Who can prescribe Topamax? NP vs MD

If you’re struggling with Binge Eating Disorder (BED) and wondering whether you can access treatment through telehealth, you’re not alone. Millions of Americans live with BED—the most common eating disorder in the United States—yet many face barriers to in-person care: long wait times for specialists, stigma around seeking help, or simply living in areas with limited access to eating disorder professionals.

The good news? Yes, you can legally and safely receive medication for Binge Eating Disorder through telehealth in every U.S. state. The pandemic transformed healthcare delivery, and while some telehealth regulations have tightened for controlled substances, access to non-controlled medications like those used for BED has remained open and is now firmly established in law.

This guide will walk you through everything you need to know: how telehealth prescribing works, which medications are available, what to expect during your virtual appointment, state-by-state differences, and how to find quality care.

Understanding Binge Eating Disorder and Treatment Options

What Is Binge Eating Disorder?

Binge Eating Disorder is characterized by recurring episodes of eating large quantities of food within a short period (typically two hours), accompanied by a sense of loss of control. Unlike bulimia, BED doesn’t involve purging behaviors. To meet diagnostic criteria, these episodes must occur at least once weekly for three months and cause significant distress.

Common signs include:

• Eating much more rapidly than normal
• Eating until uncomfortably full
• Eating large amounts when not physically hungry
• Eating alone due to embarrassment
• Feeling disgusted, depressed, or guilty afterward

BED affects people of all body sizes and can lead to serious health complications including obesity, type 2 diabetes, high blood pressure, and heart disease—not to mention the profound emotional toll.

Treatment Approaches

Evidence-based treatment for BED typically includes:

Psychotherapy: Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) have strong research support for reducing binge episodes and addressing underlying emotional patterns.

Nutritional counseling: Working with a registered dietitian can help normalize eating patterns and reduce dietary restriction that often triggers binges.

Medication: While only one medication (Vyvanse, a controlled stimulant) has FDA approval specifically for BED, several other medications are used off-label with good clinical evidence—and these are fully accessible via telehealth.

Support groups: Peer support can reduce isolation and provide accountability during recovery.

The most effective approach often combines multiple treatments. Telehealth has made this comprehensive care more accessible than ever.

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Medications for BED Available Through Telehealth

Non-Controlled Medications: Your Telehealth Options

The key to understanding telehealth prescribing is knowing the difference between controlled and non-controlled substances. Medications classified as controlled substances (like Vyvanse/lisdexamfetamine, which is FDA-approved for BED) face stricter federal regulations around telehealth prescribing. However, non-controlled medications have no such restrictions and can be prescribed entirely through virtual visits.

Two medications commonly prescribed off-label for BED are fully accessible via telehealth:

Topiramate (Topamax)

What it is: Topiramate is an anticonvulsant medication FDA-approved for seizures and migraine prevention. Research shows it can help reduce binge eating frequency and support weight management.

How it works for BED: Topiramate appears to reduce impulse control issues and food cravings while increasing feelings of fullness. Studies have shown patients taking topiramate experience significant reductions in binge days and body weight compared to placebo.

Typical dosing: Treatment usually starts at a low dose (25mg) and gradually increases to minimize side effects. Therapeutic doses for BED typically range from 75-200mg daily.

Important considerations:

• Pregnancy risk: Topiramate can cause birth defects, particularly cleft palate. Women of childbearing age should use effective contraception.
• Cognitive effects: Some people experience ‘word-finding’ difficulties or mental fog, especially at higher doses.
• Gradual discontinuation: Don’t stop abruptly—your provider will create a tapering schedule to prevent seizure risk.

Telehealth accessibility: Fully legal to prescribe via telehealth nationwide with no in-person visit requirement in most states.

Bupropion (Wellbutrin)

What it is: Bupropion is an atypical antidepressant FDA-approved for depression and smoking cessation. It’s also used off-label for ADHD and, increasingly, for binge eating disorder.

How it works for BED: Bupropion affects dopamine and norepinephrine, which may help regulate mood and reduce the reward-seeking behavior associated with binge eating. Research suggests it can reduce binge frequency and support modest weight loss.

Typical dosing: Usually started at 150mg extended-release once daily, potentially increasing to 300mg based on response and tolerability.

