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SD · STATE RULES

Telehealth rules in South Dakota

South Dakota answered the telehealth question with a definition rather than a rulebook. Telehealth here means delivery through HIPAA-compliant interactive audio and video, which leaves audio-only calls, email and fax outside the term entirely, so most of what other states regulate never arises. The licensure test is equally blunt: a professional is fully licensed here, or employed by a licensed health care facility or a similar approved entity, and that is the whole of it.

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First visit
Async with conditions
Physician license
Own license or facility role
Controlled drugs
Federal rules, no state layer
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Full practice

Rules checked September 2026 · 22 sources cited

ONLY IN SOUTH DAKOTA

What is different about South Dakota

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

  1. 01 · Practice

    Only video counts as telehealth

    The statutory definition is delivery of health care services through the use of HIPAA-compliant interactive audio and video. Audio-only contact, email, fax and an ordinary phone call fall outside it, which means they are not regulated as telehealth and are not treated as telehealth for coverage either.

    Source: S.D. Codified Laws 58-17-167

    Across the border

    • North Dakota

      North Dakota keeps audio inside its definition and excludes it only from a first examination, providing that an evaluation consisting only of an audio conversation does not meet the standard of care.

      Source: N.D. Cent. Code 43-17-44

    • Minnesota

      Minnesota explicitly counts audio-only communication as telehealth in defined circumstances, with the statute carrying that recognition through to 1 July 2027 before it sunsets.

      Source: Minn. Stat. 62A.673

    • Iowa

      Iowa regulates the artifact rather than the channel, ruling that an internet questionnaire with a static set of questions is not an acceptable medical interview for prescribing purposes.

      Source: Iowa Admin. Code 481-655.9

    • Nebraska

      Nebraska lets any credential holder establish the relationship through telehealth and recognizes asynchronous contact, putting its weight on the written consent statement instead of on modality.

      Source: Neb. Rev. Stat. 38-1,143

    • Wyoming

      Wyoming publishes no general telehealth definition, so what counts is decided profession by profession in board rules that differ on modality as well as on consent.

      Source: Wyoming rules and regulations

    • Montana

      Montana defines the routes into a relationship rather than the technology, and lets telemedicine carry a first encounter wherever the standard of care does not demand hands-on examination.

      Source: Montana Admin. Rule 24.156.813

  2. 02 · Licenses

    A license, or a job at a licensed facility

    The telehealth chapter requires a health care professional to be fully licensed to practice in the state or to be employed by a licensed health care facility or a similar approved entity. The second limb is unusual: employment by the right organization, not the individual credential, can be what authorizes the encounter.

    Source: S.D. Codified Laws 34-52-7

    Across the border

    • North Dakota

      North Dakota lists situations instead of employers, allowing a physician licensed in another state, a territory or a Canadian province to continue an established relationship for up to a year.

      Source: N.D. Admin. Code 50-02-15-03

    • Minnesota

      Minnesota routes out-of-state physicians through the compact toward a license issued by its own board, with limited licensure exceptions tied to particular professions rather than to an employer.

      Source: Center for Connected Health Policy: Minnesota

    • Iowa

      Iowa requires an active Iowa license from a physician who uses telemedicine in the diagnosis and treatment of a patient located there, with no employment-based alternative available.

      Source: Iowa Admin. Code 481-655.9

    • Nebraska

      Nebraska's alternative is a consultation exemption for a physician incidentally called in or contacted electronically, which permits advice but never independent practice with the patient.

      Source: Nebraska Uniform Credentialing Act

    • Wyoming

      Wyoming's opening is temporal rather than institutional, letting a physician licensed elsewhere continue care for six months where the relationship began at an in-person visit in that state.

      Source: Wyoming Board of Medicine

    • Montana

      Montana requires a state license for anyone treating a patient physically located there, with its only carve-out covering dietitians delivering medical nutrition therapy alongside a local practitioner.

      Source: Center for Connected Health Policy: Montana

  3. 03 · Practice

    A consent rule that points elsewhere

    The statute says a health care professional using telehealth shall follow any applicable state or federal statute or rule for informed consent, and stops there. It adds no telehealth-specific content of its own, with one exception: explicit consent is required for remote patient monitoring services.

    Source: S.D. Codified Laws 34-52-7

    Across the border

    • North Dakota

      North Dakota writes consent content by profession, with optometry required to explain the technology in use and how a technical disconnection would be resolved before the service begins.

      Source: Center for Connected Health Policy: North Dakota

    • Minnesota

      Minnesota layers a health records act on top, requiring a signed and dated consent before records are released and limiting how long that consent stays good for.

