What do I need to qualify for Trazodone?

Insomnia affects millions of Americans, leaving them tired, frustrated, and impacting both health and productivity. With the rise of telemedicine, more people are seeking virtual care for sleep issues. But questions remain about what treatments are legally available online, whether insurance covers them, and if telehealth providers can legally prescribe sleep medications without an in-person visit.

This comprehensive guide explores the current landscape of telehealth insomnia treatment in 2025, focusing on what’s legal, what’s available, and how to access effective care from your home.

The Legal Landscape of Telehealth Insomnia Treatment in 2025

Can Sleep Medications Be Prescribed Via Telehealth?

Yes, in most cases. Non-controlled insomnia treatments like trazodone or doxepin can be prescribed through telemedicine nationwide, as long as a proper evaluation is conducted. There is no federal in-person requirement for non-controlled substances—that rule applies only to controlled drugs. Patients can legally receive these prescriptions after a virtual consult with a licensed provider, provided telehealth standards of care are met.

For controlled sleep medications (like Ambien, a Schedule IV drug), a pandemic-era waiver currently allows telehealth prescribing through December 31, 2025. After this date, new rules are expected.

Federal Regulations: What You Need to Know

The Ryan Haight Act of 2008 required an in-person exam before prescribing controlled substances online. However, this restriction does not apply to non-controlled medications like trazodone or doxepin.

During COVID-19, the DEA temporarily waived the in-person requirement for controlled substances. As of late 2025, this telehealth flexibility remains in effect under a temporary extension through December 31, 2025.

State-by-State Telehealth Regulations

While telehealth for insomnia is broadly permitted nationwide, specific requirements vary by state:

In-Person Examination Requirements

• Most states do not require in-person visits for prescribing non-controlled insomnia medications
• Alabama requires an in-person evaluation if a patient has more than 4 virtual visits or telehealth-only treatment for over a year
• New Hampshire explicitly removed in-person requirements in 2025 to expand telehealth access

Telehealth Technology Requirements

• States like California and Florida accept a live video examination as meeting the ‘good faith exam’ requirement prior to prescribing
• Texas requires two-way audio/video for certain prescriptions, though for non-controlled insomnia medications, a phone or video consult typically suffices

Free consultations available with select providers only.

Get a free consultation

And find an affordable, caring specialist.

Find a provider

Free consultations available with select providers only.

Available Insomnia Medications Through Telehealth

Telehealth providers typically focus on prescribing non-controlled medications for insomnia, which have fewer regulatory restrictions:

Trazodone

• Classification: Non-controlled (unscheduled)
• Telehealth Availability: Available in all states without in-person exam requirement
• Typical Supply: 30-90 days, with refills up to 1 year
• Notes: Used off-label for insomnia (FDA-approved for depression)

Doxepin (Silenor – low-dose)

• Classification: Non-controlled (unscheduled)
• Telehealth Availability: Available in all states for insomnia
• Typical Supply: 30-90 days, with refills up to 1 year
• Notes: Low-dose doxepin is FDA-approved for insomnia; contraindicated for untreated glaucoma or urine retention

These medications can legally be prescribed for up to 90 days per fill, with refills up to 12 months at the provider’s discretion. Telehealth providers often start with smaller supplies (e.g., 30 days) to monitor efficacy and side effects before authorizing refills.

Who Can Prescribe Insomnia Medications Via Telehealth?

Physician Authority

In all states, licensed MDs and DOs can prescribe non-controlled insomnia medications via telehealth if it’s within their scope of practice.

Nurse Practitioners and Physician Assistants

NPs and PAs can also prescribe these medications in every state, but their level of independence varies:

• States with Independent Practice Authority: New Hampshire, New York (after certain experience), Delaware (NPs independent after 2 years)
• States Requiring Collaboration: Texas, Florida, California, Georgia, Alabama (require varying levels of physician oversight)

No state completely bars NPs or PAs from prescribing standard non-controlled insomnia medications, though collaboration requirements differ.

Is Telehealth Right for Your Insomnia?

Good Candidates for Telehealth Insomnia Treatment

• Primary insomnia or mild to moderate insomnia cases
• Patients willing to discuss sleep patterns, medical history, and possibly keep a sleep diary
• Those seeking non-pharmacological approaches like CBT-I (Cognitive Behavioral Therapy for Insomnia)
• Patients requiring follow-up for existing insomnia treatment

When In-Person Care May Be Needed

Certain scenarios warrant in-person evaluation rather than telehealth:

• Red-Flag Symptoms: Chest pain, difficulty breathing, neurological symptoms, hallucinations, severe daytime drowsiness causing near accidents
• Suspected Underlying Conditions: Heavy snoring and breathing pauses suggesting sleep apnea, thyroid disease, or severe depression requiring lab tests
• Complex Cases: Conditions requiring specialized testing like restless legs syndrome, parasomnias, or periodic limb movement disorder

