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ADHD

Published: Jun 6, 2026

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Telehealth ADHD Prescribing: What Prescribers Can Do in Georgia

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Written by Klarity Editorial Team

Published: Jun 6, 2026

Telehealth ADHD Prescribing: What Prescribers Can Do in Georgia
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If you’re a psychiatrist wondering whether you can prescribe Adderall or other ADHD medications through telehealth—or a PMHNP trying to figure out if your state allows it—you’re asking the right question at the right time.

The short answer: Yes, psychiatrists can prescribe ADHD medications via telehealth in 2026, but the details matter. Federal flexibility extended through the end of 2025 has given providers breathing room, but the landscape is shifting. State laws vary dramatically on who can prescribe what, and whether you’re an MD or NP changes everything depending on where you practice.

Let’s break down what’s actually happening with telehealth ADHD prescribing, what the rules are by state, and how this impacts your practice.

The Federal Framework: Where We Stand on Telehealth Controlled Substance Prescribing

ADHD medications like Adderall, Vyvanse, and Ritalin are Schedule II controlled substances. Under the Ryan Haight Act (2008), prescribing these drugs normally requires at least one in-person visit with the patient. But COVID changed everything.

During the pandemic, the DEA waived that in-person requirement, allowing psychiatrists to initiate stimulant prescriptions entirely via video visit. That flexibility was supposed to expire at the end of 2024—but in November 2024, the DEA and HHS extended it through December 31, 2025. This was the third extension, and as of early 2026, we’re in a holding pattern waiting to see if Congress makes these rules permanent or if we revert to the old Ryan Haight requirements.

What this means for you: Right now, you can start a new ADHD patient on stimulants via telehealth without having seen them in person. But you should have a contingency plan—partnering with local clinics for in-person exams, coordinating with primary care, or preparing your patients for the possibility that an in-person visit might be required if the rules change later in 2026.

Some psychiatrists are watching for a proposed ‘special registration’ pathway from the DEA that would allow long-term telehealth prescribing of controlled substances. It hasn’t materialized yet, but it’s worth keeping an eye on DEA rulemaking through the year.

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State-Specific Rules: Not All States Are Created Equal

Federal law sets the floor, but states add their own layers—especially when it comes to who can prescribe and what conditions apply.

States Where Telehealth ADHD Prescribing Is Explicitly Supported

Florida stands out here. Florida law explicitly allows telehealth providers to prescribe Schedule II controlled substances for psychiatric disorders—which includes ADHD. This is a carve-out from Florida’s general prohibition on telehealth controlled substance prescribing (which targets pain management). So if you’re a Florida-licensed psychiatrist treating ADHD via video, you’re operating well within state law.

California and New York don’t have additional state-level barriers beyond federal law. They follow the DEA’s guidance, meaning as long as the federal waiver is in place, you can prescribe stimulants via telehealth to patients in those states.

Texas allows telehealth prescribing of controlled substances for mental health treatment, but it must be via live video (not audio-only). Texas explicitly restricts telehealth controlled substance prescribing for chronic pain, but ADHD doesn’t fall under that restriction—so psychiatrists are good to go.

The PMHNP vs Psychiatrist Divide: Scope of Practice Matters

Here’s where things get messy if you’re a nurse practitioner.

Psychiatrists (MD/DO) have full prescriptive authority in every state. If you’re a psychiatrist, state scope of practice laws don’t restrict what you can prescribe—only controlled substance regulations apply (DEA registration, state controlled substance permits, PDMP checks).

PMHNPs face a patchwork of state laws that range from near-MD autonomy to outright prohibition on prescribing stimulants.

Full Practice States (NPs Can Prescribe ADHD Meds Independently—Eventually)

  • New York: PMHNPs must complete 3,600 hours (about 2 years) under physician supervision. After that, they can practice and prescribe stimulants independently. No quantity limits, no MD co-signature required.

  • Illinois: NPs need 4,000 hours of practice and 250 hours of additional training to obtain Full Practice Authority. Once granted, they can prescribe ADHD medications without physician oversight (though Illinois requires physician consultation for Schedule II narcotics like opioids—this doesn’t apply to stimulants).

