Do I need an in-person exam for Wellbutrin in Texas?

If you’re struggling with binge eating disorder (BED) and wondering whether you can access treatment through telehealth, you’re not alone. Millions of Americans are turning to virtual healthcare for mental health support, and the good news is that telehealth is a fully legal and effective way to get evaluated and treated for BED in 2026.

This comprehensive guide will walk you through everything you need to know about getting BED medications like Topamax (topiramate) and Wellbutrin (bupropion) through telehealth—including federal and state regulations, who can prescribe, safety considerations, and what to expect during your virtual appointments.

Understanding Telehealth for Binge Eating Disorder

Binge eating disorder is the most common eating disorder in the United States, affecting people of all ages, genders, and backgrounds. It’s characterized by recurring episodes of eating large amounts of food in a short period, feeling out of control during these episodes, and experiencing significant distress—without the compensatory purging behaviors seen in bulimia.

While therapy remains a cornerstone of BED treatment, certain medications have shown promise in reducing binge frequency and helping patients regain control. The challenge? Many people face barriers to in-person psychiatric care, including long wait times, limited specialist availability, and geographic constraints.

Telehealth bridges this gap. Virtual mental health platforms now connect patients with licensed providers who can evaluate, diagnose, and prescribe medications for BED—all from the comfort and privacy of home.

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Federal Regulations: The Legal Foundation for Telehealth Prescribing

Non-Controlled Medications Are Fully Accessible

Here’s the most important thing to understand: medications commonly used for BED treatment—specifically Topamax (topiramate) and Wellbutrin (bupropion)—are not controlled substances. This distinction is crucial because it means they’re exempt from the strict federal telehealth restrictions that apply to controlled medications.

The Ryan Haight Act of 2008, which typically requires an in-person medical evaluation before prescribing controlled substances via telehealth, does not apply to non-controlled medications. This means that from a federal perspective, licensed providers can prescribe these BED medications via telehealth without any mandatory in-person visit requirement.

What About Controlled Substance Regulations?

While Vyvanse (lisdexamfetamine) is the only FDA-approved medication specifically for BED, it’s a Schedule II controlled substance. The DEA has extended pandemic-era flexibilities for controlled substance prescribing through December 31, 2026, but most reputable telehealth platforms don’t prescribe controlled stimulants for BED due to abuse potential and regulatory complexity.

Instead, they focus on evidence-based off-label medications like topiramate and bupropion, which offer therapeutic benefits without controlled substance restrictions.

State-by-State Telehealth Rules: What You Need to Know

While federal law sets the baseline, each state has its own telehealth regulations. The good news? Most states have permanently adopted or expanded telehealth prescribing flexibility that was first introduced during the COVID-19 pandemic.

States with No In-Person Requirements

The majority of states, including California, New York, Texas, Florida, Michigan, Wisconsin, and Delaware, have no in-person visit requirement for non-controlled medication prescriptions via telehealth. In these states, a comprehensive virtual evaluation meets the legal standard for establishing a patient-provider relationship and prescribing appropriate medications.

California even went a step further in 2025, with Assembly Bill 1503 clarifying that asynchronous telehealth (including detailed online questionnaires) can constitute a ‘good faith exam’ for prescribing purposes, as long as it meets the standard of care.

States Requiring Periodic In-Person Follow-Up

A handful of states—including Alabama, Georgia, and New Hampshire—require periodic in-person visits for ongoing telehealth care:

• Alabama requires an in-person visit within 12 months if you’ve had more than four consecutive telehealth visits for the same condition. This can be satisfied by seeing any collaborating provider in person, not necessarily your telehealth prescriber.

• Georgia asks providers to ‘attempt’ an annual in-person examination for continued telemedicine treatment, though the initial evaluation can be conducted entirely via telehealth.

• New Hampshire updated its law in 2025 to allow telehealth initiation of treatment but requires at least one in-person follow-up visit within 12 months for certain medication classes.

Even in these states, you can start treatment entirely online—the in-person requirement only applies to long-term continuation of care.

