PMHNP Scope of Practice for Narcolepsy in North Carolina

You’re treating a patient who falls asleep mid-conversation, struggles to stay awake driving, and experiences sudden muscle weakness when laughing. Classic narcolepsy. You want to start them on a stimulant or modafinil to restore their quality of life. But here’s the catch: you’re seeing them via telehealth, they’re in another state, and you’re navigating a maze of federal DEA rules, state telehealth laws, and scope-of-practice restrictions that change every few months.

If you’re a psychiatrist or PMHNP wondering whether you can legally diagnose and treat narcolepsy remotely—especially prescribing the controlled substances these patients need—this guide breaks down exactly what’s allowed, what’s forbidden, and what’s still in regulatory flux as of 2026.

The Bottom Line Up Front

As of early 2026, you CAN prescribe narcolepsy medications (including Schedule II stimulants) via telehealth in most states—but only because of temporary federal waivers that expire December 31, 2026. After that, the rules could change dramatically. And even now, state laws add critical restrictions depending on where your patient is located and whether you’re an MD/DO or a nurse practitioner.

Here’s what you need to know:

• Federal DEA rules normally require an in-person exam before prescribing any controlled substance via telemedicine (the Ryan Haight Act). COVID-era flexibilities waived this requirement, and those waivers have been extended through the end of 2026 (HHS Jan 2026 announcement).

• After 2026, expect new DEA telemedicine rules that will likely impose some restrictions—possibly requiring an initial in-person visit or limiting initial supply to 30 days. The DEA is still finalizing these regulations after receiving over 38,000 public comments.

• State laws vary wildly. Florida outright bans Schedule II stimulant prescribing via telehealth for narcolepsy (it’s only allowed for psychiatric disorders). New York requires in-person exams unless federal exceptions apply. Texas, California, Illinois, and Pennsylvania currently follow federal guidance but have their own documentation and PDMP requirements.

• PMHNP scope matters. Texas and Georgia prohibit NPs from prescribing Schedule II stimulants in outpatient settings—period. Florida limits NPs to 7-day supplies of Schedule II unless treating a mental health disorder (narcolepsy doesn’t count). Meanwhile, California, New York, and Illinois grant experienced NPs full prescriptive authority, including for stimulants.

Let’s dig into the details so you know exactly where you stand.

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Federal DEA Rules: The Ryan Haight Act and COVID Waivers

The Law That Almost Killed Telepsychiatry for Narcolepsy

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 was designed to stop rogue online pharmacies from selling controlled substances without legitimate prescriptions. It amended the Controlled Substances Act to require that any prescription for a controlled substance issued via the internet must be based on at least one in-person medical evaluation by the prescribing practitioner (21 USC §829(e)).

In practice, this meant pre-COVID, you couldn’t start a patient on Adderall, Ritalin, modafinil, or any other narcolepsy medication via video visit alone. You had to see them face-to-face at least once, or use one of a few narrow exceptions (like the patient being treated in a DEA-registered hospital, or being referred by a physician who’d done the in-person exam).

For psychiatrists treating narcolepsy remotely—especially in underserved rural areas—this was a dealbreaker. It forced hybrid models where patients had to travel for initial visits, defeating much of telehealth’s purpose.

COVID Changed Everything (Temporarily)

In March 2020, the DEA announced it would temporarily waive the in-person exam requirement during the COVID-19 Public Health Emergency. Suddenly, you could prescribe controlled substances—including Schedule II stimulants for narcolepsy—via telehealth without ever meeting the patient in person, as long as:

• The prescription was for a legitimate medical purpose
• You complied with all other DEA requirements (valid DEA registration, state licensure, etc.)
• The prescription met the standard of care

This was a game-changer. Narcolepsy patients in remote areas could finally access specialists. Psychiatrists could manage stimulant therapy entirely via video.