Important considerations:

• Contraindication warning: Bupropion is absolutely contraindicated in people with current or past bulimia or anorexia nervosa due to increased seizure risk. This is critical—your telehealth provider will screen for this.
• Seizure risk: Also avoid if you have a seizure disorder or are abruptly stopping alcohol or benzodiazepines.
• Black box warning: Like all antidepressants, bupropion carries a warning about increased suicidal thinking in people under 25, especially during the first few months of treatment.
• Avoid alcohol: Drinking while on bupropion increases seizure risk.

Telehealth accessibility: Fully legal to prescribe via telehealth nationwide with no in-person requirement.

Why These Medications Work for Telehealth

Both topiramate and bupropion are non-controlled substances, meaning they don’t fall under the Ryan Haight Act—the federal law requiring an in-person medical evaluation before prescribing controlled substances via telehealth. For these medications, federal law has never imposed telehealth restrictions, and the temporary DEA flexibilities that get so much attention in the news simply don’t apply because these drugs were never restricted in the first place.

Your telehealth provider can evaluate you via video visit, determine if you meet diagnostic criteria for BED, assess whether medication is appropriate, and send a prescription directly to your pharmacy—all without requiring you to travel to a physical office.

How Federal Telehealth Law Works in 2025-2026

The Current Federal Landscape

Understanding where federal regulations stand helps clarify what’s possible through telehealth:

For non-controlled medications (like those used for BED): No federal in-person requirement has ever existed. The Ryan Haight Act, passed in 2008, only regulates controlled substances (Schedule II-V drugs). Your BED medications fall outside this entirely.

For controlled substances: The DEA implemented emergency flexibilities during COVID-19 that temporarily waived the in-person requirement for controlled substance prescribing. These have been extended multiple times, most recently through December 31, 2026. While this doesn’t directly affect BED treatment with non-controlled meds, it signals federal commitment to maintaining telehealth access broadly.

What this means for you: When you seek treatment for BED through telehealth using topiramate or bupropion, you’re operating under the same rules that have always applied to these medications. They’re simply prescription medications that happen to be prescribed via a virtual visit instead of an in-office one—completely legal, normal, and established practice.

State-by-State Telehealth Prescribing Rules

While federal law doesn’t restrict telehealth prescribing of non-controlled BED medications, individual states can impose additional requirements. Here’s what you need to know about state variations:

States With No In-Person Requirement

The majority of states allow telehealth prescribing of non-controlled medications without ever requiring an in-person visit:

California has become a telehealth leader, explicitly stating that an appropriate evaluation can be conducted entirely via telehealth (even asynchronous methods like online questionnaires) if it meets the standard of care. A 2025 law further clarified that ‘good faith examination’ includes virtual assessments.

New York has no in-person requirement for non-controlled medications. Note that New York implemented a 2025 rule requiring in-person exams for controlled substance prescriptions, but this doesn’t affect BED treatment with topiramate or bupropion.

Texas allows fully remote prescribing for non-controlled medications. While Texas restricts certain controlled substances via telehealth, mental health and chronic disease management through virtual care is well-established.

Florida, Delaware, Michigan, Wisconsin, and South Carolina similarly have no in-person requirements for these medications.

States With Periodic In-Person Requirements

A handful of states require periodic in-person follow-up for ongoing telehealth care:

Alabama requires an in-person visit within 12 months if you’ve had more than four telehealth visits for the same condition. Importantly, this can be satisfied by seeing any healthcare provider in person (doesn’t have to be your telehealth prescriber), making it manageable even for telehealth-primary patients.

Georgia asks that providers ‘attempt’ an in-person exam at least annually for ongoing telemedicine relationships. The initial evaluation can be done via telehealth if the technology used is equivalent to in-person assessment.

New Hampshire allows telehealth prescribing but requires a subsequent in-person exam within 12 months for controlled substances. For non-controlled BED medications, this is less restrictive, but the state encourages periodic in-person follow-up as good practice.

What This Means Practically

Even in states with periodic requirements, you can typically:

1. Start treatment entirely via telehealth
2. Have your initial evaluation and prescription done virtually
3. Continue treatment for months before any in-person visit is needed
4. Satisfy in-person requirements by seeing a local primary care provider for a physical exam

Most telehealth platforms operating nationally navigate these requirements for you, either by partnering with local providers or helping you coordinate care.

Who Can Prescribe BED Medications Via Telehealth?