      Source: Minn. Stat. 144.293

    • Iowa

      Iowa requires appropriate informed consent for the medical services and for the use of telemedicine, with individual professions adding disclosures about technology limits and unauthorized access.

      Source: Iowa Admin. Code 481-655.9

    • Nebraska

      Nebraska names four written statements the patient must receive before a first consultation and requires a signed statement within ten days where consent was given verbally.

      Source: Neb. Rev. Stat. 71-8505

    • Wyoming

      Wyoming has no single consent provision at all, so psychology, physical therapy, chiropractic and dentistry each publish their own text with different formalities and different disclosures.

      Source: Wyoming rules and regulations

    • Montana

      Montana requires informed consent through the Board of Medical Examiners rules and leaves the content to professional judgement rather than deferring to whatever other law happens to apply.

      Source: Montana Admin. Rule 24.156.1701

PRACTICE RULES

How telehealth works in South Dakota

Chapter 34-52 of the codified laws is short, and that is the point. It settles who may deliver telehealth and defers on nearly everything else to the law that would have applied in person.

  1. 01

    The definition does the work

    Because telehealth means HIPAA-compliant interactive audio and video, a brand's product decisions about modality are effectively legal decisions here. A service delivered another way is simply not telehealth in this state.

    Source: S.D. Codified Laws 58-17-167

  2. 02

    Two ways to be authorized

    Full licensure here is one route. Employment by a licensed health care facility or a similar approved entity is the other, which is how hospital-affiliated and facility-based remote services reach patients.

    Source: S.D. Codified Laws 34-52-7

  3. 03

    Consent borrows from elsewhere

    The professional follows whatever informed consent requirement already applies to them by state or federal law. For most clinicians that means the ordinary consent standard of their own practice act.

    Source: S.D. Codified Laws 34-52-7

  4. 04

    Remote monitoring is the exception

    Remote patient monitoring services carry their own explicit consent requirement, which is the one place the chapter departs from its general policy of pointing at other law.

    Source: Center for Connected Health Policy: South Dakota

FIRST VISIT

Can a first visit happen without a live call in South Dakota?

Yes, with conditions

Yes, on interactive video. Nothing requires a prior in-person visit, but because the statutory definition of telehealth is HIPAA-compliant interactive audio and video, a questionnaire-only or telephone-only first encounter sits outside the framework rather than inside it.

The practical effect for a brand is that the first visit design is settled by the definition. Everything downstream, from consent to prescribing, then follows the ordinary law of the profession.

  1. 01

    No prior in-person requirement

    The chapter imposes no requirement that a patient be seen in person before telehealth begins, so the constraint on a first visit is the modality and the clinician's own standard of care.

    Source: S.D. Codified Laws 34-52

  2. 02

    Asynchronous sits outside

    Because store-and-forward and email exchanges are not within the definition, a brand relying on them is operating outside the telehealth chapter and should not expect its protections or its coverage rules.

    Source: S.D. Codified Laws 58-17-167

  3. 03

    Consent follows the profession

    The informed consent the patient gives is the one their clinician's own practice act requires, which means the consent screen has to be built per profession rather than once for the platform.

    Source: S.D. Codified Laws 34-52-7

PRESCRIBING

Prescriptions and controlled drugs in South Dakota

There are no telehealth-specific prescribing limits in the chapter. A remote prescriber works within their own scope, the federal controlled substance framework, and the state monitoring program.

  1. 01

    Scope, not modality

    The chapter does not narrow prescriptive authority for a remote encounter. What the clinician may prescribe in person, they may prescribe on an interactive video visit that meets the standard of care.

    Source: S.D. Codified Laws 34-52

  2. 02

    Federal conditions carry controlled drugs

    Because no state telemedicine exception exists for controlled substances, the federal conditions are the operative ones, and a prescriber has no state allowance to fall back on when they are not met.

    Source: Center for Connected Health Policy: South Dakota

  3. 03

    The monitoring program

    The prescription drug monitoring program takes dispensing data and is queried by prescribers and pharmacists, and it is the record that shows what else a patient was receiving at the time.

    Source: S.D. Codified Laws 34-52

  4. 04

    Video for the encounter behind it

    Since only interactive audio and video counts as telehealth, a prescription written after a telephone call is not supported by a telehealth encounter in this state's terms, whatever its clinical merit.

    Source: S.D. Codified Laws 58-17-167

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 South Dakota

Physicians are licensed by the Board of Medical and Osteopathic Examiners, the state belongs to a long list of compacts, and reciprocal licensure is available to qualifying applicants from other states.