The Waiver Keeps Getting Extended—For Now

When the federal Public Health Emergency ended on May 11, 2023, the DEA didn’t pull the plug. Instead, recognizing the chaos that would ensue, they issued temporary extensions of the telehealth prescribing flexibilities:

• First extension: through November 2023
• Second extension: through December 31, 2024 (DEA Nov 2024 announcement)
• Latest extension: through December 31, 2026 (HHS Jan 2026 press release)

So as of February 2026, you can still prescribe narcolepsy medications via telehealth without an in-person visit, as long as you follow state laws and standard prescribing practices.

But this is a temporary stopgap while the DEA finalizes permanent telemedicine rules.

What’s Coming: Permanent DEA Telemedicine Rules

The DEA has been working on permanent telemedicine prescribing regulations since 2022. Their initial 2023 proposal suggested:

• Requiring an in-person exam after an initial 30-day telemedicine prescription for most controlled substances
• Potentially banning telehealth initiation of Schedule II stimulants entirely without an in-person visit

This proposal was met with fierce opposition from telehealth providers, patient advocates, and even Congress. Over 38,000 public comments flooded in (DEA announcement). The DEA pulled back, extended the temporary waivers, and went back to the drawing board.

As of early 2026, no final rule has been published. The only finalized telemedicine-specific rules address narrow cases:

1. Buprenorphine for opioid use disorder can be prescribed via telemedicine without an in-person exam (DEA Jan 2025 final rules)
2. VA health system patients can continue controlled substance care via telehealth under a ‘continuity of care’ exception

For narcolepsy, there’s no special exception yet. You’re operating under the general COVID-era waiver. When the final rules drop (likely sometime in 2025–2026), expect them to be more flexible than the initial proposal—but probably still requiring some in-person component, at least for Schedule II stimulants.

What This Means for Your Practice

Right now (through 2026):

• You can diagnose narcolepsy via video visit
• You can prescribe Adderall, Ritalin, modafinil, armodafinil, sodium oxybate, etc. via telehealth
• You must follow standard prescribing practices: thorough history, mental status exam, documented clinical rationale, PDMP checks, e-prescribing compliance

After 2026 (likely):

• You’ll probably need to see new narcolepsy patients in person at least once before prescribing Schedule II stimulants, OR
• You’ll be limited to a short initial supply (e.g., 30 days) via telehealth, then require an in-person visit for ongoing treatment

Smart strategy: Start building hybrid care relationships now. Partner with local clinics or sleep centers in states where you practice remotely, so you can arrange in-person visits when needed. Or focus on states where you can easily travel to see patients once (then manage them remotely thereafter).

State-by-State Breakdown: Who Can Prescribe What, Where

Federal law sets the floor. But state medical boards, pharmacy boards, and legislatures add their own layers—and some of them make practicing narcolepsy telemedicine nearly impossible.

Here’s what you need to know for the six most important states (by population and telehealth adoption): California, Texas, Florida, New York, Pennsylvania, and Illinois.

California: NP Independence Meets Telehealth Freedom

Psychiatrists: Full authority. No state-imposed barriers to telehealth prescribing of controlled substances beyond federal DEA rules. You can see a patient via video, diagnose narcolepsy, and e-prescribe stimulants or modafinil. Just comply with standard of care and check the CURES PDMP before every controlled substance prescription (required by state law).

PMHNPs: California recently became a full practice authority state—with conditions. As of January 2023, nurse practitioners with at least 4,600 hours (roughly 3 years) of supervised clinical experience can qualify as independent practitioners under AB 890 (RxAgent NP guide).

Independent NPs in California can prescribe Schedule II–V controlled substances on their own license, including stimulants for narcolepsy. But you need:

• A furnishing number from the California Board of Registered Nursing with Schedule II authorization
• Completion of required pharmacology training on controlled substances (including addiction risk) (CA BRN requirements)
• A DEA registration

If you haven’t hit the 4,600-hour mark yet, you’ll work under a physician’s standardized procedure agreement. But once you qualify for full practice authority, you can handle narcolepsy cases independently—diagnosing, prescribing, managing.

Bottom line: California is one of the most NP-friendly states for narcolepsy telemedicine. Experienced PMHNPs can build independent practices here.

