16.92

    • West Virginia

      West Virginia's Board of Medicine rules, Title 11 Series 1A to 16, include no obesity-drug series and set no BMI floor or three-month weight-loss target for phentermine.

      Source: W. Va. Board of Medicine rules, Title 11

    • Kentucky

      Kentucky's 201 KAR 9:016 sets a lower bar, BMI 27 or 25 to 27 with a comorbidity, and asks for a KASPER report and a written justification to continue past three months.

      Source: 201 KAR 9:016

    • Indiana

      Indiana's IC 35-48-3-11 names no BMI number; it requires a documented, unsuccessful diet-and-exercise program and a thorough exam, and ends the drug when weight loss stops.

      Source: IC 35-48-3-11

    • Michigan

      Michigan's controlled-substance rules list phentermine in Schedule 4 without any BMI or weight-loss test; the MAPS report and bona fide relationship rules of MCL 333.7303a apply instead.

      Source: MCL 333.7303a

  3. 03 · Licenses

    One CME hour on the duty to report

    Ohio physicians renew every two years with 50 CME hours, and OAC 4731-10-02 makes at least one of them a board-approved hour on the licensee's duty to report misconduct to the State Medical Board of Ohio.

    Source: OAC 4731-10-02 (physician CME hours)

    Across the border

    • Pennsylvania

      Pennsylvania's 49 Pa. Code 16.19 asks for 100 hours every two years, including 12 in patient safety and risk management and two on child abuse recognition and reporting.

      Source: 49 Pa. Code 16.19

    • West Virginia

      West Virginia's W. Va. Code 30-1-7a aims prescriber CME at controlled substances, requiring drug diversion, best-practice prescribing and opioid antagonist training rather than a misconduct-reporting hour.

      Source: W. Va. Code 30-1-7a

    • Kentucky

      Kentucky's 201 KAR 9:310 requires controlled-substance prescribers to complete 4.5 hours on KASPER, pain management or addiction disorders in each three-year cycle.

      Source: 201 KAR 9:310

    • Indiana

      Indiana's physician renewal rule, 844 IAC 4-6, covers renewal timing, the renewal oath, fees and inactive status, and lists no CME hour requirement.

      Source: 844 IAC 4-6

    • Michigan

      Michigan's R 338.2443 sets 150 hours every three years, with at least one hour of medical ethics and three of pain and symptom management.

      Source: Mich. Admin. Code R 338.2443

PRACTICE RULES

How telehealth works in Ohio

Ohio's telehealth statute, ORC 4743.09, directs every Ohio licensing board to permit telehealth within each profession's scope, and the State Medical Board of Ohio sets the physician and physician assistant details in OAC 4731-37-01.

  1. 01

    Check who and where the patient is

    OAC 4731-37-01 requires the provider to verify the patient's identity and physical location in Ohio. For a patient the provider has not treated before, the provider must also give their name and the type of active Ohio license they hold.

    Source: OAC 4731-37-01 (State Medical Board telehealth rule)

  2. 02

    Consent and records

    The Ohio chart must document consent to telehealth treatment from the patient or a legal representative, and the record must be available to the patient on request and forwarded to a primary care provider or referral practitioner where applicable. ORC 4743.09 adds a consent before billing that is collected only once.

    Source: OAC 4731-37-01 (State Medical Board telehealth rule)

  3. 03

    Phone visits must be full visits

    OAC 4731-37-01 accepts synchronous video and asynchronous store-and-forward technology when the standard of care is met. A telephone call counts as an Ohio telehealth service only when all the elements of a bona fide health care visit meeting that standard are performed.

    Source: OAC 4731-37-01 (State Medical Board telehealth rule)

  4. 04

    No facility or equipment fee

    ORC 4743.09 bars an Ohio telehealth provider from charging the patient or a health plan issuer a facility fee, an origination fee, or any fee tied to the cost of equipment at the provider site. Durable medical equipment used at the patient's location can still be billed to an insurer.

    Source: ORC 4743.09 (telehealth services)

  5. 05

    Business owners may employ doctors

    The State Medical Board of Ohio has stated that Ohio no longer prohibits the corporate practice of medicine (CPOM, the doctrine that only doctors may own a medical practice), relying on ORC 4731.226. Pain management clinics remain the exception and must be physician-owned under ORC 4729.552, and physicians keep independent professional judgment.

    Source: Vorys alert on the Medical Board's CPOM statement

FIRST VISIT

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

Yes

Yes. ORC 4743.09 and OAC 4731-37-01 let a first Ohio visit use synchronous or asynchronous technology, including store-and-forward review, when the standard of care for an initial visit is met; a new patient's first Schedule II drug is the exception.

Ohio answers the async question in statute rather than in board guidance: ORC 4743.09 says an initial visit may use synchronous or asynchronous technology if the initial-visit standard of care is satisfied.

