Is telehealth allowed to prescribe Clomid?

Introduction

Low testosterone (hypogonadism) affects millions of American men, causing symptoms like fatigue, depression, reduced libido, and difficulty building muscle. Fortunately, advancements in telehealth have made treatment more accessible than ever. But with a patchwork of federal and state regulations—some of which change frequently—many men are left wondering: ‘Is it legal to get testosterone or other low T treatments via telehealth in my state?’

The good news is that in 2025, telehealth treatment for low testosterone is legal nationwide, though specific requirements vary by state and medication type. This comprehensive guide will help you understand the current regulations for telehealth low T treatment, whether you’re considering testosterone replacement therapy or alternatives like Clomid.

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Federal Telehealth Rules for Low T Medications in 2025

Non-Controlled Medications (Like Clomid)

The most straightforward telehealth option for treating low testosterone is through medications that aren’t classified as controlled substances. Clomiphene citrate (Clomid)—often prescribed off-label for men with low T who want to maintain fertility—falls into this category.

Key facts about non-controlled medications via telehealth:

• No federal in-person requirement: The Ryan Haight Act (which restricts online prescribing of controlled substances) doesn’t apply to non-controlled medications like Clomid
• Available in all 50 states: Providers can legally prescribe these medications after a proper telehealth evaluation
• E-prescriptions: Can be sent directly to your local pharmacy
• Lab requirements: Legitimate providers will require testosterone blood tests

At Klarity Health, our providers ensure you have proper lab testing to confirm low testosterone before discussing treatment options, whether controlled or non-controlled medications are appropriate for your situation.

Controlled Substances (Like Testosterone)

Testosterone (in injectable, gel, or pellet form) is classified as a Schedule III controlled substance, meaning it’s more heavily regulated:

• Extended COVID flexibility: The DEA has extended pandemic-era flexibilities allowing controlled substance prescribing via telehealth through December 31, 2025
• No in-person exam currently required: Until the extension expires, providers can prescribe testosterone after a telehealth evaluation with no prior in-person visit
• Future changes likely: The DEA is developing new permanent rules, potentially requiring an in-person exam or registration in a special telemedicine program
• State laws may be stricter: Some states impose additional requirements beyond federal rules

State-by-State Telehealth Requirements for Low T Treatment in 2025

State regulations vary significantly, particularly regarding:

1. Whether an in-person exam is required (initially or periodically)
2. Who can prescribe (physicians, nurse practitioners, physician assistants)
3. Prescription monitoring requirements

California

• In-person requirement: None for non-controlled medications like Clomid; telehealth evaluation is sufficient
• Provider authority: Nurse Practitioners have independent practice authority and can prescribe all medications including controlled substances
• Special notes: AB 1503 (effective July 2025) further expands telehealth by allowing asynchronous evaluations (questionnaires) to meet the ‘good faith exam’ requirement

Texas

• In-person requirement: None for non-controlled medications; telehealth exam satisfies the standard of care
• Provider authority: NPs require physician collaboration agreements and cannot prescribe Schedule II drugs in outpatient settings
• Special notes: Texas extended telehealth coverage parity, meaning insurance must cover telehealth visits similarly to in-person care

Florida

• In-person requirement: None for non-controlled medications; for controlled substances like testosterone, telehealth prescribing is allowed (since 2022 law changes) except for Schedule II substances in non-exempt settings
• Provider authority: NPs must have MD supervision to prescribe controlled substances
• Prescription monitoring: Required for all controlled substance prescriptions

New York

• In-person requirement: None currently for telehealth prescribing of any medication while federal waiver is active; however, NY has a rule (effective May 2025) that will require in-person evaluations for controlled substances once the federal waiver ends
• Provider authority: NPs have full independent practice authority including Schedule II-V prescribing
• Special notes: E-prescribing is mandatory for all medications

Georgia

• In-person requirement: Georgia has some of the strictest telehealth rules: requires a patient be examined in-person by a GA-licensed provider before telehealth treatment, or by referral, with annual in-person follow-ups
• Provider authority: NPs cannot prescribe Schedule II drugs at all (including testosterone) and require MD supervision
• Special notes: One of two states (with Oklahoma) that bars NPs from prescribing Schedule II medications

States with Recent Changes

New Hampshire recently eliminated its prior telehealth in-person exam requirement for controlled substances. The 2025 rule now allows providers to prescribe Schedule II-IV medications via telemedicine, provided patients receive an in-person evaluation at least every 12 months (by any licensed prescriber, not necessarily the telehealth provider).

Alabama requires an in-person visit if treating a patient via telehealth more than 4 times in 12 months for the same issue. This visit can be conducted by a local collaborating provider.

