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PA · STATE RULES

Telehealth rules in Pennsylvania

Pennsylvania lets a first telehealth visit run asynchronously: Act 42 counts self-reported history and clinical images as telemedicine and holds them to the in-person standard of care (40 Pa.C.S. 4805). The stricter rules sit in other Pennsylvania laws: prescribers query ABC-MAP before every opioid or benzodiazepine, take an initial history and physical exam before any controlled substance, carry malpractice cover under the MCARE Act, and nurse practitioners stop at 30-day Schedule II supplies. Tessic Health's providers hold Pennsylvania licenses and work to each rule.

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Rules checked September 2026 · 42 sources cited

ONLY IN PENNSYLVANIA

What is different about Pennsylvania

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

  1. 01 · Prescribing

    Check ABC-MAP for each opioid

    Pennsylvania splits its prescription-monitoring (PDMP) duty by drug class. Prescribers query ABC-MAP before every opioid or benzodiazepine prescription, but for other controlled drugs such as testosterone or phentermine, only the first time that prescriber gives the patient any controlled substance, or when misuse is suspected (35 P.S. 872.8).

    Source: 35 P.S. 872.8

    Across the border

    • New York

      New York checks by schedule, not drug class: the I-STOP registry must be consulted before every Schedule II, III or IV prescription, so each testosterone or phentermine renewal triggers a lookup too.

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

    • New Jersey

      New Jersey requires a lookup the first time a new patient gets a Schedule II drug or opioid for pain, or a benzodiazepine, then quarterly while those prescriptions continue.

      Source: N.J.S.A. 45:1-46.1

    • Delaware

      Delaware ties PMP queries to stages of opioid treatment: the first prescription past an initial 7-day supply, then at least every six months for chronic pain or whenever a benzodiazepine is added.

      Source: 24 Del. Admin. Code UCSA Reg. 9.0

    • Maryland

      Maryland prescribers pull at least four months of PDMP data before starting an opioid or benzodiazepine, then at least every 90 days; supplies of 3 days or less are exempt.

      Source: Md. Health-Gen. 21-2A-04.2

    • West Virginia

      West Virginia requires a Controlled Substances Monitoring Program check when first prescribing a Schedule II drug, opioid or benzodiazepine, then at least annually while controlled-substance treatment continues.

      Source: W. Va. Code 60A-9-5a

    • Ohio

      Ohio requires an OARRS report before the first opioid or benzodiazepine prescription and every 90 days after that, and exempts supplies of seven days or less.

      Source: Ohio Admin. Code 4731-11-11

  2. 02 · Licenses

    Twelve hours on patient safety

    Pennsylvania Board of Medicine licensees renew every two years with 100 CME hours, at least 20 in AMA PRA Category 1 and at least 12 in patient safety or risk management. Physicians who hold a DEA registration also log 2 hours on pain management, addiction or opioid prescribing each cycle (49 Pa. Code 16.19).

    Source: 49 Pa. Code 16.19

    Across the border

    • New York

      New York's registration statute (Educ. Law 6502) sets no CME hour total; DEA-registered prescribers instead take 3 hours on pain management, palliative care and addiction once every three years.

      Source: N.Y. Pub. Health Law 3309-a

    • New Jersey

      New Jersey also asks for 100 credits every two years, but its named topics are end-of-life care, opioid prescribing and sexual-misconduct prevention, with no patient-safety block.

      Source: N.J.A.C. 13:35-6.15

    • Delaware

      Delaware physicians complete 40 CME hours per renewal period, and the only named topic is training on child abuse, exploitation and domestic violence under 24 Del. C. 1723.

      Source: Delaware Board of Medical Licensure CME page

    • Maryland

      Maryland requires 50 hours every two years, and its licensing statute bars the Board of Physicians from requiring a specific course of every licensee.

      Source: Md. Health Occ. 14-316

    • West Virginia

      West Virginia requires 50 Category I hours every two years, including nutrition and, for controlled-substance prescribers, 3 hours of drug-diversion and responsible-prescribing training.

      Source: W. Va. Code 30-3-12

    • Ohio

      Ohio requires 50 CME hours per two-year registration, and its single named topic is one hour on a licensee's duty to report misconduct.