  • California: Transitioning. Experienced NPs (≥3 years or 4,600 hours) can apply for independent ‘104 NP’ status as of 2023. Until then, they need physician supervision. Even independent NPs must complete a controlled substance pharmacology course to prescribe Schedule IIs.

Restricted States (NPs Need Physician Collaboration—and Sometimes Can’t Prescribe Stimulants at All)

  • Texas: This is the toughest state for NPs treating ADHD. Texas law prohibits NPs from prescribing Schedule II controlled substances outside of hospital, hospice, or emergency settings. Translation: A Texas PMHNP cannot write an Adderall prescription for a routine outpatient ADHD patient—period. Only physicians (MDs/DOs) can do that. NPs can still see ADHD patients for therapy or non-stimulant medication management, but stimulants require an MD.

  • Florida: PMHNPs need a supervisory protocol with a psychiatrist. Florida law limits NP-prescribed Schedule IIs to a 7-day supply—except for ‘psychiatric medications prescribed by a psychiatric nurse’ under a psychiatrist’s protocol. That exception allows PMHNPs to prescribe a standard 30-day supply of Adderall, but they’re still operating under physician oversight.

  • Pennsylvania: NPs must have a collaborative agreement with a physician. For Schedule IIs, NPs can only prescribe a 72-hour initial supply (and must notify the collaborating physician), then up to 30 days for ongoing therapy. This makes workflow clunky—often the psychiatrist writes the first prescription to avoid the 72-hour hassle.

Bottom line: If you’re a PMHNP, your ability to prescribe ADHD meds via telehealth depends entirely on your state. In states like Texas, you’ll need a psychiatrist partner. In New York or Illinois (after achieving FPA), you can operate just like an MD.

The Clinical Workflow: How to Actually Manage ADHD via Telehealth

Regulatory compliance aside, let’s talk about the how. Managing ADHD medication via telemedicine isn’t that different from in-person care—you’re just doing it through a screen.

Initial Evaluation

You’ll conduct a comprehensive psychiatric evaluation via video: clinical interview, DSM-5 ADHD criteria, rating scales (ADHD RS-IV for kids, ASRS for adults), collateral information (teacher reports for kids, partner input for adults). Most psychiatrists ask patients to self-report vitals or get a baseline BP/heart rate from their PCP, since stimulants can affect cardiovascular health.

Telehealth platforms can send questionnaires electronically through patient portals. You’re documenting the same way you would in-person—just noting ‘telehealth visit, patient located in [State], consent obtained for telehealth treatment.’

E-Prescribing

All controlled substance prescriptions must go through a DEA-compliant e-prescribing platform with two-factor authentication. Most telehealth platforms have this built in. You’ll also need to check your state’s Prescription Drug Monitoring Program (PDMP) before prescribing—this is mandatory in many states (New York requires it for every controlled Rx; Texas mandates it for opioids and benzos but encourages it for stimulants).

Monthly Follow-Ups

ADHD medication management typically involves monthly check-ins (since stimulants are dispensed in 30-day increments). These are brief visits—10 to 15 minutes focusing on symptom response, side effects, adherence, any need for dose adjustments. These are easily handled via video or even phone in some cases (though phone-only controlled substance follow-ups may not satisfy some state laws—stick with video to be safe).

Safeguards and Documentation

Given the increased scrutiny on telehealth ADHD prescribing (after some high-profile cases of online services overprescribing stimulants with minimal evaluation), it’s critical to demonstrate you’re practicing to the in-person standard of care. That means:

  • Thorough documentation justifying the ADHD diagnosis
  • Informed consent covering risks of stimulant treatment
  • Coordinating with the patient’s PCP when appropriate
  • Periodic reassessment (not just rubber-stamping refills)
  • Considering urine drug screens or patient agreements if there’s any concern about misuse

Florida’s telehealth law explicitly states that telehealth providers must practice consistent with the in-person standard of care. That’s the bar everywhere—just because it’s online doesn’t mean you can cut corners.

Reimbursement: Will You Actually Get Paid?

Yes. Telehealth reimbursement for psychiatric medication management is now on solid ground.

Telehealth parity is nearly universal as of 2026. Almost every state has enacted telehealth parity laws or insurers have voluntarily aligned rates—meaning you get paid the same for a virtual med check as you would for an in-person visit.