Texas: NPs Hit a Brick Wall

Psychiatrists: No problem. Texas law allows physicians to establish a patient relationship via live two-way video (audio-only isn’t sufficient for prescribing controlled substances). You can diagnose and treat narcolepsy remotely as long as you meet the standard of care.

One caveat: Texas bans telehealth prescribing of controlled substances for chronic pain management (defined as pain lasting >90 days) except under very narrow conditions (CCHP telehealth report). But narcolepsy isn’t chronic pain, so this doesn’t affect you.

PMHNPs: This is where Texas becomes a nightmare. Texas is a restricted practice state—all NPs must work under physician supervision with a written prescriptive delegation agreement. But here’s the dealbreaker:

Texas law prohibits APRNs (including PMHNPs) from prescribing Schedule II controlled substances in outpatient settings. Period.

The only exceptions are:

• Patients admitted to a hospital for ≥24 hours
• Patients in the emergency department
• Terminally ill hospice patients (and even then, the prescription must be filled at the hospital or hospice pharmacy)

(Texas Medical Board FAQ)

This means a Texas PMHNP cannot prescribe Adderall, Ritalin, or other Schedule II stimulants to an outpatient narcolepsy patient. The supervising physician has to write those prescriptions.

You can prescribe Schedule III–V medications under delegation—so modafinil (Schedule IV) is fair game. But classic stimulants? Off the table.

Impact: If you’re running a telehealth platform serving Texas, you’ll need psychiatrists (MDs/DOs) on staff to handle Schedule II prescriptions for narcolepsy patients. Or you’ll need to refer patients to local physicians for those specific medications while managing the rest of their care.

Florida: Telehealth Stimulants Only for Psychiatric Disorders

Psychiatrists: Florida is tricky. The state’s telehealth statute (Florida Statutes §456.47) explicitly prohibits prescribing Schedule II and III controlled substances via telehealth (FL Statute 456.47)—except in four scenarios:

1. Treating a psychiatric disorder
2. Inpatient hospital care
3. Hospice care
4. Nursing home residents

Here’s the problem: Narcolepsy is not a psychiatric disorder. It’s a neurological sleep disorder. So under Florida law, you cannot prescribe Schedule II stimulants (Adderall, Ritalin) via telehealth to a narcolepsy patient, even if you’re a psychiatrist.

You can prescribe modafinil or armodafinil (Schedule IV) via telehealth—those aren’t covered by the ban.

But for classic stimulants, you’ll need at least one in-person visit to legally prescribe, then you can manage refills remotely (though the statute is ambiguous on whether ongoing telehealth management is allowed once the medication is established).

PMHNPs: Florida is a reduced practice state—NPs need physician collaboration agreements. For controlled substances, Florida law limits Schedule II prescriptions by APRNs to a 7-day supply for any acute illness (FL Statute 464.012)—unless the APRN is a ‘psychiatric nurse’ (PMHNP with specific training and experience) and is prescribing for a mental health disorder.

Since narcolepsy isn’t a mental health disorder, even a Florida PMHNP who qualifies as a ‘psychiatric nurse’ can only prescribe a 7-day supply of Schedule II stimulants at a time. For ongoing management, a physician must be involved.

Modafinil (Schedule IV) doesn’t have the 7-day limit, so PMHNPs can prescribe it under their collaborative agreement.

Bottom line: Florida is one of the least telehealth-friendly states for narcolepsy care. If you’re targeting Florida patients, plan on either:

• Using modafinil as your first-line agent (many narcolepsy patients do well on it)
• Partnering with local clinics for in-person visits to prescribe stimulants
• Having an MD on your platform handle Florida narcolepsy cases

New York: Aligning with Federal Rules

Psychiatrists: New York recently updated its telehealth prescribing rules to require an in-person exam before prescribing controlled substances—unless specific exceptions apply (NY DOH rule via Nixon Peabody analysis).