South Carolina and Other Evolving States

South Carolina explicitly allows telehealth prescribing as long as the provider conducts an ‘appropriate evaluation,’ which state regulations confirm ‘need not be in-person’ if adequate via telemedicine technology. However, legislation to grant nurse practitioners full practice authority in the state is still pending.

Who Can Prescribe BED Medications via Telehealth?

Physicians (MDs and DOs)

Licensed medical doctors and doctors of osteopathic medicine can prescribe Topamax and Wellbutrin for BED via telehealth in all 50 states, provided they’re licensed in your state of residence.

Nurse Practitioners (NPs)

The landscape for nurse practitioner practice authority has evolved dramatically. As of 2025, 34 states plus Washington, D.C. grant nurse practitioners full practice authority, meaning they can evaluate, diagnose, and prescribe medications independently without physician oversight.

Recent additions to this list include:

• Wisconsin (APRN Modernization Act, August 2025)
• Michigan (Public Act 47 of 2023, implemented 2025)
• Louisiana, Kansas, and others (expanded 2023-2025)

In these states, an NP working for a telehealth platform like Klarity Health can provide your entire BED treatment independently, from initial evaluation through ongoing medication management.

In states without full practice authority—such as Texas, Florida, Georgia, and Alabama—NPs can still prescribe these non-controlled medications, but they must work under a collaborative agreement with a physician. This is typically a behind-the-scenes arrangement that doesn’t affect your care experience; you’ll see the NP for appointments, but a supervising physician reviews and co-signs prescriptions.

Physician Assistants (PAs)

Physician assistants can also prescribe Topamax and Wellbutrin for BED under delegated authority from a supervising physician in all states. Like NPs in collaborative practice states, this supervision requirement is usually administrative and doesn’t impact your patient experience.

Medications Commonly Prescribed via Telehealth for BED

Topamax (Topiramate)

What it is: Topiramate is an anticonvulsant medication FDA-approved for seizure prevention and migraine prophylaxis. For BED, it’s prescribed off-label based on research showing it can reduce binge frequency and support weight management.

How it works for BED: Topiramate appears to modulate neurotransmitters involved in appetite regulation and impulse control, helping some patients reduce the frequency and intensity of binge episodes.

Typical dosing: Providers usually start with a low dose (25mg) and gradually increase over weeks to minimize side effects. Therapeutic doses for BED typically range from 75-200mg daily.

Important safety considerations:

• Pregnancy risk: Topiramate is associated with increased risk of cleft palate and other birth defects. Women of childbearing potential should use effective contraception.
• Cognitive effects: Some people experience mental slowing, difficulty finding words, or memory issues, especially at higher doses.
• Gradual discontinuation: Never stop topiramate suddenly—it must be tapered to prevent seizure risk.
• Monitoring: Regular follow-ups to assess cognitive function, weight, and metabolic effects

Telehealth accessibility: ✅ Fully available via telehealth in all states with no in-person requirement (except periodic follow-up in AL, GA, NH for long-term treatment)

Wellbutrin (Bupropion)

What it is: Bupropion is an atypical antidepressant FDA-approved for major depressive disorder and smoking cessation. It’s used off-label for BED based on evidence suggesting it can reduce binge eating behaviors.

How it works for BED: Bupropion affects dopamine and norepinephrine pathways, which may help regulate mood, reduce impulsive eating behaviors, and curb appetite in some patients.

Typical dosing: Usually started at 150mg once daily (extended-release formulation) and may be increased to 300mg after several weeks based on response and tolerability.

Important safety considerations:

• Black Box Warning: Like all antidepressants, bupropion carries a warning about increased risk of suicidal thoughts in people under 25. Close monitoring is essential, especially when starting treatment.
• Seizure risk: Bupropion lowers the seizure threshold. It’s contraindicated in anyone with a history of seizures, eating disorders involving purging (bulimia or anorexia), or conditions that increase seizure risk.
• Alcohol interaction: Avoid alcohol while taking bupropion due to increased seizure risk.
• Blood pressure: Can increase blood pressure; monitoring recommended, especially if combined with other medications.

Telehealth accessibility: ✅ Fully available via telehealth in all states with no federal or state-level in-person requirements

Why Off-Label Use Is Standard and Safe

You might wonder why your provider is prescribing medications that aren’t FDA-approved specifically for BED. Off-label prescribing is a common, legal, and medically appropriate practice when supported by clinical evidence.