      Source: Ohio Admin. Code 4731-10-02

  3. 03 · Licenses

    Insurance and the MCARE Fund

    The MCARE Act requires every provider treating patients in Pennsylvania to carry malpractice insurance or approved self-insurance. Physicians with more than half their practice in the state also pay the yearly MCARE Fund assessment, and the Fund pays claims above the primary policy up to $500,000 per occurrence; those with half or less carry $1 million per claim and $3 million a year on their own (40 P.S. 1303.711).

    Source: 40 P.S. 1303.711

    Across the border

    • New York

      New York's professional registration statute lists an application and fee but no malpractice-insurance condition for physicians, and no state fund assessment attaches to the license.

      Source: N.Y. Educ. Law 6502

    • New Jersey

      New Jersey mandates coverage too, at $1 million per occurrence and $3 million per policy year or a $500,000 letter of credit, but the statute creates no state fund or assessment.

      Source: N.J.S.A. 45:9-19.17

    • Delaware

      Delaware's renewal statute asks for CME and abuse-recognition training but no proof of malpractice coverage, and its medical-negligence chapter (18 Del. C. ch. 68) sets no coverage mandate.

      Source: 24 Del. C. 1723

    • Maryland

      Maryland's renewal statute lists no malpractice-insurance condition; its main liability control is a noneconomic-damages cap that rises $15,000 each January under Cts. & Jud. Proc. 3-2A-09.

      Source: Md. Health Occ. 14-316

    • West Virginia

      West Virginia leaves coverage optional but withholds its noneconomic-damages caps from any defendant without at least $1 million of coverage per occurrence, or a self-funded trust.

      Source: W. Va. Code 55-7B-8

    • Ohio

      Ohio lets physicians practice uninsured if each patient first signs a written notice that the physician lacks malpractice coverage, kept in the medical record.

      Source: Ohio Rev. Code 4731.143

  4. 04 · Licenses

    Nurse practitioner supply caps

    A certified registered nurse practitioner (CRNP) prescribes only under a written collaborative agreement with a Pennsylvania-licensed physician, filed with the Bureau of Professional and Occupational Affairs. Even under that agreement, a CRNP may write a Schedule II controlled substance for no more than a 30-day supply and a Schedule III or IV drug for no more than 90 days (49 Pa. Code 21.284).

    Source: 49 Pa. Code 21.284

    Across the border

    • New York

      New York nurse practitioners prescribe under a written practice agreement or, past 3,600 hours, collaborative relationships, and Educ. Law 6902 sets no days'-supply cap by schedule.

      Source: N.Y. Educ. Law 6902

    • New Jersey

      New Jersey advanced practice nurses prescribe controlled drugs under joint protocols with a collaborating physician, which decide when prior consultation is needed; the statute sets no days'-supply cap.

      Source: N.J.S.A. 45:11-49

    • Delaware

      Delaware APRNs with full practice authority prescribe Schedule II–V drugs without a collaborative agreement, and the Board of Nursing rule sets no days'-supply cap.

      Source: 24 Del. Admin. Code 1900-8.0

    • Maryland

      Maryland nurse practitioners prescribe independently, with no collaboration or attestation requirement, and the Board of Nursing scope rule sets no days'-supply cap.

      Source: COMAR 10.27.07.03

    • West Virginia

      West Virginia APRNs may not prescribe any Schedule I drug and may write only a three-day supply of a Schedule II narcotic.

      Source: W. Va. Code 30-7-15a

    • Ohio

      Ohio APRNs may write Schedule II drugs only in listed settings such as hospitals and hospices, or for terminally ill patients in amounts covering 72 hours.

      Source: Ohio Rev. Code 4723.481

PRACTICE RULES

How telehealth works in Pennsylvania

Pennsylvania regulates telemedicine through Act 42, codified at 40 Pa.C.S. 4801–4805, and through the ordinary rules of the State Board of Medicine. The Department of State treats a telehealth visit with a Pennsylvania patient as practice in Pennsylvania, with no separate telemedicine registration.