Key exceptions include:

• The patient was recently examined in person by a consulting provider who referred them to you
• You’re covering for another practitioner who saw the patient in person
• Emergency situations
• The prescription is being done in accordance with applicable federal law

That last exception is the critical one. Because the DEA’s COVID-era telehealth waiver is still in effect through 2026, New York’s rule essentially defers to federal policy. So right now, you can prescribe narcolepsy medications via telehealth in New York without an in-person visit.

But when the DEA waiver expires or new federal rules require in-person exams, New York’s requirement will automatically kick in.

PMHNPs: New York is a full practice authority state for experienced NPs. As of 2022, NPs with more than 3,600 hours of clinical practice can practice independently without a collaborative agreement (Rivkin Rounds analysis).

Independent PMHNPs in New York have full prescriptive authority for controlled substances (Schedule II–V). They can diagnose and treat narcolepsy entirely on their own, including prescribing stimulants—subject to the same telehealth rules as psychiatrists (i.e., following federal DEA policy).

You’ll need:

• A New York NP certificate to prescribe
• DEA registration
• Registration with New York’s I-STOP prescription monitoring program (mandatory PDMP check before every controlled substance prescription)

Bottom line: New York is NP-friendly and currently telehealth-friendly for narcolepsy care, but you should plan for eventual in-person visit requirements once federal rules change.

Pennsylvania: Collaboration Required, Telehealth Allowed

Psychiatrists: Pennsylvania has no state-specific prohibition on telehealth prescribing of controlled substances. You can establish a patient relationship via telemedicine and prescribe narcolepsy medications remotely, as long as you comply with federal DEA rules and document a thorough evaluation.

Pennsylvania law requires checking the PA PDMP before prescribing controlled substances. E-prescribing is also mandatory.

PMHNPs: Pennsylvania is a restricted practice state—Certified Registered Nurse Practitioners (CRNPs) must have a collaborative agreement with a physician to prescribe.

Under that agreement, CRNPs can prescribe Schedule II–V controlled substances, but with limits:

• Schedule II prescriptions are limited to a 30-day supply for acute conditions. If a patient needs ongoing Schedule II therapy, the physician must be consulted and the patient re-evaluated.
• Schedule III–IV prescriptions are limited to a 90-day supply.

Older Pennsylvania rules imposed a 72-hour initial limit on Schedule II prescriptions by CRNPs, but that was removed in 2021 (PA Code & Bulletin updates).

So a PMHNP in Pennsylvania can start a narcolepsy patient on a stimulant via telehealth (under the collaborating physician’s oversight), prescribe up to a 30-day supply, and then involve the physician for periodic review if the patient needs ongoing treatment.

Bottom line: Pennsylvania allows NP-led narcolepsy care with physician oversight. It’s workable, but you’ll need a collaborative agreement in place and physician involvement for long-term stimulant management.

Illinois: Full Practice Authority for Experienced NPs

Psychiatrists: Illinois has no state restrictions on telehealth prescribing of controlled substances. You can practice narcolepsy telemedicine freely, following federal DEA rules and checking the Illinois PMP (PDMP) before prescribing.

PMHNPs: Illinois is a full practice authority state—with a catch. NPs can qualify for independent practice after completing 4,000 hours of clinical practice under a collaborative agreement + 250 hours of continuing education in their specialty (RxAgent NP guide).

Once you achieve Full Practice Authority (FPA), you can practice independently and prescribe Schedule II–V controlled substances on your own license. But there’s a caveat: if you prescribe benzodiazepines or opioids, you must have a ‘consultation relationship’ with a physician (a compromise written into the law).

Stimulants for narcolepsy are Schedule II but not opioids, so it’s unclear whether the consultation requirement applies. Most legal interpretations suggest it doesn’t—meaning Illinois FPA-NPs can prescribe Adderall, Ritalin, etc. independently for narcolepsy.

You’ll need:

• Illinois Mid-Level Practitioner Controlled Substance License (in addition to DEA registration)
• E-prescribing compliance (Illinois mandates electronic prescriptions for controlled substances as of January 2023)
• PDMP checks before prescribing

Bottom line: Illinois is one of the best states for PMHNP-led narcolepsy telemedicine. If you’ve achieved FPA, you can build an independent practice treating narcolepsy patients entirely remotely.