The reality is that only one medication—Vyvanse, a controlled stimulant—has FDA approval for BED. Yet research demonstrates that topiramate and bupropion can be effective alternatives, particularly for patients who:

• Don’t want to take a controlled substance
• Have contraindications to stimulants
• Prefer to avoid the potential for medication dependence

Reputable telehealth providers will clearly explain that they’re prescribing off-label, discuss the evidence supporting this approach, obtain your informed consent, and monitor you appropriately.

The Telehealth Evaluation Process: What to Expect

Initial Consultation

A legitimate telehealth evaluation for BED should be comprehensive—typically 30-45 minutes for an initial consultation. Your provider will:

Assess BED diagnostic criteria: Expect detailed questions about:

• Frequency of binge eating episodes (must occur at least once weekly for 3 months)
• Amount of food consumed during binges
• Feelings of loss of control during episodes
• Distress about binge eating
• Absence of regular compensatory behaviors (purging, excessive exercise)

Review medical history: Including:

• Previous psychiatric diagnoses and treatments
• Current medications and supplements
• History of eating disorders (especially bulimia or anorexia, which would contraindicate certain medications)
• Seizure history
• Pregnancy status and contraception use
• Substance use, particularly alcohol

Mental health screening: Assessment for:

• Depression and anxiety symptoms
• Suicidal ideation (especially important before prescribing antidepressants)
• Other psychiatric conditions that might influence treatment

Physical health review:

• Current weight and BMI
• Metabolic health markers
• Blood pressure and cardiovascular history
• Lab work (may request recent results or order new labs)

Identity and Location Verification

Don’t be surprised when your provider verifies your identity and confirms your physical location at the start of the visit. This isn’t invasive—it’s legally required in many states to ensure:

• The provider is licensed in your state
• They’re prescribing according to your state’s regulations
• The platform is preventing fraud and ensuring patient safety

Informed Consent and Treatment Planning

Your provider should:

• Explain why they’re recommending a particular medication
• Discuss off-label use if applicable
• Review potential side effects and contraindications
• Outline the treatment plan, including:
• Starting dose and titration schedule
• Expected timeline for benefits
• Follow-up appointment schedule
• When to contact the provider between visits
• Emphasize the role of therapy and other interventions alongside medication

At Klarity Health, our providers take time to ensure patients understand their treatment options and feel comfortable with the plan before moving forward.

Prescription Management and Pharmacy Coordination

Once your provider determines that medication is appropriate, they’ll electronically send your prescription to the pharmacy of your choice. This should be a licensed retail pharmacy or legitimate mail-order service—never directly from the telehealth company’s own ‘pharmacy.’

Prescription Monitoring Programs (PMPs): While most states don’t legally require PMP checks for non-controlled medications like topiramate and bupropion, responsible providers may still review your medication history to:

• Ensure you’re not receiving duplicate prescriptions
• Check for potential drug interactions
• Verify comprehensive medication history

Follow-Up Schedule

Medication management for BED isn’t a ‘set it and forget it’ situation. Expect:

Initial phase (first 1-2 months):

• Check-in at 2 weeks to assess tolerability and side effects
• Monthly appointments to monitor response and adjust dosing
• More frequent contact if experiencing side effects or concerns

Maintenance phase:

• Appointments every 1-3 months once stable on medication
• Ongoing assessment of binge frequency and overall functioning
• Coordination with therapy if you’re receiving concurrent counseling

State-specific requirements:

• In Alabama, Georgia, and New Hampshire: Plan for an in-person visit within 6-12 months if treatment continues long-term (can often be with any local provider, not necessarily your telehealth prescriber)

Safety and Quality: Choosing a Reputable Telehealth Provider

The telehealth industry has grown exponentially, but not all platforms maintain the same standards. Recent enforcement actions—including criminal charges against executives of a telehealth company that inappropriately prescribed ADHD stimulants—underscore the importance of choosing wisely.

Red Flags to Avoid

🚩 Guaranteed prescriptions before evaluation: Any platform promising medication before a thorough assessment is operating outside medical standards.

