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Published: May 24, 2026

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Telehealth Weight Loss/GLP-1 Prescribing: What Prescribers Can Do in Texas

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Written by Klarity Editorial Team

Published: May 24, 2026

Telehealth Weight Loss/GLP-1 Prescribing: What Prescribers Can Do in Texas
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If you’re a psychiatrist or PMHNP watching the GLP-1 explosion and wondering ‘Can I prescribe these for my patients?’ — you’re asking the right question at the right time.

The short answer: Yes, psychiatrists can prescribe weight-loss medications, including GLP-1 agonists like semaglutide and tirzepatide. But the real answer is more nuanced — it depends on your state, your training, whether you’re an MD or NP, and how you structure your practice.

Here’s what you need to know about adding weight management to your psychiatric practice in 2026, including the clinical rationale, state-by-state regulations, telehealth prescribing rules, and the business case for integrating this service.

Why Psychiatrists Are Uniquely Positioned for Weight Loss Treatment

Let’s start with the ‘why’ before the ‘how.’

The Metabolic-Psychiatric Connection

If you’ve been practicing psychiatry for more than a year, you’ve seen it: the patient who gains 40 pounds on olanzapine. The depressed patient whose weight feeds a vicious cycle of low self-esteem and social withdrawal. The ADHD patient who self-medicates with food.

Psychiatric patients have higher rates of obesity than the general population — not by coincidence, but by biology and medication side effects. Many psychotropics (especially atypical antipsychotics, mood stabilizers, and some antidepressants) cause significant metabolic dysfunction. You’re already monitoring their weight, glucose, and lipids. Why wouldn’t you treat what you’re tracking?

Dr. Elliott Lewis, a board-certified psychiatrist and obesity medicine specialist, puts it plainly: ‘If we truly understand that metabolic and mental health systems are inseparable, then psychiatrists being involved in metabolic treatment makes complete sense.’ You’re not stepping outside your scope — you’re practicing comprehensive care.

GLP-1s Show Promise for Mental Health

Beyond weight loss, emerging research suggests GLP-1 receptor agonists might have direct mental health benefits:

  • Reduced binge-eating and food cravings in patients with BED and obesity
  • Lower rates of substance use in preliminary studies (reduced alcohol and nicotine cravings)
  • Improved mood and quality-of-life scores independent of weight loss
  • No increase in depression or suicidality (the FDA and EMA both reviewed this and found no causal link)

In fact, large trials like the STEP studies showed slightly lower rates of depressive symptoms in GLP-1-treated groups compared to placebo. The biological mechanism isn’t fully understood, but GLP-1s reduce systemic inflammation and may influence reward pathways in the brain — both relevant to psychiatric conditions.

The Safety Question: What About Suicidality?

You’ve probably seen the headlines: ‘Ozempic linked to suicidal thoughts.’ Here’s what the evidence actually shows:

A 2025 meta-analysis in JAMA Psychiatry found no increased risk of depression or suicidality with GLP-1 medications versus placebo across multiple large trials. Regulatory agencies (FDA and European Medicines Agency) conducted exhaustive reviews and concluded there’s no causal relationship.

As a psychiatrist, you’re better equipped than most providers to monitor for psychiatric side effects. If you’re already managing SSRIs, stimulants, and antipsychotics, adding a medication with a favorable psychiatric safety profile is well within your clinical competence.

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The Scope of Practice Question: Is This ‘Your Lane’?

For Psychiatrists (MD/DO)

You have full prescriptive authority in all 50 states. Your medical license and DEA registration allow you to prescribe any FDA-approved medication, including:

  • GLP-1 agonists (semaglutide/Wegovy, tirzepatide/Mounjaro, liraglutide/Saxenda)
  • Non-controlled obesity medications (orlistat, naltrexone-bupropion)
  • Schedule IV appetite suppressants (phentermine) in most states

The question isn’t legal authority — it’s clinical competency and standard of care. Some states have specific rules about how to prescribe weight-loss medications (more on this below), but none prohibit psychiatrists from doing so.