  1. 01

    What counts as telemedicine

    Act 42 defines telemedicine as care from a provider at a different location through synchronous interactions (real-time audio or video), asynchronous interactions or remote patient monitoring. Its asynchronous definition expressly covers clinical images, lab results and self-reported medical history, which is where questionnaire-based intake fits (40 Pa.C.S. 4802).

    Source: 40 Pa.C.S. 4802

  2. 02

    Same care as in person

    Under 40 Pa.C.S. 4805, a provider treating a Pennsylvania patient by telemedicine is held to the same standard of care that would apply in an in-person setting. The Medical Practice Act makes care below that standard unprofessional conduct the Board of Medicine can discipline (63 P.S. 422.41(8)).

    Source: 40 Pa.C.S. 4805

  3. 03

    A Pennsylvania license is needed

    The Department of State's telemedicine guidance says practitioners serving individuals in Pennsylvania must hold a Pennsylvania license, whether care is in person or through a telehealth consultation. The guidance names no telemedicine exception, so a physician licensed only in a bordering state cannot treat a patient located in Pennsylvania.

    Source: Pa. Department of State telemedicine FAQ

  4. 04

    Consent for Medical Assistance

    Pennsylvania's Medical Assistance program requires consent from the beneficiary or guardian before a telehealth service and lets the beneficiary choose in-person care instead (MA Bulletin 99-23-08). Act 42 adds no consent form for commercial or cash-pay telemedicine, and electronic signatures count under the state's Electronic Transactions Act.

    Source: CCHP, Pennsylvania (MA Bulletin 99-23-08)

  5. 05

    Who can own the practice

    The Medical Practice Act limits medical practice to licensed doctors (63 P.S. 422.10), and Pennsylvania's corporate practice of medicine doctrine (CPOM) traces to Neill v. Gimbel Brothers. A Duquesne Law review of the doctrine calls it largely symbolic in enforcement, yet it still shapes the MSO and friendly-PC split, so counsel should review each Pennsylvania structure.

    Source: Duquesne Juris, Pennsylvania CPOM

FIRST VISIT

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

Yes

Yes, for non-controlled prescriptions. Act 42 counts self-reported history and clinical images as telemedicine and holds them to the in-person standard, while controlled substances also need the initial history and physical exam in 49 Pa. Code 16.92.

Neither Act 42 nor the Department of State's telemedicine guidance sets a modality for a first Pennsylvania visit. The limits come from the 40 Pa.C.S. 4805 standard of care and, for controlled substances, the Board of Medicine's exam rule.

  1. 01

    Questionnaires can start care

    Because 40 Pa.C.S. 4802 treats self-reported medical history, clinical images and lab results as telemedicine, a store-and-forward review can start care for a non-controlled prescription when it meets the in-person standard under section 4805. Pennsylvania has no rule that a first visit be live video or audio.

    Source: 40 Pa.C.S. 4802, 4805

  2. 02

    Controlled drugs need an exam

    Before prescribing any controlled substance, 49 Pa. Code 16.92(a)(1) requires an initial medical history and an initial physical examination unless an emergency justifies otherwise. The rule's only telehealth carve-out covers opioid treatment program admissions, which still need a full in-person exam within 14 days, so whether a video exam satisfies (a)(1) elsewhere is unsettled and needs counsel review.

    Source: 49 Pa. Code 16.92

  3. 03

    What the chart must show

    For every controlled-substance prescription, 49 Pa. Code 16.92(a)(4) requires the record to show the symptoms observed, the diagnosis, the directions given and the drug's name, strength, quantity and date. Subsection (a)(2) adds reevaluation as the condition, drug and side effects warrant, and (a)(3) requires counseling on both.

    Source: 49 Pa. Code 16.92(a)(2)–(4)

PRESCRIBING

Prescriptions and controlled drugs in Pennsylvania

Pennsylvania adds ABC-MAP queries, an electronic-prescribing mandate for Schedule II–V and the Board of Medicine exam rule to federal DEA requirements, whose telemedicine flexibilities run through December 31, 2026.

  1. 01

    Check ABC-MAP before prescribing

    Prescribers query ABC-MAP (Achieving Better Care by Monitoring All Prescriptions), Pennsylvania's PDMP, the first time a patient gets any controlled substance from them, whenever misuse or diversion is suspected, and each time they prescribe an opioid or a benzodiazepine. A first testosterone or phentermine prescription from a new prescriber triggers the baseline query under 35 P.S. 872.8.