  1. 01

    The statute allows async first visits

    ORC 4743.09 lets an Ohio health care professional conduct an initial visit through synchronous or asynchronous technology when the appropriate standard of care for an initial visit is satisfied. OAC 4731-37-01 applies the same condition to store-and-forward care by physicians and physician assistants.

    Source: ORC 4743.09 (telehealth services)

  2. 02

    Same standard as an office visit

    OAC 4731-37-01 states that the standard of care for a telehealth visit is the same as for an in-person visit, and ORC 4743.09 tells each Ohio board to adopt that equal standard. Neither text mentions questionnaires, so an intake form is judged by whether it gathers what an in-person initial visit would.

    Source: OAC 4731-37-01 (State Medical Board telehealth rule)

  3. 03

    Schedule II still needs an in-person exam

    The async route ends at Schedule II. ORC 4743.09 lets boards require an in-person initial visit before a new patient's first Schedule II drug, and OAC 4731-11-09 does so, with exceptions for hospice, addiction treatment, mental-health conditions and emergencies.

    Source: OAC 4731-11-09 (controlled substances and telehealth)

PRESCRIBING

Prescriptions and controlled drugs in Ohio

Ohio's controlled-substance rules come from the State Medical Board's OAC Chapter 4731-11 and the Board of Pharmacy's statutes in ORC Chapter 3719. OARRS, the Ohio Automated Rx Reporting System, is the state's prescription-monitoring database (PDMP).

  1. 01

    Check OARRS before opioids and benzos

    OAC 4731-11-11 requires a 12-month OARRS report before a first opioid analgesic or benzodiazepine, then a fresh report at least every 90 days while treatment lasts. For any other OARRS-reported drug, a report is due once treatment passes 90 days and at least yearly after that, and each review is noted in the chart.

    Source: OAC 4731-11-11 (OARRS review)

  2. 02

    Schedule II: in-person exam and exceptions

    OAC 4731-11-09 requires a physical exam of a new patient at an initial in-person visit before a Schedule II prescription. The telehealth exceptions are hospice or palliative care, FDA-approved medication-assisted treatment, a DSM-5-TR mental-health condition the drug treats, an emergency capped at three days, and exceptions federal law permits; the chart records which one applies.

    Source: OAC 4731-11-09 (controlled substances and telehealth)

  3. 03

    Phentermine rules; GLP-1s not covered

    OAC 4731-11-04 governs Schedule III–IV drugs approved for obesity. Before starting, the Ohio prescriber documents history, a physical exam, BMI and past diet, counseling and exercise efforts, then rechecks weight, blood pressure and heart rate at least every three months. The rule names controlled substances only, so non-controlled GLP-1 drugs fall outside it.

    Source: OAC 4731-11-04 (controlled substances for obesity)

  4. 04

    Schedule II scripts go electronically

    ORC 3719.06, added by House Bill 193, requires Ohio prescribers to issue every Schedule II prescription electronically. Written scripts stay lawful for a technical or broadband failure, nursing home or hospice patients, prescribers employed by the dispensing pharmacy's operator, urgent medical risk, and prescribers issuing 50 or fewer Schedule II prescriptions a year.

    Source: ORC 3719.06 (electronic Schedule II prescriptions)

  5. 05

    Federal exception through 2026

    OAC 4731-11-09 also exempts telehealth prescribing done under an exception permitted by federal controlled-substance law. The DEA's telemedicine flexibilities run through December 31, 2026; whether they satisfy that Ohio exception for a new Schedule II patient, and what the final DEA special-registration rule changes, is worth counsel's review.

    Source: OAC 4731-11-09 (controlled substances and telehealth)

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 Ohio

Every Ohio patient needs a clinician licensed in Ohio: the State Medical Board of Ohio licenses physicians and physician assistants, and the Ohio Board of Nursing licenses advanced practice registered nurses.

  1. 01

    Ohio is an IMLC state

    Senate Bill 6 made Ohio a member of the Interstate Medical Licensure Compact (IMLC, a faster route to more state licenses for qualified physicians). The State Medical Board of Ohio issues Letters of Qualification to physicians who name Ohio as their state of principal license, and Compact licenses keep Ohio's renewal cycle.

    Source: State Medical Board of Ohio IMLC FAQ

  2. 02

    NPs need a standard care arrangement

    AANP classes Ohio as reduced practice. Ohio nurse practitioners work under a career-long standard care arrangement with a collaborating physician or podiatrist (ORC 4723.431), and one physician may hold prescribing arrangements with no more than five nurses.

    Source: AANP state policy fact sheet: Ohio

  3. 03

    NP Schedule II limits by site

    ORC 4723.481 lets an Ohio APRN write Schedule II outside listed sites only for a terminal patient whose physician started the drug, capped at a 72-hour supply. Hospitals, hospices, FQHCs, physician-owned practices and behavioral health practices are listed sites; convenience care clinics are barred outright.