Building Your Competency

The most legitimate way to address scope concerns: get trained. Many psychiatrists pursuing this service line obtain additional certification:

  • American Board of Obesity Medicine (ABOM) — open to physicians of any specialty, requires ~60 hours of CME in obesity medicine plus a comprehensive exam. This demonstrates formal proficiency.
  • CME courses in metabolic psychiatry, obesity pharmacotherapy, and nutrition science
  • Mentorship with obesity medicine or endocrinology colleagues

Dr. Lewis (who is ABOM-certified) notes: ‘This isn’t about expanding scope to grab more patients. It’s about offering more integrated care to the patients I already see.’

If a patient is gaining weight on your antipsychotic and developing prediabetes, addressing that metabolically is part of psychiatric care. You’re not opening a med spa — you’re treating the whole person.

For PMHNPs: State-by-State Variability

Psychiatric Nurse Practitioners face a patchwork of state laws. Your ability to prescribe weight-loss medications independently depends on:

  1. Your state’s NP scope-of-practice laws (full practice, reduced practice, or restricted practice)
  2. Whether weight management falls within a PMHNP’s specialty scope
  3. Specific state regulations on obesity treatment drugs

Full Practice Authority States (≈24 states + DC)

In states like New York (after 3,600 practice hours), Illinois (with FPA application), Washington, and Arizona, NPs can prescribe weight-loss medications independently without physician oversight — if it’s within their competency.

The catch: Some insurers and pharmacies still request physician involvement for high-cost GLP-1 prescriptions, even when not legally required. This is a practical barrier, not a legal one, but it’s real.

Collaboration/Delegation States

In Texas, Florida, Pennsylvania, and California (until 2026), PMHNPs must have a written agreement with a physician to prescribe. This means:

  • Texas: Prescriptive Authority Agreement required; physician must be available for consultation, conduct chart reviews, and meet monthly
  • Florida: Protocol agreement with MD required; no independent prescribing of controlled substances (including phentermine) even for autonomous NPs in primary care specialties
  • Pennsylvania: Collaboration agreement required; both NP and physician names must appear on prescriptions
  • California: Currently requires standardized procedures; transitioning to full practice authority by Jan 2026 for qualified NPs (but still subject to Corporate Practice of Medicine rules)

Key point: Even in collaborative states, NPs can prescribe weight-loss meds — you just need the right physician relationship documented.

The Specialty Scope Question

Some state boards expect NPs to practice within their population focus (psychiatric-mental health). Prescribing weight-loss medications to otherwise healthy patients might raise eyebrows.

The safe approach: Frame weight management as part of holistic psychiatric care. Examples:

  • Treating antipsychotic-induced metabolic syndrome
  • Addressing binge-eating disorder with both therapy and GLP-1s
  • Managing weight gain that’s worsening depression or anxiety

If you’re advertising a standalone ‘weight loss clinic’ as a PMHNP, ensure you have additional training (obesity medicine CME, collaboration with an MD, or working within a physician-led practice).

State-Specific Prescribing Rules: The Compliance Landmines

Beyond scope-of-practice, many states have specific regulations for weight-loss prescribing that apply to both MDs and NPs. Ignore these at your peril — state medical boards have disciplined providers for non-compliance.

Florida: The Most Restrictive

Florida’s Board of Medicine has detailed rules (64B15-14.004) for prescribing anti-obesity medications:

Required before prescribing:

  • BMI ≥30, or ≥27 with comorbidity (documented in chart)
  • Comprehensive history and physical exam (can be delegated to an APRN but must meet standard of care)
  • Lab workup to rule out secondary causes of obesity (thyroid, glucose, etc.)
  • Written informed consent from the patient
  • Provision of the state’s ‘Weight-Loss Consumer Bill of Rights’ brochure

Ongoing requirements:

  • Face-to-face follow-up every 3 months minimum (can be via telehealth)
  • Document weight, vital signs, and medication tolerance at each visit
  • Chart must justify continued use of medication

Telehealth restrictions:

  • Florida prohibits prescribing controlled substances via telehealth except for psychiatric treatment, inpatient/hospice care, or emergency addiction treatment
  • This means phentermine (Schedule IV) cannot be prescribed via pure telehealth for weight loss in Florida unless there’s a co-occurring psychiatric diagnosis (and even then, tread carefully)
  • GLP-1 agonists are NOT controlled and can be prescribed via telehealth if standard of care is met

Bottom line: If you’re seeing Florida patients via telehealth for weight loss, stick to non-controlled medications (GLP-1s, orlistat, etc.) or ensure an in-person component for controlled substances.