How Telehealth Insomnia Treatment Works

The Evaluation Process

A thorough telehealth insomnia evaluation typically includes:

1. Comprehensive Sleep History: Discussion of sleep patterns, duration of symptoms, impact on daily functioning
2. Medical History Review: Identifying conditions that may contribute to insomnia
3. Medication Review: Checking for drugs that might affect sleep
4. Sleep Hygiene Assessment: Evaluating bedtime routines, screen use, caffeine intake
5. Mental Health Screening: Assessing for depression, anxiety, or stress affecting sleep

Treatment Approaches

Reputable telehealth providers take a comprehensive approach:

• Sleep Hygiene Education: Practical advice on improving sleep habits
• CBT-I: Many platforms offer or partner with apps and therapists for Cognitive Behavioral Therapy for Insomnia, considered the first-line treatment
• Medication Management: When appropriate, prescribing non-controlled medications with regular follow-up
• Ongoing Support: Virtual check-ins to adjust treatment as needed

At Klarity Health, our providers offer comprehensive insomnia evaluations with both medication options and behavioral strategies. With convenient appointment availability and transparent pricing (including both insurance and self-pay options), we make quality insomnia care accessible without the wait.

Prescription Process and Follow-Up

Once a telehealth provider determines a medication is appropriate:

1. The prescription is typically sent electronically to your preferred pharmacy (e-prescribing is required in many states)
2. Initial prescriptions are often written for 2-4 weeks to assess effectiveness and side effects
3. Follow-up appointments allow for dose adjustments or medication changes
4. For chronic insomnia, providers may schedule regular check-ins every 3-6 months

Looking Ahead: The Future of Telehealth Insomnia Treatment

Federal regulations for telehealth prescribing continue to evolve. The DEA is expected to implement new rules for controlled substances in 2026, which may reinstate an in-person exam requirement or create a special telemedicine registration process for certain medications.

For non-controlled insomnia medications like trazodone and doxepin, access via telehealth is expected to remain stable. The trend is toward maintaining telehealth accessibility while ensuring appropriate safeguards.

Future developments to watch include improvements in interstate licensing (making it easier for telehealth providers to serve patients in more states) and better integration of telehealth with in-person care through hybrid models.

Conclusion: Getting Quality Insomnia Care Online

Telehealth offers a convenient, effective option for many people struggling with insomnia. Non-controlled sleep medications are legally available through telehealth providers in all states, though specific requirements vary.

When seeking telehealth treatment for insomnia, look for providers who:

• Conduct thorough evaluations, not just quick prescriptions
• Discuss both medication and behavioral approaches
• Have clear follow-up protocols
• Are transparent about pricing and insurance coverage

If you’re struggling with sleep issues, platforms like Klarity Health connect you with licensed providers who can evaluate your symptoms, discuss treatment options, and if appropriate, prescribe medications—all from the comfort of your home. With both insurance coverage and affordable self-pay rates, getting help for

Source:

• https://www.healthcarefinancenews.com/news/telehealth-prescribing-controlled-drugs-extended-through-2025#:~:text=For%20the%20third%20time%2C%20the,medications%20and%20certain%20narcotic%20drugs
• https://www.dea.gov/documents/2024/2024-11/2024-11-15/dea-and-hhs-extend-telemedicine-flexibilities-through-2025#:~:text=We%20continue%20to%20carefully%20consider,HHS%20on%20November%2015%2C%202024
• https://www.cchpca.org/topic/online-prescribing/#:~:text=Controlled%20Substance%20Act
• https://natlawreview.com/article/telehealth-and-person-visits-tracking-federal-and-state-updates-pandemic-era?amp=#:~:text=1,long%20as%20the%20issuing%20provider
• https://rn.ca.gov/practice/ab890.shtml#:~:text=Practicing%20Without%20Standardized%20Procedures%20in,103%20NP
• https://www.bon.texas.gov/faqpracticeaprn.asp.html#:~:text=A%20free%20standing%20emergency%20department,32%20Back%20to
• https://natlawreview.com/article/telehealth-and-person-visits-tracking-federal-and-state-updates-pandemic-era?amp=#:~:text=5,7
• https://www.bon.texas.gov/faqpracticeaprn.asp.html#:~:text=may%20prescribe%20Schedule%20II%20drugs%3F,registration%20but%20I%20do%20not
• https://www.cchpca.org/topic/online-prescribing/#:~:text=A%20telehealth%20provider%20may%20use,care%20services%20to%20the%20patient
• https://www.cchpca.org/topic/online-prescribing/#:~:text=A%20telehealth%20provider%20may%20not,is%20prescribed%20for%20the%20following