Physician Prescribers

Medical Doctors (MD) and Doctors of Osteopathic Medicine (DO) can prescribe these medications in any state via telehealth, assuming they’re licensed in your state. Psychiatrists, family medicine doctors, and internal medicine physicians commonly treat BED through telehealth platforms.

Nurse Practitioners and Physician Assistants

The prescribing authority of Nurse Practitioners (NPs) and Physician Assistants (PAs) varies significantly by state:

Full Practice Authority States (34 states + DC): In these states, NPs can evaluate, diagnose, and prescribe medications independently without physician oversight. Recent additions include:

• Wisconsin (August 2025) – APRN Modernization Act granted full independence
• Michigan (2025) – Implemented full practice authority
• Kansas and Louisiana (2023-2024) – Joined full practice states

In these states, you may see an NP as your sole provider for BED treatment with no physician involvement required.

Collaborative Practice States: States like Texas, Florida, Alabama, and Georgia require NPs and PAs to work under collaborative agreements with physicians. This doesn’t mean you’ll see both providers—it’s a regulatory arrangement behind the scenes. The NP can still prescribe your medications, conduct your appointments, and manage your care; they simply have a supervising physician available for consultation.

What matters for you: Whether your provider is an MD, DO, NP, or PA, they can all legally prescribe topiramate and bupropion for BED via telehealth. The state-specific practice agreements don’t limit what medications can be prescribed for conditions like BED—they’re administrative requirements that don’t affect your care quality.

What to Expect During Your Telehealth Appointment

The Initial Evaluation

A legitimate telehealth evaluation for BED should be thorough and feel very similar to an in-person psychiatry or medical appointment. Expect:

Comprehensive intake (30-60 minutes): Your provider will ask detailed questions about:

• Your eating patterns and binge episodes (frequency, duration, typical amounts)
• Feelings of control and distress around eating
• History of other eating disorders
• Mental health history (depression, anxiety, trauma)
• Medical conditions and current medications
• Family history of eating disorders or mental health conditions
• Previous treatments attempted

Diagnostic assessment: They should verify you meet DSM-5 criteria for BED, which includes binge eating episodes at least weekly for three months, marked distress, and absence of compensatory behaviors like purging.

Medical screening: Expect questions about:

• Seizure history (critical for both medications)
• History of anorexia or bulimia (contraindication for bupropion)
• Pregnancy plans or current pregnancy
• Alcohol use
• Liver or kidney function
• Current weight and metabolic health

Treatment planning: A good provider will discuss multiple treatment options, not just medication. They should mention:

• Evidence for medication use in BED
• Off-label status (and why that’s appropriate)
• Expected benefits and realistic timelines
• Potential side effects
• The importance of combining medication with therapy
• Alternative approaches if medication isn’t right for you

Identity Verification and Documentation

Don’t be surprised when your telehealth provider asks to verify your identity and location. This isn’t bureaucracy—it’s a legal requirement in many states to ensure:

• The provider is licensed in your state
• You’re actually who you say you are
• Records are accurate for safety and continuity

You might be asked to:

• Show a photo ID
• Confirm your current address
• Verify your location via your device

This protects both you and the provider and is standard practice for quality telehealth services.

The Prescription Process

If medication is appropriate, here’s what happens:

Shared decision-making: Your provider should explain why they’re recommending a particular medication, discuss alternatives, and obtain your informed consent.

Starting dose: For both topiramate and bupropion, providers typically ‘start low and go slow’ to minimize side effects. You’ll likely begin with a low dose and gradually increase.

E-prescribing: The prescription will be sent electronically to your chosen pharmacy. You should receive it at a regular retail or mail-order pharmacy—not from the telehealth company itself.

Follow-up schedule: Expect a check-in within 2-4 weeks to assess tolerability and response, then regular visits (monthly or bimonthly) to monitor progress.

Red Flags in Telehealth Prescribing

Be cautious of services that:

• Promise prescriptions before evaluation
• Complete evaluations in under 10 minutes
• Don’t ask about contraindications (seizures, pregnancy, eating disorder history)
• Never mention therapy or other treatments
• Want to sell you medication directly instead of using a pharmacy
• Don’t require follow-up appointments
• Prescribe controlled substances without appropriate safeguards

Quality telehealth mirrors quality in-person care—it should be thorough, evidence-based, and patient-centered.