New Jersey: Comprehensive Evaluation Required

New Jersey requires prescribers to:

  • Conduct a complete physical exam and appropriate lab tests
  • Assess for psychiatric conditions and ensure they’re treated or stable before starting weight-loss meds
  • Provide or arrange nutritional counseling, exercise recommendations, and behavioral modification
  • Document all of this in the medical record

This is actually an area where psychiatric providers have an advantage — you’re already screening for and treating mental health conditions, which many PCPs skip.

Virginia: Monthly Follow-Up Early On

Virginia’s Board of Medicine requires:

  • Initial in-person evaluation (or equivalent telehealth exam)
  • Follow-up within 30 days of starting medication
  • Monthly visits for the first several months
  • Documentation of a diet and exercise plan

This means frequent check-ins — good for patient safety, but requires commitment to close monitoring.

Texas: Collaboration Documentation

Texas doesn’t have obesity-specific prescribing rules, but:

  • NPs must have Prescriptive Authority Agreements that explicitly authorize weight-loss medications
  • Physicians must conduct quality assurance reviews of NP prescribing
  • Both providers must check the Texas PMP (Prescription Monitoring Program) before prescribing controlled substances

California, New York, Pennsylvania, Illinois: Less Restrictive

These states don’t impose specific clinical protocols for weight-loss prescribing beyond standard of care. However:

  • California: Strong Corporate Practice of Medicine doctrine — even independent NPs (starting 2026) must operate within physician-owned entities or use MSO structures
  • New York: No special rules, but I-STOP (PMP) check required for all Schedule II-IV prescriptions
  • Pennsylvania: NPs need collaboration agreements; no obesity-specific protocols
  • Illinois: FPA-APRNs can prescribe independently; no obesity-specific state rules

General best practice across all states:

  • Document qualifying BMI or medical necessity
  • Obtain informed consent about risks/benefits
  • Monitor regularly (at minimum, every 3 months)
  • Check prescription monitoring databases for controlled substances
  • Coordinate with the patient’s PCP or endocrinologist when appropriate

Telehealth Prescribing: The Federal-State Compliance Trap

Here’s where it gets tricky. Federal DEA waivers allow telehealth prescribing of controlled substances through December 31, 2025 (likely to be extended again). But state laws can override federal permissions.

The Federal Landscape

The Ryan Haight Act traditionally required an in-person exam before prescribing controlled substances. During COVID, the DEA waived this requirement. As of early 2026, that waiver is still in effect, meaning you can technically prescribe Schedule II-V medications via telehealth nationwide — if your state allows it.

State Overrides: Where Telehealth Controlled Substance Prescribing Is Banned

About 8 states have laws stricter than federal rules, including:

  • Florida: Controlled substances via telehealth prohibited except for psychiatric disorders, inpatient care, or addiction treatment (weight loss doesn’t qualify)
  • Alabama: Requires in-person exam for controlled substances; no remote initiation
  • South Carolina, Idaho: Similar in-person requirements for controlled drugs

If you’re practicing telehealth across state lines, you need to check each state’s specific telehealth laws before prescribing phentermine or other controlled appetite suppressants.

GLP-1 agonists (semaglutide, tirzepatide, liraglutide) are NOT controlled substances and can generally be prescribed via telehealth in all states, as long as you establish a proper patient-provider relationship and meet standard of care.

Establishing a Valid Telehealth Relationship

Most states now recognize that a video consultation can establish a legitimate doctor-patient relationship. Best practices:

  • Use synchronous audio-video (live video call) for initial visits
  • Conduct a thorough history and visual exam (assess patient appearance, discuss symptoms)
  • Review or order recent vital signs, weight, labs (many telehealth platforms partner with local labs)
  • Document that you’ve conducted an adequate evaluation equivalent to in-person standard of care

Avoid: Pure questionnaire-based or asynchronous prescribing for weight loss. Multiple providers have faced board discipline for this. In 2023, a Mississippi physician lost his license for prescribing Ozempic through an instant-messaging platform with no audio/video contact.