    Source: ORC 4723.481

  4. 04

    Renewal CME includes a reporting hour

    OAC 4731-10-02 sets 50 hours of CME for each two-year Ohio registration period, with at least one board-approved hour on a licensee's duty to report misconduct. Physicians licensed through the Compact follow the same Ohio renewal and CME rules as everyone else.

    Source: OAC 4731-10-02 (physician CME hours)

ADVERTISING

Marketing to patients in Ohio

Ohio polices physician marketing through the Medical Board's discipline statute, ORC 4731.22, and polices phone sales through the Ohio Attorney General under ORC Chapter 4719.

  1. 01

    No misleading claims

    ORC 4731.22(B)(5) lets the State Medical Board of Ohio discipline a physician for false, fraudulent, deceptive or misleading statements in advertising or soliciting patients, defined to include failing to disclose material facts and creating false or unjustified expectations of favorable results. Weight-loss result claims are judged against that expectations test.

    Source: ORC 4731.22 (Medical Board discipline grounds)

  2. 02

    No paying for referrals

    ORC 4731.22(B)(17) bars an Ohio physician from dividing fees for referring patients, except as ORC 4731.31 allows, and from taking payment for referring a particular patient. Per-patient payments to affiliates or lead sellers that route patients to Ohio physicians raise this issue; have counsel review the pricing.

    Source: ORC 4731.22 (Medical Board discipline grounds)

  3. 03

    Phone sales need AG registration and a bond

    ORC 4719.02 bars acting as a telephone solicitor without an Ohio Attorney General registration certificate, and ORC 4719.04 requires a $50,000 surety bond filed with the Attorney General. The law reaches out-of-state callers who solicit Ohio residents, and its exemption list in ORC 4719.01 names home health agencies and hospice providers, not telehealth brands.

    Source: ORC 4719.02 (telephone solicitor registration)

TESSIC HEALTH IN OHIO

How Tessic Health's providers cover Ohio

Tessic Health's providers hold Ohio licenses and work inside the Ohio rules above, under an MSO and friendly-PC structure in which the brand owns its Ohio patients, records and data.

  1. 01

    Ohio license and location check

    Every Ohio visit is handled by a provider with an active Ohio license, who confirms the patient's identity and Ohio location and, on a first visit, gives their name and Ohio license type as OAC 4731-37-01 requires.

  2. 02

    Async intake for non-controlled treatment

    For non-controlled treatment such as GLP-1 weight-loss plans or hair and skin prescriptions, Tessic Health's providers can start Ohio patients by store-and-forward review under ORC 4743.09 when the intake supports the initial-visit standard of care.

  3. 03

    OARRS and in-person steps for controlled drugs

    Before a first opioid or benzodiazepine the provider pulls a 12-month OARRS report, and a new Ohio patient's first Schedule II prescription waits for an in-person exam unless an OAC 4731-11-09 exception is documented in the chart.

  4. 04

    Phentermine only after an Ohio review

    Phentermine and other controlled appetite suppressants sit outside Tessic Health's standard weight-loss protocol. Where a brand adds one for Ohio after a state review, patients start only at a BMI of 30, or 27 with a comorbidity, are reviewed every three months, and stop if they have not lost 5% of starting weight by month three.

  5. 05

    Pharmacies licensed for Ohio

    Prescriptions go out electronically, including EPCS for Schedule II, to pharmacies holding an Ohio terminal distributor of dangerous drugs license, the Ohio Board of Pharmacy license for out-of-state pharmacies shipping to Ohio patients, with fulfillment at 0% markup.

COMMON QUESTIONS

Questions about telehealth in Ohio

  • Yes, for most treatment. ORC 4743.09 allows an initial visit by synchronous or asynchronous technology when the initial-visit standard of care is met; a new patient's first Schedule II prescription still needs an in-person exam under OAC 4731-11-09.

  • Sometimes. Stimulants such as amphetamine and methylphenidate are Schedule II, which normally needs an in-person exam first, but OAC 4731-11-09 exempts a DSM-5-TR mental-health condition the drug treats, as long as federal DEA rules are also met and the reason is charted.

  • Yes. OAC 4731-11-04 requires a BMI of 30, or 27 with a comorbidity, checks at least every three months, and a 5% weight loss in the first three months to keep going. The rule covers controlled obesity drugs, not GLP-1 injections.

  • OARRS is Ohio's prescription-monitoring database. OAC 4731-11-11 requires a 12-month report before a first opioid or benzodiazepine and every 90 days after, and for other reported drugs once use passes 90 days, then at least yearly.

  • Yes. OAC 4731-37-01 has the provider tell each new patient the type of active Ohio license held. Physicians can get one faster through the Interstate Medical Licensure Compact, which Ohio joined through Senate Bill 6.

  • Not a facility or equipment fee. ORC 4743.09 bars charging patients or health plans a facility fee, an origination fee, or a fee for equipment at the provider site; how a subscription or membership price is described is worth counsel's review.

SOURCES

Rules checked September 2026 · 28 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

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