🚩 Minimal evaluation: If your ‘consultation’ is just a 5-minute questionnaire with automatic prescription, that’s not legitimate medical care.

🚩 No discussion of alternatives: Reputable providers discuss therapy, nutrition counseling, and other evidence-based approaches—not just medication.

🚩 Prescribing controlled substances for BED: While Vyvanse is FDA-approved for BED, most legitimate telehealth platforms avoid prescribing stimulants for this condition due to abuse potential and regulatory complexity.

🚩 Direct medication sales: The platform should send prescriptions to independent pharmacies, not sell you pills directly.

🚩 No licensed provider interaction: You should have a real video or phone consultation with a licensed clinician, not just submit forms.

Green Flags of Quality Care

✅ Comprehensive initial evaluation: 30+ minutes with detailed history-taking

✅ Licensed, credentialed providers: Clear information about who you’re seeing and their qualifications

✅ Transparent about limitations: Honest about what telehealth can and can’t treat, and when in-person care is needed

✅ Evidence-based approach: Treatment recommendations based on clinical guidelines and research

✅ Multidisciplinary perspective: Discusses therapy, lifestyle interventions, and other supports alongside medication

✅ Clear follow-up plan: Scheduled appointments and accessible support between visits

✅ Privacy and security: HIPAA-compliant platforms with secure messaging and video

✅ Insurance transparency: Clear information about costs, whether insurance is accepted, and cash-pay options

How Klarity Health Approaches BED Treatment

At Klarity Health, we’ve built our telehealth platform around the principles of safe, evidence-based, and accessible mental healthcare. Our approach to BED treatment includes:

Provider availability: We maintain a network of licensed psychiatrists, psychiatric nurse practitioners, and physician assistants across multiple states, reducing typical wait times from months to days.

Transparent pricing: We accept both insurance and cash pay, with clear upfront pricing—no surprise bills or hidden fees.

Comprehensive care: Our providers view medication as one component of BED treatment, discussing therapy referrals and lifestyle interventions as part of holistic care.

Quality standards: Every provider undergoes credentialing verification, and our clinical team reviews prescribing patterns to ensure adherence to evidence-based guidelines.

Flexible access: Beyond scheduled video appointments, patients can message their provider between visits for questions or concerns.

Who Is NOT a Good Candidate for Telehealth BED Treatment?

While telehealth expands access to care, it’s not appropriate for everyone. Providers will screen for conditions that require in-person evaluation or make certain medications unsafe:

Medical Contraindications

❌ History of bulimia or anorexia nervosa: Bupropion (Wellbutrin) is contraindicated due to significantly increased seizure risk. Many providers will also be cautious with topiramate.

❌ Seizure disorder: Both commonly used medications can affect seizure threshold. While topiramate is an anticonvulsant, it requires careful monitoring; bupropion is contraindicated.

❌ Pregnancy or planning pregnancy: Topiramate carries significant teratogenic risk (birth defects, particularly cleft palate). Not recommended unless benefits clearly outweigh risks, and effective contraception is essential.

❌ Severe medical instability: Conditions requiring urgent in-person evaluation, such as:

• Recent syncope or cardiac symptoms
• Uncontrolled diabetes with frequent complications
• Severe obesity with urgent health concerns
• Signs of nutritional deficiency requiring labs and physical exam

Situations Requiring In-Person Care

🏥 Need for FDA-approved controlled medication: If clinical assessment suggests Vyvanse would be the most appropriate treatment, most telehealth platforms will refer you to in-person care for that prescription.

🏥 Complex psychiatric presentation: Multiple active psychiatric conditions, recent psychiatric hospitalization, or active suicidal ideation often require in-person intensive treatment.

🏥 Severe BED with medical complications: If binge eating has led to severe metabolic consequences or other urgent medical issues requiring comprehensive workup.

🏥 Limited digital access or comfort: Telehealth requires reliable internet, a device with video capability, and basic comfort with technology.

Insurance Coverage and Costs

Insurance Coverage for Telehealth

Most health insurance plans now cover telehealth mental health services at the same rate as in-person visits, thanks to parity laws and pandemic-era policy changes that have largely been made permanent.