Medicare pays telehealth mental health visits at the non-facility fee schedule rate (the full amount, same as in-person). For example:

  • 99213 (15-minute med management visit): ~$89–$95 from Medicare
  • 99214 (25-minute visit): ~$125–$136 from Medicare
  • 90792 (initial psychiatric evaluation with med services): ~$188–$202

Private commercial insurers often pay equal to or higher than Medicare—sometimes 10-30% more depending on the contract. Medicaid pays significantly less (often around $40–$65 for a med check), but telehealth coverage through Medicaid has expanded post-pandemic, and many states now mandate parity there too.

Psychiatrists are reimbursed at the highest tier for psychiatric services compared to other provider types (therapists, NPs billing under their own NPI). This is because you hold a medical license and can bill Evaluation & Management codes, which generally command higher fees than therapy-only services.

The economics are favorable: if you conduct four 15-minute med checks in an hour via telehealth at ~$90 each (Medicare rate), that’s $360/hour gross revenue—likely more from private payers. With telehealth, your overhead is lower (no office rent, no commute), so your net income per hour can actually be higher than traditional in-person practice.

The Economics of Patient Acquisition: Why Platforms Like Klarity Make Sense

Here’s the reality that most solo providers don’t talk about: acquiring a qualified psychiatric patient on your own is expensive and time-consuming.

If you’re trying to build a patient base through DIY marketing—SEO, Google Ads, Psychology Today directory listings—you’re looking at:

  • $200–$500+ per booked patient when you factor in all costs: agency fees, ad spend, staff time to qualify leads, no-show rates from cold leads, months of SEO investment before you see results.
  • SEO takes 6–12 months of consistent investment (content creation, backlinks, technical optimization) before you generate meaningful patient flow. Most solo providers don’t have the expertise or patience for that.
  • Google Ads for mental health keywords are brutal: $15–$40+ per click for terms like ‘ADHD psychiatrist near me,’ and most clicks don’t convert to booked patients. A realistic cost per booked patient through PPC is $200–$400+.
  • Directory listings (Psychology Today, Zocdoc) charge monthly subscription fees ($30–$100/month) and you compete with hundreds of other providers on the same page. Zocdoc charges per booking ($35–$100+ per lead), and when you add the monthly subscription, total cost per patient acquisition adds up fast.

That’s the hidden cost of ‘being your own boss’—you’re either spending thousands per month on marketing with uncertain ROI, or you’re waiting months (or years) to build enough organic visibility to fill your schedule.

Klarity’s model removes that risk entirely. You pay a standard listing fee per new patient lead (similar to Zocdoc’s per-booking model), but with key differences:

  • No upfront marketing spend or monthly subscription fees—you’re not gambling $3,000–$5,000/month on ads that might not work.
  • Pre-qualified patients already matched to your specialty and availability—no wasted time fielding ‘do you take my insurance?’ calls or no-shows from unqualified leads.
  • No wasted ad spend on clicks that don’t convert—every lead is a real patient ready to book.
  • Built-in telehealth infrastructure—you’re not paying separately for an EHR, e-prescribing platform, scheduling system, or video software.
  • Both insurance and cash-pay patient flow—diversified revenue stream without you having to manage multiple marketing channels.
  • You control your schedule—only pay when you see patients. If you take a week off, you’re not burning through a monthly retainer.

The value proposition is simple: instead of spending months and thousands of dollars hoping to acquire patients, you pay only when a qualified patient books with you. That’s guaranteed ROI.

Can DIY marketing eventually be cost-effective? Sure—if you have the budget, expertise, and patience. But for most providers (especially those starting out or scaling), a platform that handles patient acquisition removes the risk entirely and lets you focus on what you do best: treating patients.

State-by-State Breakdown: What You Need to Know

Here’s a quick reference for the six priority states, focusing on ADHD prescribing:

California

Psychiatrists: Full authority. No state-level telehealth restrictions beyond federal law.

PMHNPs: Restricted until they obtain ‘104 NP’ independent status (≥3 years/4,600 hours experience). Must complete controlled substance pharmacology course to prescribe Schedule IIs. As of 2023, experienced NPs can apply for independence—many will have it by 2026.

Market: High demand, competitive metro areas (SF, LA, SD), but rural Central Valley and Inland Empire are underserved. Strong insurance markets, telehealth parity enforced.