Out-of-State Prescribing

If you’re licensed in multiple states and practicing telehealth:

  • You must hold an active license in the patient’s state (no exceptions)
  • Some states require telehealth registration (e.g., Florida requires out-of-state telehealth providers to register with the Department of Health)
  • You must follow the patient’s state laws, not your home state’s laws

Klarity Health note: Platforms like Klarity handle multi-state credentialing and compliance, but you’re ultimately responsible for knowing each state’s rules.

The Business Case: Why Weight Loss Management Makes Financial Sense

Let’s talk economics. Adding weight loss services to your psychiatric practice isn’t just clinically sound — it’s financially smart.

Reimbursement Is Getting Better

Insurance coverage for GLP-1 weight-loss medications is expanding rapidly:

  • Many commercial insurers now cover Wegovy, Saxenda, and Mounjaro with prior authorization (typically requiring BMI ≥30 or ≥27 with comorbidity)
  • Medicare will begin covering anti-obesity medications in 2026 — a game-changer for providers seeing older patients
  • State Medicaid programs are adding coverage (varies by state, but momentum is strong)

For the clinical visit itself:

  • Bill standard E/M codes (99213-99215 for follow-ups, 99202-99205 for new patients)
  • Psychiatrists get 100% of Medicare physician fee schedule (~$75-150 per visit depending on complexity)
  • PMHNPs typically get 85% of physician rates for Medicare (though some state Medicaid programs like Illinois pay NPs at 100%)
  • Telehealth parity laws in CA, NY, IL, and many other states ensure equal reimbursement for video visits

Typical visit economics:

  • 15-20 minute medication management follow-up: $100-150 reimbursement
  • Initial evaluation (45 min): $200-250
  • If you see 4 weight management patients per day (1 hour total), that’s $400-600 in revenue

Compare that to traditional psychiatric med management (already your bread and butter) — it’s the same billing model, just applied to a different clinical problem.

Prior Authorizations: Worth the Hassle?

Yes, GLP-1 PAs can be time-consuming. Most require:

  • Documented BMI and comorbidities
  • Attestation that patient tried lifestyle modifications
  • Treatment plan including diet/exercise counseling

But: Once approved, these patients tend to stay on treatment for months or years (chronic care = recurring revenue). Many platforms and EHRs now have PA automation tools that streamline the process.

Cash-pay alternative: Some patients opt to pay out-of-pocket for compounded semaglutide ($200-400/month) or use manufacturer savings programs. This avoids insurance hassles but limits your market to higher-income patients.

Patient Acquisition: The Klarity Advantage

Here’s where the traditional provider marketing model breaks down. If you tried to build your own weight-loss telehealth practice from scratch, you’d face:

  • DIY marketing costs of $3,000-5,000/month (SEO, Google Ads, directory listings)
  • 6-12 months before SEO generates meaningful patient flow
  • Google Ads for ‘weight loss doctor’ at $15-40 per click, with most clicks not converting
  • True cost per acquired patient: $200-500+ when you factor in ad spend, failed campaigns, no-shows, and staff time

Psychology Today and Zocdoc charge monthly subscriptions plus per-booking fees, and you’re competing with hundreds of other providers on the same platform.

Klarity’s model is different: You pay a standard fee per new patient lead — that’s it. No upfront marketing spend, no monthly subscriptions, no wasted ad budget. Klarity handles:

  • Patient acquisition and matching (qualified patients already seeking psychiatric or weight management care)
  • Telehealth infrastructure (HIPAA-compliant video, EHR integration)
  • Credentialing across multiple insurance plans
  • Both insurance and cash-pay patient flow

You control your schedule and only pay when a patient books with you. That’s guaranteed ROI versus gambling on marketing channels you may not have the expertise or budget to execute effectively.

For providers who want to expand into weight management without the overhead of building a separate practice, this model removes all the friction.