Comparison Table: Who Can Prescribe What, Where

Practical Challenges: What This Means for Your Narcolepsy Practice

Diagnosis Requires More Than a Video Visit

Confirming a narcolepsy diagnosis typically requires:

• Overnight polysomnography (sleep study) to rule out other sleep disorders
• Multiple Sleep Latency Test (MSLT) to measure daytime sleepiness and REM sleep onset

These tests must be done in person at a sleep lab. You can’t diagnose narcolepsy from a video visit alone (though you can certainly suspect it based on clinical history).

Solution: Establish referral relationships with sleep centers in states where you practice. Evaluate the patient remotely, order the appropriate tests, review results, then prescribe based on confirmed diagnosis. This hybrid model is already common in sleep medicine.

PDMP Checks Are Non-Negotiable

Every state on this list requires prescribers to check the prescription drug monitoring program (PDMP) before prescribing controlled substances. Some states require checks before every prescription (California, New York); others allow periodic checks for established patients (e.g., every 3–6 months).

Failure to check the PDMP can result in state board discipline, even if the prescription was otherwise appropriate. Make sure your telehealth platform integrates PDMP access, or build it into your workflow manually.

E-Prescribing Is Mandatory in Most States

Illinois, New York, and several other states require electronic prescribing for controlled substances (with very limited exceptions). Paper or phone-in prescriptions aren’t allowed.

Make sure your telehealth EHR supports EPCS (Electronic Prescribing for Controlled Substances) with two-factor authentication and DEA compliance.

Sodium Oxybate Has Extra Hoops

Sodium oxybate (Xyrem, Xywav) is Schedule III but subject to an FDA-mandated REMS program. To prescribe it, you must:

• Enroll in the Xyrem/Xywav REMS program
• Ensure the patient enrolls and uses a certified pharmacy
• Document counseling on risks (respiratory depression, CNS depression, abuse potential)

This adds administrative overhead but is doable via telehealth. Just be prepared for the extra paperwork.

What Happens After 2026? Preparing for DEA Rule Changes

The current DEA telehealth waiver expires December 31, 2026. After that, one of three things will happen:

1. DEA extends the waiver again (unlikely—they’ve already extended it four times)
2. DEA finalizes new telemedicine rules that allow some form of remote controlled substance prescribing with safeguards (most likely)
3. Waiver expires and Ryan Haight Act in-person requirement kicks back in (possible but would cause massive access disruptions)

What to expect in final DEA rules:

• Likely an initial 30-day telemedicine prescription allowed for Schedule II stimulants, with in-person visit required for ongoing therapy
• Possible exceptions for established patients (e.g., if you saw them in person once, you can manage them remotely thereafter)
• Stricter documentation requirements (clinical rationale, risk assessment, treatment agreements)

How to prepare:

• Build hybrid care relationships now. Partner with local clinics in key states so you can arrange in-person visits when needed.
• Focus on modafinil first-line. It’s Schedule IV, less likely to be restricted, and effective for many narcolepsy patients.
• Get multi-state licensed. Join the Interstate Medical Licensure Compact (IMLC) if you’re a physician in a member state (Illinois, Texas, Pennsylvania are members). This lets you obtain licenses in other member states faster.
• Document everything. Even under current waivers, thorough documentation of your telehealth evaluation, clinical reasoning, and follow-up plan is critical for both medical-legal protection and DEA compliance.

The Business Case: Why Narcolepsy Telehealth Still Makes Sense

Despite these regulatory headaches, narcolepsy is a significant market opportunity for telehealth psychiatrists and PMHNPs:

Massive Underdiagnosis and Specialist Shortage

• Estimated 135,000–200,000 people in the U.S. have narcolepsy, but only about 25% are diagnosed (most cases are misdiagnosed as depression, ADHD, or sleep apnea for years).
• Very few sleep medicine specialists focus on narcolepsy. Most are concentrated in major metro areas.
• Wait times for sleep specialists can be 3–6 months in many regions.