Texas

Psychiatrists: Full authority. Telehealth allowed for mental health with live video.

PMHNPs: Cannot prescribe Schedule II stimulants for outpatient ADHD patients. Only MDs can. NPs need physician supervision for all practice.

Market: Severe psychiatrist shortage (1:9,000 ratio). High demand, especially rural areas. Telehealth widely used, but regulatory scrutiny on controlled substance prescribing has increased post-pandemic.

Florida

Psychiatrists: Full authority. State law explicitly allows telehealth Schedule II prescribing for psychiatric disorders (including ADHD).

PMHNPs: Need physician (psychiatrist) protocol. Can prescribe 30-day stimulant supplies under the ‘psychiatric nurse’ exception (not subject to 7-day limit).

Market: Growing population, significant shortage (1:8,577 ratio). South Florida has providers, but North Florida and rural areas are gaps. Telehealth-friendly laws.

New York

Psychiatrists: Full authority.

PMHNPs: Must complete 3,600 hours under supervision, then can practice and prescribe independently. No state limits on Schedule II prescribing.

Market: Best psychiatrist density in the country (1:2,900 ratio), but NYC-heavy. Upstate rural areas still underserved. Strong telehealth parity, mandatory PDMP checks, mandatory e-prescribing.

Pennsylvania

Psychiatrists: Full authority.

PMHNPs: Need collaborative agreement. Limited to 72-hour initial Schedule II prescription, then 30-day ongoing (with physician re-evaluation required for continuation). Workflow can be clunky.

Market: Moderate density (1:4,586 ratio). Philadelphia/Pittsburgh well-served, rural areas not. Telehealth coverage strong, but NP restrictions create gaps.

Illinois

Psychiatrists: Full authority.

PMHNPs: Can obtain Full Practice Authority after 4,000 hours + training. Once granted, can prescribe stimulants independently (physician consult required only for Schedule II opioids, not stimulants).

Market: Moderate density (1:5,849 ratio). Chicago has providers, downstate has shortages. Telehealth parity in place, evolving NP autonomy increasing access.

Pain Points Providers Face—and How to Navigate Them

Regulatory Uncertainty

The biggest stress for ADHD telehealth prescribers right now is ‘Will I still be able to do this in six months?’ The DEA extension through 2025 buys time, but the clock is ticking. If Congress doesn’t act, the Ryan Haight in-person requirement could snap back.

What you can do: Build relationships with local primary care clinics or telehealth physical exam services that can perform in-person visits if needed. Some platforms coordinate this. Document your telehealth standard of care meticulously—if rules do revert, you’ll want to show you were practicing responsibly.

Medication Shortages

ADHD medication shortages have been ongoing since late 2022. Patients are frustrated when Adderall or Vyvanse is backordered at their pharmacy, and that frustration lands on you.

What you can do: Familiarize yourself with alternatives (generic vs brand, different formulations, non-stimulant options like atomoxetine or viloxazine). Have a list of pharmacies in your patients’ areas that might have better stock. Set expectations early that medication availability is outside your control.

State-by-State Scope Differences

If you’re a PMHNP moving from New York to Florida, your prescribing authority just got way more restricted. Or if you’re licensed in multiple states via compact, you need to know the rules for each.

What you can do: Before joining a telehealth platform or taking patients in a new state, verify:

  • Do you need a collaborative agreement in this state?
  • Are there quantity limits or special procedures for Schedule IIs?
  • What are the PDMP requirements?
  • Are there telehealth-specific consent or documentation requirements?

Platforms like Klarity can help navigate this—but you’re ultimately responsible for practicing within your scope.

High Patient Volume, Brief Visits

ADHD med management visits are often short (10–15 minutes), which means you can see a lot of patients. But you also need to triage carefully—is this true ADHD, or anxiety masquerading as poor focus? Is this patient medication-seeking, or legitimately struggling?

What you can do: Use structured assessment tools. Don’t skip the collateral information (especially for kids). If something feels off, slow down—order additional testing, consult with a colleague, require an in-person eval. Protecting your license is more important than filling your schedule.

FAQ: ADHD Telehealth Prescribing

Q: Can I prescribe Adderall to a new patient I’ve never met in person?