What to verify with your insurance:

• Telehealth coverage for psychiatry/mental health services
• Whether your plan has a separate telehealth deductible
• Copay amount for mental health visits
• Coverage for out-of-state providers (if using a multistate platform)
• Medication coverage (formulary tier for topiramate and bupropion)

Cash Pay Options

For patients without insurance or with high deductibles, many telehealth platforms offer transparent cash-pay pricing:

Typical costs:

• Initial evaluation: $150-$300
• Follow-up visits: $75-$150
• Medication costs (without insurance): Generics like topiramate and bupropion are typically $10-$50/month

At Klarity Health, we accept both insurance and cash pay, giving patients flexibility regardless of their coverage situation.

Prescription Monitoring and Refills

One advantage of non-controlled medications is the ability to provide refills without monthly prescriptions:

Refill policies:

• Providers can typically authorize refills for 6-12 months (varies by state)
• You’ll still need regular follow-up appointments, but not necessarily monthly
• Most prescriptions include 3-month supplies with refills to reduce pharmacy trips

Prescription Monitoring Programs:While not legally required for these medications, responsible providers may check your state’s PMP database to:

• Identify potential drug interactions
• Ensure you’re not receiving duplicate prescriptions from multiple providers
• Maintain comprehensive medication history

This is a safety measure, not surveillance—part of good medical practice.

The Future of Telehealth BED Treatment

The regulatory landscape for telehealth continues to evolve, but the trajectory is toward expansion and permanence rather than restriction:

Federal Developments

The DEA has extended pandemic-era flexibilities for controlled substance prescribing through December 31, 2026, with a permanent rulemaking process underway. While this primarily affects controlled medications, it signals federal commitment to telehealth access.

For non-controlled medications like those used for BED, there are no expected restrictions on the horizon—telehealth prescribing is fully established and unlikely to be limited.

State Trends

States are increasingly:

• Removing barriers to telehealth prescribing
• Expanding nurse practitioner scope of practice (increasing provider availability)
• Requiring insurance parity for telehealth services
• Establishing clear standards for telehealth quality

As of 2025, Wisconsin, Michigan, and several other states joined the ranks of full practice authority for NPs, expanding the workforce of providers who can independently treat BED via telehealth.

Quality and Enforcement

Increased regulatory scrutiny of telehealth platforms is actually good for patients—weeding out bad actors while establishing higher standards across the industry. Expect to see:

• More robust credentialing requirements for providers
• Clearer guidelines around appropriate telehealth prescribing
• Better patient education about telehealth standards
• Enhanced privacy and security protections

Frequently Asked Questions

Do I need an in-person visit before starting medication for BED via telehealth?

In most states, no. The majority of states allow a comprehensive telehealth evaluation to establish the patient-provider relationship necessary for prescribing non-controlled medications. A few states (Alabama, Georgia, New Hampshire) may require an in-person follow-up within 6-12 months for ongoing treatment, but you can still start treatment entirely online.

Can nurse practitioners prescribe BED medications via telehealth?

Yes. In 34 states plus D.C., nurse practitioners have full independent practice authority and can prescribe these medications without physician oversight. In other states, NPs can prescribe under collaborative agreements with physicians—this is typically an administrative arrangement that doesn’t affect your care experience.

Are topiramate and bupropion FDA-approved for BED?

No—they’re prescribed off-label based on clinical evidence showing effectiveness in reducing binge eating behaviors. Off-label prescribing is legal, common, and medically appropriate when supported by research and clinical guidelines. Your provider should explain this and obtain your informed consent.

Will my telehealth provider check my prescription history?

They may, as part of good medical practice, even though it’s not legally required for non-controlled medications. This helps identify potential drug interactions and ensure comprehensive care—it’s a safety measure, not an invasion of privacy.

What if I’m pregnant or planning to become pregnant?

Topiramate is associated with birth defect risks and generally isn’t recommended during pregnancy. Your provider will discuss contraception if prescribing topiramate, and may recommend alternative approaches (like therapy-only treatment) if you’re pregnant or planning pregnancy soon.

Can I get BED treatment via telehealth if I live in a rural area?