How to Add Weight Loss Services to Your Practice: Practical Steps

1. Get Trained

  • Complete CME in obesity medicine (ABOM offers comprehensive courses)
  • Review FDA-approved obesity medications (mechanisms, dosing, contraindications)
  • Learn to interpret metabolic labs and assess cardiovascular risk
  • Consider ABOM board certification if you’re serious about this service line

2. Ensure Legal Compliance in Your State(s)

  • MDs: Review state-specific obesity prescribing rules (if any)
  • NPs: Confirm your collaborative/supervisory agreement covers weight management prescribing
  • Check telehealth laws if practicing remotely
  • Register with state PDMPs and integrate checking into your workflow

3. Develop Clinical Protocols

  • Intake questionnaire: BMI calculation, medical history, prior weight loss attempts, psychiatric screening
  • Initial visit template: Comprehensive history, discussion of risks/benefits, informed consent, treatment plan with lifestyle modifications
  • Follow-up template: Weight, vital signs, side effects, med tolerance, labs as needed
  • Documentation: Justify BMI criteria, note nutritional counseling provided, record PMP checks for controlled substances

4. Set Up Billing

  • Verify your payer contracts cover obesity counseling/medication management
  • Set up CPT codes for E/M visits and obesity counseling (if applicable)
  • Train staff on GLP-1 prior authorization requirements (or use platform automation)
  • Consider cash-pay pricing structure for patients without coverage

5. Market Appropriately

  • If you’re on a platform like Klarity: Let the platform handle patient acquisition
  • If building your own patient base: Emphasize the psychiatric-metabolic connection (target patients on weight-gaining psych meds, those with binge-eating disorder, etc.)
  • Collaborate with PCPs and endocrinologists (offer to co-manage complex patients)

FAQ: Psychiatrists and Weight Loss Prescribing

Can a psychiatrist prescribe Ozempic or Wegovy?

Yes. Psychiatrists (MD/DO) have full prescriptive authority to prescribe FDA-approved medications including GLP-1 agonists like semaglutide (Wegovy/Ozempic) and tirzepatide (Mounjaro/Zepbound) for weight loss, provided they follow standard of care and any state-specific rules.

Do I need special certification to prescribe GLP-1s?

No legal requirement for additional certification, but obtaining ABOM (American Board of Obesity Medicine) certification or completing obesity medicine CME strengthens your clinical competency and addresses scope-of-practice concerns.

Can PMHNPs prescribe weight loss medications independently?

Depends on your state. In full-practice-authority states (like NY after 3,600 hours, or Illinois with FPA status), yes. In restricted states (TX, FL, PA), you need a collaborative/supervisory agreement with a physician that explicitly authorizes weight-loss prescribing.

Can I prescribe phentermine via telehealth?

In most states, yes — federal DEA waivers allow it through 2025 (likely extended). Exception: Florida, Alabama, and a few others prohibit controlled substance prescribing via telehealth for weight loss. Always check your state’s specific telehealth laws.

Are GLP-1s safe for patients with psychiatric conditions?

Current evidence shows no increased risk of depression or suicidality with GLP-1 medications. Large trials actually showed slightly lower rates of depressive symptoms in treated groups. As a psychiatrist, you’re well-positioned to monitor for any mood changes.

What if my patient is on an antipsychotic that causes weight gain?

This is an ideal use case. Managing medication-induced metabolic side effects is clearly within psychiatric scope. Consider GLP-1s, metformin, or other interventions as part of comprehensive care — and bill appropriately for the additional management complexity.

How do I bill for weight loss medication management?

Use standard E/M codes (99213-99215 for established patients, 99202-99205 for new patients) based on visit complexity and time. For obesity counseling, you can also use G0447 (15-min face-to-face obesity counseling) though this is more commonly used in primary care. Most psychiatrists bill E/M codes.

Will insurance cover GLP-1 prescriptions?

Increasingly, yes. Most commercial insurers cover FDA-approved obesity medications (Wegovy, Saxenda, Mounjaro) with prior authorization. Medicare coverage begins in 2026. Medicaid coverage varies by state. Cash-pay and compounded options also available.

What’s the realistic time commitment for adding weight loss services?

Initial visit: 30-45 minutes (history, exam, education, consent)
Follow-ups: 15-20 minutes every 1-3 months
Administrative: Prior auths (15-30 min per patient initially), chart documentation (5-10 min per visit)

If you integrate this into existing psychiatric med management visits for appropriate patients, the incremental time is minimal.

Do I need malpractice insurance coverage for prescribing weight loss meds?

Check with your carrier, but most psychiatric malpractice policies cover prescribing FDA-approved medications within your scope, including obesity drugs. If you’re significantly expanding this service line, notify your insurer. Some carriers may require additional rider for ‘obesity medicine’ if it becomes >25% of your practice.