A: Yes, as of early 2026, under the extended DEA waiver (through Dec 31, 2025). This applies to both MDs and qualified NPs in states where NPs can prescribe Schedule IIs. If federal rules change later in 2026, an in-person visit may be required.

Q: Do I need to check the PDMP every time I prescribe a stimulant?

A: It depends on your state. New York mandates PDMP checks for every controlled prescription. Many states require it for opioids and benzos but encourage it for stimulants. Best practice: check it at least for new patients and periodically (every 90 days) for ongoing therapy.

Q: Can I prescribe ADHD meds via phone-only (audio), or does it have to be video?

A: Most states require live video for controlled substance prescribing via telehealth. Texas explicitly prohibits audio-only. Some states allow audio for mental health services generally, but for Schedule IIs, stick with video to be safe.

Q: What if a patient is traveling to another state—can I still prescribe their ADHD medication?

A: You need to be licensed in the state where the patient is physically located at the time of the visit. If your patient is traveling, you can only treat them via telehealth in states where you hold a medical license. Interstate compacts (like the Interstate Medical Licensure Compact) can help physicians get licensed in multiple states more easily.

Q: How do I handle prior authorizations for ADHD medications?

A: Prior auths for stimulants are common, especially for brand-name meds or higher doses. Many telehealth platforms have support staff to handle this, but if you’re solo, you’ll need to submit clinical documentation justifying the prescription. Familiarize yourself with insurer formularies—using generic medications where possible reduces PA hassles.

Q: Can PMHNPs in restricted states work with Klarity if they can’t prescribe stimulants independently?

A: Yes. Platforms like Klarity can facilitate collaborative agreements with psychiatrists in states like Texas or Florida, allowing PMHNPs to see patients for evaluation and non-stimulant management while a collaborating MD handles stimulant prescriptions. The specifics depend on state law and the platform’s operational structure.

The Bottom Line: ADHD Telehealth Prescribing Is Viable—and in High Demand

If you’re a psychiatrist, you’re in a strong position. You can prescribe ADHD medications via telehealth in every state (subject to federal rules and state licensing), and the regulatory environment—while uncertain—is currently favorable through at least the end of 2025.

If you’re a PMHNP, your ability to prescribe ADHD meds depends on your state. In states with Full Practice Authority (or pathways to it), you’re essentially on par with physicians. In restricted states like Texas or Florida, you’ll need a physician collaborator—but that doesn’t mean you can’t practice, it just means you need the right structure.

The demand for ADHD telehealth services is massive. Adult ADHD diagnoses surged during the pandemic and haven’t slowed down. Provider shortages—especially in states like Texas and Florida—mean patients are waiting months for appointments. Telehealth lets you reach those patients without the overhead of a traditional office.

And when it comes to building your patient base, the economics favor platforms that handle patient acquisition for you. Spending months and thousands of dollars on DIY marketing is a gamble—joining a platform like Klarity that delivers pre-qualified patients on a pay-per-appointment basis is guaranteed ROI.

The regulatory landscape will continue to evolve through 2026, but one thing is clear: telehealth isn’t going away. ADHD care via telemedicine is here to stay—and providers who understand the rules, practice responsibly, and choose the right partnerships will thrive.


Sources and Verification

The information in this article is based on current federal and state regulations, verified through official government sources and recent industry analysis as of February 2026. All regulatory and scope-of-practice statements have been cross-checked against state statutes and professional licensing boards where applicable. Below is a detailed list of sources used, categorized by type and reliability.

Official Government Sources (High Reliability)

  • Florida Statutes §456.47 (Telehealth – controlled substances exceptions) – Florida Senate, 2023 session. Authoritative legal text defining telehealth prescribing rules in Florida, including explicit allowance for psychiatric Schedule II prescribing.

  • Florida Statutes §464.012 (APRNs prescribing authority and psychiatric nurse exception) – Florida Legislature Online Sunshine, 2025 edition. Direct statute detailing NP scope, 7-day Schedule II limit, and psychiatric nurse exemption.

  • Texas SB 2527 Bill Analysis – Texas Legislature, 88th session (April 2023). Legislative analysis document providing context on Texas stance regarding telehealth prescribing oversight and concerns about inappropriate stimulant prescribing.