    Source: 35 P.S. 872.8

  2. 02

    Controlled drugs go electronic

    Schedule II–V prescriptions must be electronic under 35 P.S. 780-111, with listed exceptions such as technology failures, hospice patients and prescriptions dispensed by a pharmacy outside Pennsylvania. The Department of Health may grant an exemption for economic hardship, technical limits or exceptional circumstances for up to one year at a time.

    Source: 35 P.S. 780-111

  3. 03

    Refill limits by schedule

    Under 35 P.S. 780-111, a Schedule II prescription may not be refilled, and a Schedule III–V prescription may not be filled or refilled more than six months after it is written or more than five times. Testosterone (Schedule III) and phentermine (Schedule IV) subscriptions in Pennsylvania run inside that cap.

    Source: 35 P.S. 780-111

  4. 04

    Out-of-state pharmacies register

    A pharmacy outside Pennsylvania may not ship, mail or deliver legend drugs into the state without a certificate of registration from the State Board of Pharmacy. Registration renews every two years and requires a valid home-state license, disclosure of officers and the pharmacist in charge, and a recent inspection report (63 P.S. 390-4.1).

    Source: 63 P.S. 390-4.1

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 Pennsylvania

Treating a patient located in Pennsylvania takes a Pennsylvania license, and the State Board of Medicine now issues them through the Interstate Medical Licensure Compact (IMLC), the multistate fast track for qualifying physicians. Pennsylvania adds its own training, insurance and nurse practitioner rules on top.

  1. 01

    Compact licenses are available

    The State Board of Medicine reports that Pennsylvania has fully implemented the IMLC and that physicians may now designate Pennsylvania as their state of principal license. A physician qualified through another compact state can use a letter of qualification to add a Pennsylvania license without a full separate application.

    Source: Pa. State Board of Medicine, IMLC

  2. 02

    Training for new licensees

    A new Pennsylvania licensee documents 3 hours of approved child-abuse recognition and reporting training, then 2 hours each renewal cycle (23 Pa.C.S. 6383(b)(3)). Prescribers who need a DEA number also complete, within 12 months of licensure, 2 hours on pain management or addiction and 2 hours on opioid prescribing under section 9.1 of the ABC-MAP Act.

    Source: 23 Pa.C.S. 6383

  3. 03

    Insurance is part of the license

    Under 49 Pa. Code 16.32, a physician must keep the professional liability coverage the MCARE Act requires and pay any MCARE Fund assessment as a condition of practice. Only federal employees practicing as such and physicians who provide no medical service in Pennsylvania, with notarized proof of nonpractice, are exempt.

    Source: 49 Pa. Code 16.32

  4. 04

    Nurse practitioner agreements

    A CRNP may collaborate only with physicians who hold a current Pennsylvania license (49 Pa. Code 21.282a). The prescriptive authority agreement names at least one substitute physician, lists the drug categories and liability coverage, is reviewed every two years, stays at the CRNP's practice site and is filed with the Bureau of Professional and Occupational Affairs (49 Pa. Code 21.285).

    Source: 49 Pa. Code 21.285

ADVERTISING

Marketing to patients in Pennsylvania

Pennsylvania polices telehealth marketing through the Board of Medicine's conduct rules, the Unfair Trade Practices and Consumer Protection Law and the Telemarketer Registration Act rather than a telehealth-specific advertising statute.

  1. 01

    No ads that mislead

    The Board of Medicine treats advertising of a medical business that is intended to or tends to deceive the public as unprofessional conduct (49 Pa. Code 16.61(a)(5)). The Medical Practice Act separately bars misleading, deceptive, untrue or fraudulent representations in the practice of medicine (63 P.S. 422.41(2)).

    Source: 49 Pa. Code 16.61

  2. 02

    Consumer law covers claims

    Pennsylvania's Unfair Trade Practices and Consumer Protection Law lists as deceptive: implying sponsorship, approval or certification a service lacks, claiming benefits it does not have, and advertising with intent not to sell as advertised (73 P.S. 201-2(4)(ii), (v), (ix)). An untrue 'FDA-approved' line on a compounded product falls within those items.