The Bottom Line: Should You Prescribe Weight Loss Medications?

If you’re a psychiatrist or PMHNP asking this question, here’s the real answer:

Yes, if:

  • You’re willing to get appropriate training (CME or ABOM certification)
  • You can commit to proper monitoring and follow-up
  • You work in or with a state-compliant structure (collaboration agreements for NPs where required)
  • You see the clinical value in treating metabolic health alongside mental health

No, if:

  • You view this as a quick revenue grab without proper competency
  • You’re not willing to stay on top of state regulations and prescribing rules
  • You can’t commit to the administrative work (PAs, documentation, labs)

The field of psychiatry is evolving. The artificial line between ‘mental health’ and ‘metabolic health’ is dissolving. GLP-1 medications are the most effective obesity treatment we’ve ever had, and many of your patients desperately need them — both for physical health and because their weight is affecting their mental health.

Psychiatrists have the clinical skills, the prescriptive authority, and the patient relationships to do this well. The regulatory landscape is complex but navigable. The reimbursement is improving. And platforms like Klarity remove the traditional barriers of marketing and patient acquisition.

The question isn’t ‘Can I do this?’ It’s ‘What’s stopping me?’

If you’re ready to add evidence-based weight management to your practice — or if you’re a PMHNP looking for a platform that handles the heavy lifting so you can focus on patient care — Klarity Health offers the infrastructure, compliance support, and patient flow to make it happen.

Ready to expand your practice? Join Klarity’s provider network and start seeing patients who need your expertise — whether for psychiatric care, weight management, or both.


Sources and References

  1. MedicalDirector Co. – ‘How Much Does a Collaborative Physician Cost for Weight Loss, Telehealth, and Medspas? (2025 Definitive Guide)’ (www.medicaldirectorco.com, 2025)
  2. MedicalDirector Co. – ‘Florida Weight Loss Clinic and Telehealth Compliance Guide (2025)’ (www.medicaldirectorco.com, Updated 2025)
  3. MedicalDirector Co. – ‘Texas Weight Loss Clinic & Telehealth Compliance Guide (2025)’ (www.medicaldirectorco.com, Updated 2025)
  4. Florida Administrative Code Rule 64B15-14.004 – Standards for Prescription of Obesity Drugs (www.law.cornell.edu, Effective Aug 8, 2022)
  5. Mondaq (Foley & Lardner) – ‘A Changing Regulatory and Reimbursement Landscape for Weight-Loss Drugs’ (www.mondaq.com, July 24, 2023)
  6. RxAgent.co – ‘Federal Permission, State Prohibition: The 2026 Telehealth Compliance Trap’ (rxagent.co, Dec 16, 2025)
  7. The Nurse Practitioner Journal (Susanne J. Phillips) – ’36th Annual APRN Legislative Update’ (journals.lww.com, January 2024)
  8. DrLewis.com (E. Lewis, MD) – ‘Should Psychiatrists Prescribe GLP-1s? An Evidence-Based Perspective’ (drlewis.com, Jan 4, 2026)
  9. DrLewis.com – ‘GLP-1 Medications & Mental Health: Facts vs Myths’ (drlewis.com, Nov 26, 2025)
  10. Axios Health News – ‘COVID-era telehealth prescribing extended again’ (www.axios.com, Nov 18, 2024)
  11. Axios – ‘Trump announces Medicare coverage of weight-loss drugs’ (www.axios.com, Nov 6, 2025)
  12. Associated Press – ‘Biden proposes Medicare and Medicaid cover costly weight-loss drugs’ (apnews.com, Nov 26, 2024)
  13. TheraThink – ‘Insurance Reimbursement Rates for Psychiatrists [2026]’ (therathink.com, 2026)
  14. Blue Cross Blue Shield of Texas – Provider Notice on GLP-1 Supply Limit (www.bcbstx.com, Oct 4, 2024)

All sources verified current as of publication date (February 2026). State laws and regulations subject to change; providers should verify current requirements with state boards before implementing new services.

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All professional services are provided by independent private practices via the Klarity technology platform. Klarity Health, Inc. does not provide medical services.
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