How Telehealth Low T Diagnosis and Treatment Works

For telehealth treatment to be legal and medically appropriate, providers should follow these standard practices:

1. Proper Diagnosis

According to the American Urological Association guidelines, low testosterone diagnosis requires:

• At least two morning testosterone tests showing levels below the normal range
• Presence of symptoms consistent with low testosterone
• Evaluation of potential causes and risk factors

Legitimate telehealth providers will insist on lab confirmation before prescribing any treatment.

2. Treatment Options Discussion

During your telehealth appointment, the provider should discuss:

• Treatment options (injections, topical gels, clomiphene, etc.)
• Potential benefits and risks of each option
• Monitoring requirements
• Cost considerations
• Fertility implications

Klarity Health providers spend time explaining all options so you can make an informed decision based on your specific health goals and concerns.

3. Prescription Process

For non-controlled medications like Clomid:

• E-prescription sent directly to your pharmacy
• No prescription monitoring program checks required
• Can typically be prescribed with refills

For controlled medications like testosterone (while federal waiver active):

• E-prescription to local pharmacy
• Prescription monitoring program check required in most states
• More frequent follow-ups typically required
• Quantity limits may apply based on state laws

4. Ongoing Monitoring

Responsible telehealth providers will:

• Schedule regular follow-up appointments to assess effectiveness
• Order periodic lab tests to monitor testosterone levels and other relevant markers
• Adjust treatment as needed based on results and side effects
• Document all findings in your medical record

Red Flags: How to Identify Illegitimate Telehealth Services

With the growing demand for testosterone and other hormone therapies, some questionable operators have emerged. Avoid services that:

• Promise prescriptions without requiring labs or medical history
• Offer anabolic steroids or unusually high testosterone doses
• Ship controlled substances directly to you (bypassing pharmacies)
• Don’t verify your identity or location
• Use providers not licensed in your state
• Have no clear follow-up protocol
• Cannot be reached for questions after payment

Recent federal prosecutions have targeted telehealth operations that prescribed controlled substances without proper evaluations. In one high-profile case, executives of a telehealth startup were convicted for prescribing millions of Adderall pills without proper exams.

Looking Ahead: Changes on the Horizon

The telehealth regulatory landscape continues to evolve:

• The current DEA telehealth flexibility expires December 31, 2025
• The DEA is developing a ‘special registration’ system for telehealth prescribers of controlled substances
• Many states are modernizing their telehealth laws to improve access
• Medicare telehealth coverage extensions require congressional action

Patients currently receiving testosterone via telehealth should stay informed about potential rule changes that could require an in-person visit in 2026.

Finding Quality Telehealth Low T Treatment

When choosing a telehealth provider for low testosterone treatment, look for:

• Licensed medical providers in your state
• Transparent pricing and insurance options
• Required lab testing before prescribing
• Comprehensive medical history evaluation
• Clear follow-up protocols
• Ability to connect with your primary care provider
• Multiple treatment options (not just one-size-fits-all)

At Klarity Health, we offer convenient appointments with experienced providers who follow all state and federal guidelines for telehealth prescribing. Our transparent pricing and insurance acceptance make treatment accessible, and our providers take time to find the right

Source:

• https://www.axios.com/2024/11/18/covid-telehealth-prescribing-extended-adderall#:~:text=The%20Drug%20Enforcement%20Administration%20,year%20extension
• https://www.jdsupra.com/legalnews/dea-signals-extension-of-telemedicine-3341195/#:~:text=,to%20prescribe%20%E2%80%93%20and%20online
• https://www.jdsupra.com/legalnews/dea-extends-telemedicine-flexibilities-4133007/#:~:text=stakeholders%20have%20long%20been%20awaiting,regulations%20regarding%20a%20special%20registration
• https://www.jdsupra.com/legalnews/dea-extends-telemedicine-flexibilities-4133007/#:~:text=The%20Ryan%20Haight%20Online%20Pharmacy,the%20majority%20of%20medical%20providers
• https://www.bon.texas.gov/faqpracticeaprn.asp.html#:~:text=there%20any%20settings%20other%20than,registration%20but%20I%20do%20not
• https://www.jdsupra.com/legalnews/telehealth-and-in-person-visits-6106096/#:~:text=standard%20to%20perform%20a%20prior,as%20of%20July%2017%2C%202025
• https://floridapolitics.com/archives/514926-governor-signs-bill-allowing-providers-to-use-telehealth-to-prescribe-some-controlled-substances/#:~:text=Telehealth%20can%20be%20used%20to,signed%20into%20law%20Wednesday%20night
• https://floridapolitics.com/archives/514926-governor-signs-bill-allowing-providers-to-use-telehealth-to-prescribe-some-controlled-substances/#:~:text=Providers%20currently%20are%20allowed%20to,of%20a%20nursing%20home%20facility
• https://www.jdsupra.com/legalnews/telehealth-and-in-person-visits-6106096/#:~:text=In%20May%202025%2C%20the%20New,1%5D%20These%20exceptions%20include
• https://www.cchpca.org/topic/online-prescribing/#:~:text=,at%20the%20request%20of%20a