Telehealth allows you to serve patients in rural areas or underserved states who otherwise have no access to narcolepsy expertise.

High Patient Retention

Narcolepsy is a lifelong chronic condition requiring ongoing medication management. Once you establish a patient on effective treatment, they’ll likely stay with you for years—monthly or quarterly follow-ups, medication adjustments, managing side effects.

This creates predictable recurring revenue unlike acute psychiatric care where patients may drop off after a few sessions.

Insurance Reimbursement Is Strong

Most private insurers and Medicare now cover telehealth psychiatry at parity with in-person visits (thanks to permanent COVID-era policy changes). Narcolepsy management codes (99213–99215 for established patient visits) reimburse well, especially when you’re managing controlled substances (which justifies higher complexity coding).

Platform Economics: Klarity Health’s Pay-Per-Appointment Model

Traditional DIY marketing for a narcolepsy telemedicine practice is expensive and risky:

• SEO takes 6–12 months of consistent content creation and technical optimization before generating meaningful patient flow. Most solo practitioners don’t have the expertise or budget.
• Google Ads for mental health keywords run $15–40+ per click, and most clicks don’t convert to booked patients. Realistic cost per booked patient through PPC is $200–400+ when you factor in ad spend, testing, optimization, and no-shows.
• Psychology Today and Zocdoc charge monthly subscription fees ($30–100+/month) plus per-booking fees ($35–100+ per new patient), and you’re competing with hundreds of other providers on the same page.

When you add up agency fees, ad spend testing, staff time to handle and qualify leads, and failed campaigns, DIY patient acquisition typically costs $200–500+ per qualified psychiatric patient.

Klarity Health’s model is different: You pay a standard listing fee per new patient lead (similar to Zocdoc’s per-booking model), but with key advantages:

✅ No upfront marketing spend or monthly subscription fees
✅ Pre-qualified patients already matched to your specialty (narcolepsy, ADHD, depression, etc.) and availability
✅ No wasted ad spend on clicks that don’t convert—you only pay when a qualified patient books with you
✅ Built-in telehealth infrastructure—no need to pay for separate EHR, video platform, or e-prescribing tools
✅ Both insurance and cash-pay patient flow—broader patient base than cash-only platforms
✅ You control your schedule—set your availability, accept or decline cases based on fit

Instead of spending $3,000–5,000/month on marketing with uncertain results, you pay only when you see patients. That’s guaranteed ROI vs. gambling on marketing channels that may or may not work.

For a psychiatrist or experienced PMHNP, this removes the biggest barrier to launching a narcolepsy telemedicine practice: patient acquisition risk.

Key Takeaways

1. You can prescribe narcolepsy medications via telehealth in most states through 2026 under temporary DEA waivers—but prepare for regulatory changes after that.

2. State laws matter more than federal law in some cases. Florida bans telehealth stimulant prescribing for narcolepsy; Texas bans NPs from prescribing Schedule II outpatient entirely. Know your state’s rules.

3. PMHNP scope varies wildly by state. If you’re an NP, California, New York, and Illinois offer the most autonomy. Texas and Florida severely limit your ability to prescribe narcolepsy stimulants.

4. Build hybrid care relationships now so you’re ready when in-person visit requirements return. Partner with local sleep labs and clinics.

5. Platforms like Klarity Health remove patient acquisition risk—you focus on clinical care while the platform handles marketing, credentialing, and telehealth infrastructure.

Narcolepsy is an underserved, high-need patient population. With the right regulatory knowledge and practice setup, you can build a sustainable telehealth practice serving these patients—whether you’re an independent psychiatrist or a PMHNP working toward full practice authority.

Ready to start treating narcolepsy patients via telehealth? Explore Klarity Health’s provider network to see how we handle the regulatory complexity, patient acquisition, and infrastructure so you can focus on what you do best: providing life-changing care.

Frequently Asked Questions

Can I prescribe Adderall or Ritalin for narcolepsy via telehealth in 2026?
In most states, yes—as long as you’re following the current DEA telehealth waiver (extended through December 31, 2026). Notable exceptions: Florida prohibits Schedule II stimulant prescribing via telehealth unless treating a psychiatric disorder (narcolepsy doesn’t count). After 2026, expect new DEA rules requiring in-person visits in some form.