    Source: 73 P.S. 201-2

  3. 03

    Register before sales calls

    A business that telemarkets to consumers in Pennsylvania registers with the Office of Attorney General at least 30 days before offering goods or services, files a $50,000 surety bond with a $500 fee, and re-registers every two years under the Telemarketer Registration Act (73 P.S. 2243–2244).

    Source: Pa. Attorney General telemarketing FAQ

  4. 04

    Do-not-call and caller name

    Telemarketers buy the Pennsylvania do-not-call list, remove listed numbers within 30 days of each quarterly update, and must give the caller's name and the business behind the call (73 P.S. 2245.2). The Attorney General can seek up to $1,000 per violation, or $3,000 when the person called is 60 or older.

    Source: 73 P.S. 2245.2

TESSIC HEALTH IN PENNSYLVANIA

How Tessic Health's providers cover Pennsylvania

Tessic Health's providers who treat Pennsylvania patients hold Pennsylvania licenses, are credentialed under the brand and work inside the brand's MSO and friendly-PC structure. The practices below apply Pennsylvania statutes and Board rules to every Pennsylvania patient.

  1. 01

    ABC-MAP is checked first

    Before a first controlled-substance prescription to a Pennsylvania patient, and before every opioid or benzodiazepine prescription after that, the prescriber queries ABC-MAP as 35 P.S. 872.8 requires and records the result in the chart, which the brand owns.

  2. 02

    Exam before controlled drugs

    Pennsylvania patients start testosterone or any other controlled substance only after the initial history and physical examination that 49 Pa. Code 16.92 requires, with symptoms, diagnosis, directions and dosing written into the brand's record.

  3. 03

    Electronic controlled prescriptions

    Schedule II–V prescriptions for Pennsylvania patients go out through electronic prescribing of controlled substances (EPCS), which meets 35 P.S. 780-111 without relying on a Department of Health hardship exemption.

  4. 04

    Registered pharmacies ship

    Pharmacies that ship brand prescriptions into Pennsylvania hold a State Board of Pharmacy nonresident registration under 63 P.S. 390-4.1, and fulfillment runs at 0% markup, with cold-chain shipping for products that need it.

  5. 05

    Coverage and agreements on file

    Physicians treating Pennsylvania patients carry the malpractice coverage the MCARE Act sets for their share of Pennsylvania practice, and CRNPs prescribe only under a collaborative agreement filed with the Bureau of Professional and Occupational Affairs.

COMMON QUESTIONS

Questions about telehealth in Pennsylvania

  • Yes, for non-controlled drugs. Act 42 counts self-reported medical history and clinical images as telemedicine (40 Pa.C.S. 4802) and holds them to the in-person standard of care (4805); controlled substances also need the initial history and physical exam in 49 Pa. Code 16.92.

  • Every time an opioid or benzodiazepine is prescribed, and the first time a prescriber gives a patient any controlled substance. Under 35 P.S. 872.8 a query is also required whenever the prescriber suspects misuse or diversion.

  • Yes. The State Board of Medicine has fully implemented the Interstate Medical Licensure Compact and accepts Pennsylvania as a state of principal license, so qualifying physicians can anchor or add a Pennsylvania license through it.

  • Yes. The MCARE Act requires coverage or approved self-insurance for anyone providing care in Pennsylvania (40 P.S. 1303.711); physicians with half or less of their practice there carry $1 million per claim and $3 million a year, and the rest also pay the MCARE Fund assessment.

  • No. A CRNP needs a prescriptive authority collaborative agreement with a Pennsylvania-licensed physician, filed with the Bureau of Professional and Occupational Affairs, and may write Schedule II for up to 30 days and Schedule III–IV for up to 90 days (49 Pa. Code 21.284).

  • Yes. A business telemarketing to Pennsylvania consumers registers with the Office of Attorney General, files a $50,000 bond, and removes numbers on the Pennsylvania do-not-call list within 30 days of each update (73 P.S. 2243, 2245.2).

SOURCES

Rules checked September 2026 · 42 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.

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