Yes—this is one of telehealth’s greatest benefits. As long as you have internet access and your provider is licensed in your state, you can receive care regardless of geographic location.

What happens during a telehealth appointment?

You’ll have a live video (or sometimes phone) consultation with a licensed provider who will take a detailed history, assess your symptoms, discuss treatment options, and create a personalized plan. Initial visits typically last 30-45 minutes; follow-ups are usually 15-30 minutes.

How quickly can I start treatment?

This varies by platform, but many telehealth services offer appointments within days or even same-day in some cases. After your initial evaluation, if medication is appropriate, you can often pick up your prescription from the pharmacy within 24 hours.

What if I experience side effects?

Reputable telehealth platforms provide ways to contact your provider between scheduled appointments—whether through secure messaging, a nurse line, or urgent consultation requests. You should never feel stranded if you have concerns about your medication.

Does insurance cover telehealth mental health services?

Most insurance plans now cover telehealth mental health at the same rate as in-person visits. However, coverage details vary, so verify your specific plan’s telehealth benefits. Many platforms also offer affordable cash-pay options.

Taking the Next Step: Getting Started with Telehealth BED Treatment

If you’re struggling with binge eating disorder, telehealth offers a legitimate, effective, and convenient path to evidence-based treatment. Here’s how to move forward:

1. Reflect on Your Symptoms

Consider whether your eating patterns meet BED criteria:

• Recurrent episodes of eating large amounts in a short period
• Feeling out of control during binges
• Significant distress about binge eating
• Occurring at least once weekly for three months
• Not accompanied by regular purging or excessive exercise

2. Research Telehealth Options

Look for platforms that demonstrate:

• Licensed providers in your state
• Comprehensive evaluation processes
• Evidence-based treatment approaches
• Transparent pricing and insurance information
• Clear policies around quality and safety
• Good patient reviews and outcomes

Klarity Health offers all of these features, with a network of experienced psychiatric providers who specialize in eating disorders and evidence-based medication management, available across multiple states with both insurance and cash-pay options.

3. Schedule an Evaluation

Most telehealth platforms make scheduling simple—often offering appointments within days rather than the months-long waits typical of in-person psychiatric care.

4. Prepare for Your Appointment

• Write down your symptoms, including frequency of binges and triggers
• List current medications and supplements
• Note relevant medical history (especially seizures, eating disorder history, pregnancy status)
• Prepare questions about treatment options
• Have pharmacy information ready

5. Be Honest and Open

The provider can only help you with accurate information. Share openly about:

• Your eating patterns and behaviors
• Mental health symptoms
• Substance use
• Previous treatments and what did or didn’t work
• Your goals for treatment

6. Follow Through with Treatment

Medication works best when combined with:

• Regular follow-up appointments to monitor progress
• Therapy (many patients benefit from CBT or DBT)
• Nutritional counseling or dietitian support
• Lifestyle modifications
• Support groups or peer support

Conclusion: Telehealth Makes BED Treatment More Accessible Than Ever

Binge eating disorder is a serious but treatable condition. For too long, people struggling with BED faced significant barriers to care—from limited specialist availability to long wait times to the stigma of seeking help in person.

Telehealth has fundamentally changed this landscape. In 2026, you can receive a comprehensive evaluation, evidence-based medication management, and ongoing support from licensed providers—all via secure video appointments from wherever you are.

The legal framework is clear: non-controlled medications like topiramate and bupropion can be legally prescribed via telehealth in every U.S. state, with minimal in-person requirements. The provider network has expanded dramatically, including both psychiatrists and nurse practitioners with full prescribing authority in most states. The quality standards have matured, with reputable platforms implementing rigorous safety protocols.

Whether you’re in a major city with competitive in-person providers or a rural area with limited mental health resources, telehealth offers a path to treatment that is:

• Accessible: Appointments available within days, not months
• Convenient: No travel, no waiting rooms, flexible scheduling
• Affordable: Transparent pricing with both insurance and cash-pay options
• Evidence-based: Treatment plans grounded in clinical research
• Safe: Comprehensive evaluations and ongoing monitoring
• Private: HIPAA-compliant platforms protecting your health information

If you’re ready to take the first step toward addressing binge eating disorder, telehealth platforms like Klarity Health are here to support you with experienced providers, transparent pricing, and a commitment to quality care that puts your health and safety first.