Can PMHNPs prescribe narcolepsy medications independently?
It depends on the state. California, New York, and Illinois allow experienced PMHNPs to practice independently and prescribe Schedule II stimulants (including for narcolepsy) once they meet state requirements. Texas prohibits NPs from prescribing Schedule II in outpatient settings—a supervising physician must write those prescriptions. Florida limits NPs to 7-day Schedule II supplies unless treating mental health disorders.

Do I need to see a narcolepsy patient in person before prescribing stimulants?
Not right now (through 2026) under the DEA’s temporary telehealth waiver. But you’ll likely need an in-person visit once permanent DEA rules are finalized (expected to require at least one in-person exam, or limit initial telehealth prescriptions to 30 days). Florida already requires in-person visits for Schedule II stimulants if not treating a psychiatric disorder.

Can I diagnose narcolepsy via telehealth alone?
You can suspect narcolepsy based on clinical history (excessive daytime sleepiness, cataplexy, sleep paralysis), but confirming the diagnosis typically requires overnight polysomnography and a Multiple Sleep Latency Test (MSLT), which must be done in person at a sleep lab. You’ll need to coordinate testing with local facilities.

What’s the difference between modafinil and Schedule II stimulants for narcolepsy?
Modafinil and armodafinil (Schedule IV) are wakefulness-promoting agents that are often first-line for narcolepsy excessive daytime sleepiness. They’re less regulated than Schedule II stimulants (Adderall, Ritalin), making them easier to prescribe via telehealth in restrictive states like Florida. **Schedule

Source:

• https://www.law.cornell.edu/definitions/uscode.php?defid=21-USC-1796173870-113781527&height=800&iframe=true&termoccur=999&term_src=title%3A21%3Achapter%3A13%3Asubchapter%3AI%3Apart%3AC%3Asection%3A831&width=840#:~:text=,that%20a%20prescription%20has%20been
• https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html#:~:text=announced%20a%20fourth%20temporary%20extension,while%20permanent%20rules%20are%20finalized
• https://www.dea.gov/documents/2024/2024-11/2024-11-15/dea-and-hhs-extend-telemedicine-flexibilities-through-2025#:~:text=promulgate%20a%20final%20set%20of,Medications%2C%E2%80%9D%20was%20submitted%20to%20the
• https://www.dea.gov/press-releases/2025/12/31/dea-extends-telemedicine-flexibilities-ensure-continued-access-care#:~:text=On%20January%2017%2C%202025%2C%20DEA,to%20as%20the%20%E2%80%9CTwo%20Final
• https://www.leg.state.fl.us/statutes/index.cfm?Appmode=DisplayStatute&URL=0400-0499%2F0456%2FSections%2F0456.47.html#:~:text=telehealth%20to%20provide%20health%20care,in%20Schedule%20II%20of%20s
• https://www.tmb.state.tx.us/page/facility-based-prescriptive-delegation#:~:text=at%20the%20hospital%E2%80%99s%20facility,from%20a%20qualified%20hospice%20provider
• https://www.cchpca.org/resources/state-telehealth-laws-and-reimbursement-policies-report-fall-2025/#:~:text=Texas%20regulations%20emphasize%20continuity%20of,Note
• https://www.nixonpeabody.com/insights/alerts/2025/06/18/new-york-state-finalizes-telemedicine-rule-for-controlled-substances#:~:text=match%20at%20L114%20The%20rule,and%20the%20US%20Department%20of
• https://www.nixonpeabody.com/insights/alerts/2025/06/18/new-york-state-finalizes-telemedicine-rule-for-controlled-substances#:~:text=In%20short%2C%20the%20exception%20permits,as%20a%20condition%20of%20state
• https://rxagent.co/blog/np-prescribing-authority#:~:text=Conversely%2C%20in%20Restricted%20Practice%20states,expand%20this%20scope%20%206