  1. 01

    Reciprocity on stated conditions

    A medical license applicant from another state may obtain reciprocal licensure where they completed a residency in the United States or Canada, passed the required examinations, have no disciplinary history and clear background checks.

    Source: S.D. Codified Laws 36-4-19

  2. 02

    Compacts across professions

    Membership covers athletic training, advanced practice nursing, counselling, dietetics, emergency medical services, medicine, nursing, occupational therapy, physician assistants, psychology, physical therapy and social work.

    Source: Center for Connected Health Policy: South Dakota

  3. 03

    Nurse practitioners practice independently

    A nurse practitioner here holds full practice authority, diagnosing, ordering tests and prescribing under the board of nursing once the practice hours the license is conditioned on have been completed.

    Source: AANP: full practice authority brief

  4. 04

    The employment route has limits

    Being employed by a licensed facility authorizes the encounter, not the clinician generally, so a brand cannot use a facility relationship to place unlicensed clinicians into direct-to-patient work.

    Source: S.D. Codified Laws 34-52-7

How Tessic Health's providers are licensed in South Dakota

ADVERTISING

Marketing to patients in South Dakota

There is no state privacy act and no telehealth advertising rule, so marketing answers to the deceptive trade practices chapter, the boards' misconduct provisions, and the federal privacy floor.

  1. 01

    Deceptive practices

    Chapter 37-24 prohibits deceptive acts and practices in connection with the sale or advertisement of merchandise, reaching misrepresentation of the characteristics or quality of a service with penalties attached.

    Source: S.D. Codified Laws 37-24

  2. 02

    Do not call a phone visit telehealth

    Because the statutory definition is interactive audio and video, describing a telephone service as telehealth to a patient in this state describes something the law does not recognize by that name.

    Source: S.D. Codified Laws 58-17-167

  3. 03

    Claims reach the license

    False or misleading advertising by a licensee is a discipline ground before the relevant board, so a brand's promotional language exposes the treating clinician's credential alongside the company itself.

    Source: Center for Connected Health Policy: South Dakota

  4. 04

    No statutory opt-out rights

    Residents have no state right to opt out of targeted advertising or data sale, so a brand's trackers are constrained by federal health privacy law and by the promises in its own notice.

    Source: Center for Connected Health Policy: South Dakota

TESSIC HEALTH IN SOUTH DAKOTA

How Tessic Health's providers cover South Dakota

Because the definition here is narrow, every encounter with a patient in this state is designed as an interactive video visit from the start rather than adapted into one.

  1. 01

    Video from the first contact

    Visits with patients here run on HIPAA-compliant interactive audio and video, and messaging or telephone contact is treated as administrative follow-up rather than as a telehealth encounter.

  2. 02

    Licensure verified, not inferred

    Clinicians hold a license issued by the relevant state board, and the employment-based route is not used as a substitute for individual licensure in direct-to-patient work.

  3. 03

    Consent built per profession

    Because the chapter defers to whatever consent law applies to the clinician, the consent text is selected by their profession rather than shown as one platform-wide screen.

  4. 04

    Monitoring gets its own consent

    Where remote patient monitoring is offered, explicit consent to that service is captured separately from consent to the visit, which is the one content requirement the chapter sets.

  5. 05

    Pharmacy and markup

    Pharmacy fulfillment uses licensed shippers into this state at 0% markup, with cold-chain handling reserved for drugs that need temperature control.

COMMON QUESTIONS

Questions about telehealth in South Dakota

  • No. Telehealth is defined as delivery through HIPAA-compliant interactive audio and video, which leaves audio-only conversations, email and fax outside the term, so they are neither regulated nor covered as telehealth here.

  • No. The chapter imposes no such requirement, so a first encounter can happen remotely provided it is an interactive video visit and the clinician's own standard of care is met.

  • Someone fully licensed to practice in the state, or employed by a licensed health care facility or a similar approved entity. The second route is what carries facility-affiliated remote services.

  • Whatever the clinician's own state or federal law already requires, because the chapter defers rather than legislating its own content. Remote patient monitoring is the exception and needs explicit consent.

  • Yes, on conditions. An applicant who completed a residency in the United States or Canada, passed the required examinations, has no disciplinary history and clears background checks may obtain reciprocal licensure.

  • No. Full practice authority applies, so a nurse practitioner diagnoses, orders tests and prescribes under the board of nursing once the practice hours attached to the license have been completed.

SOURCES

Rules checked September 2026 · 22 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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