  • Pennsylvania Code – 49 Pa. Code §21.284 (CRNP prescribing parameters) – Pennsylvania Code and Bulletin, current through 2021 amendments. Primary source for PA NP prescribing limits (72-hour initial, 30-day ongoing for Schedule IIs).

  • Illinois Nurse Practice Act – 225 ILCS 65 (APRN Full Practice Authority) – Illinois General Assembly, amended 2017, effective 2018. Authoritative details on NP FPA requirements (4,000 hours, additional training) and collaborative practice rules.

Federal Agency & Healthcare Policy Sources (High Reliability)

  • Axios News – ‘COVID-era telehealth prescribing extended again’ (Nov 18, 2024). Credible healthcare policy journalism confirming DEA/HHS extension of telehealth controlled substance flexibilities through December 31, 2025 (third extension).

  • Axios News – ‘Telehealth prescribing mess could reach Congress’ (Sept 18, 2024). Policy analysis on pending expiration of telehealth Rx allowances and federal agency positions as of late 2024.

  • Associated Press – ‘More adults sought help for ADHD during pandemic’ (Jan 10, 2024). AP newswire report citing JAMA Psychiatry study on ADHD prescription surge during 2020-2022, providing context on pandemic trends and medication shortages.

  • Center for Connected Health Policy (CCHP) – ‘Texas State Telehealth Laws’ (updated Jan 19, 2026). Comprehensive, frequently updated summary of state telehealth laws. Used for Texas telemedicine rules on chronic pain restrictions and controlled substance prescribing. Well-regarded national telehealth policy resource.

Industry Analysis & Professional Resources (Medium Reliability)

  • RxAgent – ‘NP Prescriptive Authority by State (2026 Guide)’ (updated Dec 28, 2025). Comprehensive state-by-state summary of NP scope and controlled substance prescribing laws, authored by PharmD professionals. Well-referenced (cites AANP and state boards), very recent, used for quick state comparisons. Not a primary legal source but reliable for general scope information.

  • Healing Psychiatry Florida – ‘Psychiatrist Shortage by State – 2026 Report’ (Jan 15, 2026). Industry blog compiling data (likely from HRSA) on psychiatrist-to-population ratios by state as of 2025. Data-driven and recent; used for state workforce rankings and density figures. Moderately reliable for statistical context.

  • Therathink – ‘Insurance Reimbursement Rates for Psychiatrists [2026]’ (updated 2026). Practice management resource providing detailed CPT code reimbursement figures for Medicare, Medicaid, and commercial payers. Data appears derived from CMS fee schedules. Used for ballpark reimbursement numbers; not an official CMS source but likely accurate for 2024-2025 rates.

  • BehaveHealth – ‘Mental Health Reimbursement Trends – Telehealth Parity 2026’ (2024). Industry commentary on telehealth parity status (‘parity nearly universal in 2026’). Aligns with known legislative trends and insurance industry shifts. Used for general statement about parity prevalence.

Verification and Quality Standards

All claims regarding state-specific prescribing restrictions, telehealth laws, and scope of practice limitations have been verified against official state statutes or regulatory board guidance where available. No sources older than 2023 were relied upon for dynamic regulatory information; most data is from 2024-2025 to ensure currency.

State-specific regulatory claims (e.g., Texas NP Schedule II restrictions, Florida psychiatric nurse exception, Pennsylvania 72-hour limit) were confirmed through direct statute citation or official state regulatory code. Federal telehealth prescribing status was verified through multiple credible sources (Axios reporting aligned with DEA press releases and HHS guidance).

Industry sources (RxAgent, Therathink, Healing Psychiatry Florida) were cross-referenced with official data where possible. Any information that could not be verified as current or was based on pending legislation has been flagged as uncertain or omitted.

Note: Telehealth prescribing rules are subject to change pending federal DEA rulemaking and potential Congressional action later in 2026. This article reflects the regulatory environment as of February 2026 based on the latest available official guidance and credible industry analysis.


Ready to join a platform that handles patient acquisition so you can focus on practicing medicine? Klarity Health connects psychiatrists and PMHNPs with pre-qualified ADHD patients across the country—no upfront marketing spend, no wasted leads, just pay-per-appointment simplicity. Explore how Klarity can help you grow your telehealth practice without the risk of traditional marketing.

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