You deserve effective treatment for BED—and in 2026, that treatment is more accessible than ever before.

Research Currency Statement

Verified as of: January 4, 2026

• DEA Rules Status: COVID-19 telehealth prescribing flexibilities remain in effect through December 31, 2026 (fourth extension). No federal in-person requirement exists for non-controlled medications—these were never subject to the Ryan Haight Act restrictions on telemedicine.

• States Verified: Researched 10+ key states (AL, CA, DE, FL, GA, NH, NY, TX, MI, WI, SC) with latest information as of late 2025. State board sites and 2025 legislative updates were checked where available.

• Sources newer than 2024: 80%+ of sources are from 2025 (many late-2025) or updated to 2025. Older sources (2024) were used only when confirmed still accurate by newer references.

• ⚠️ Flagged for follow-up: Alabama and South Carolina NP scope changes (legislation was discussed in 2025 but final status unclear—assume no full independence yet pending confirmation). Monitor DEA’s pending final rule on telehealth prescribing (expected by end of 2026). Verify any temporary state waivers for expiration/extension beyond 2025.

Citations

1. HHS Press Release (January 2026). ‘DEA Extends Telemedicine Prescribing Flexibilities Through 2026.’ Available at: https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html

2. Sheppard Mullin Healthcare Law Blog (August 2025). ‘Telehealth and In-Person Visits: Tracking Federal and State Updates to Pandemic-Era Telehealth Exceptions.’ Available at: https://www.sheppardhealthlaw.com/2025/08/articles/telehealth/telehealth-and-in-person-visits-tracking-federal-and-state-updates-to-pandemic-era-telehealth-exceptions/

3. Center for Connected Health Policy (November-December 2025). ‘State Telehealth Laws and Reimbursement Policies: Online Prescribing.’ Available at: https://www.cchpca.org/topic/online-prescribing/

4. National Law Review (2024-2025). ‘Telehealth and In-Person Visits: State Updates on Pandemic-Era Exceptions.’ Available at: https://natlawreview.com/article/telehealth-and-person-visits-tracking-federal-and-state-updates-pandemic-era

5. Health Jobs Nationwide Blog (January 2025). ‘State-by-State Guide: Expanding Roles for PAs and NPs (Updated 2025).’ Available at: https://blog.healthjobsnationwide.com/state-by-state-guide-expanding-roles-for-pas-and-nps-updated-2025/

Source:

• https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html#:~:text=patients%20to%20receive%20prescriptions%20for,while%20permanent%20rules%20are%20finalized
• https://www.sheppardhealthlaw.com/2025/08/articles/telehealth/telehealth-and-in-person-visits-tracking-federal-and-state-updates-to-pandemic-era-telehealth-exceptions/#:~:text=extended%20telemedicine%20prescribing%20waivers%20through,prescribing
• https://blog.healthjobsnationwide.com/state-by-state-guide-expanding-roles-for-pas-and-nps-updated-2025/#:~:text=Full%20practice%20authority%20legislation%20reached,12
• https://natlawreview.com/article/telehealth-and-person-visits-tracking-federal-and-state-updates-pandemic-era?amp=#:~:text=coordination%20with%20the%20U,prescribing
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• https://natlawreview.com/article/telehealth-and-person-visits-tracking-federal-and-state-updates-pandemic-era?amp=#:~:text=Prior%20to%20the%202024%20waiver,access%2C%20and%20diversion%20control%20measures
• https://www.cchpca.org/topic/online-prescribing/#:~:text=If%20a%20physician%20or%20practice,resolution%2C%20the%20physician%20shall%20either
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• https://www.cchpca.org/topic/online-prescribing/#:~:text=constitutes%20unprofessional%20conduct,the%20appropriate%20standard%20of%20care
• https://blog.healthjobsnationwide.com/state-by-state-guide-expanding-roles-for-pas-and-nps-updated-2025/#:~:text=California%20leads%20the%20most%20important,12