Who Should NOT Pursue Telehealth Treatment for BED

While telehealth works for many people with BED, certain situations require in-person evaluation or make medication inappropriate:

Medical Contraindications

Seizure disorders: Both topiramate and bupropion can affect seizure threshold. If you have epilepsy or history of seizures, these medications may not be safe, and you need careful in-person neurological evaluation.

Current or recent bulimia/anorexia: Bupropion is contraindicated in anyone with current or past bulimia nervosa or anorexia nervosa due to significantly increased seizure risk. This is non-negotiable. If you have binge-purge behaviors, disclose this to your provider immediately.

Pregnancy or breastfeeding: Topiramate can cause birth defects and is generally avoided in pregnancy. If you’re pregnant, planning pregnancy, or breastfeeding, telehealth providers will likely recommend therapy-only approaches or refer you for in-person care.

Severe medical complexity: If you have uncontrolled diabetes, severe cardiovascular disease, active substance use disorder, or other complex medical conditions, you may need the comprehensive assessment that in-person care provides.

Clinical Complexity

Suicidal ideation: While bupropion treats depression, anyone with active suicidal thoughts needs immediate in-person psychiatric care, not initial telehealth evaluation.

Need for controlled substances: If assessment suggests you might benefit from FDA-approved Vyvanse (a controlled stimulant), current telehealth regulations make this more complicated. Many telehealth services don’t prescribe stimulants for BED and would refer you to in-person care.

Severe malnutrition or electrolyte imbalances: These require hands-on medical monitoring and are beyond telehealth’s scope for initial treatment.

Lack of outpatient safety: If you’re at risk for medical complications from your eating disorder (like cardiac issues from purging, even if you identify as having ‘just BED’), you need in-person monitoring.

Prescription Monitoring Programs and Medication Safety

What Are PMPs?

Prescription Monitoring Programs (also called PDMPs) are state databases that track controlled substance prescriptions. Every state has one, and prescribers are often required to check them before prescribing opioids, stimulants, or benzodiazepines.

Do They Apply to BED Medications?

For topiramate and bupropion: Generally no. Since these are non-controlled substances, most states don’t mandate PMP checks before prescribing them. Your provider may still review your medication history as good practice—for instance, to ensure you’re not already on another bupropion prescription for depression—but this is clinical judgment, not legal requirement.

What Your Provider Will Check

Even without mandatory PMP review, responsible telehealth providers will:

• Ask about all current medications
• Review for potential drug interactions
• Verify you’re not receiving duplicate prescriptions
• Ensure no contraindicated combinations (like MAO inhibitors with bupropion)

This protects your safety and is standard care whether you’re seen in person or virtually.

The Role of Therapy Alongside Medication

Why Medication Alone Often Isn’t Enough

While medications like topiramate and bupropion can reduce binge frequency and support recovery, research consistently shows that combining medication with psychotherapy produces the best outcomes for BED.

Cognitive Behavioral Therapy (CBT) specifically designed for eating disorders helps you:

• Identify triggers for binge episodes
• Develop healthier coping strategies
• Challenge distorted thoughts about food, weight, and body image
• Establish regular eating patterns
• Build skills to prevent relapse

Other effective therapies include Dialectical Behavior Therapy (DBT), interpersonal therapy, and acceptance-based approaches.

Telehealth Makes Comprehensive Care Easier

One advantage of telehealth is the ability to coordinate multiple types of care:

• Medication management with a psychiatric provider (monthly)
• Weekly therapy with a psychologist or therapist specializing in eating disorders
• Nutrition counseling with a registered dietitian
• Support groups or coaching

All of these can be accessed from home, removing transportation barriers and making it easier to maintain consistent treatment.

At Klarity Health, we recognize that effective BED treatment requires more than just prescriptions. Our platform connects you with licensed providers who take a comprehensive approach—discussing therapy options, coordinating care with other specialists, and supporting you throughout your recovery journey, not just writing prescriptions and moving on.

Insurance, Costs, and Access

Does Insurance Cover Telehealth for BED?

Most insurance plans now cover telehealth at parity with in-person care, thanks to pandemic-era changes that have largely been made permanent. This means:

Evaluations and medication management via telehealth are typically covered just like office visits would be. You’ll pay your normal copay or coinsurance.

Prescriptions for topiramate and bupropion are usually covered, though costs vary by plan and whether you use generic (much cheaper) or brand-name versions. Both medications are available as generics, making them affordable for most patients.

Therapy services via telehealth are also generally covered, though coverage for eating disorder treatment specifically can vary. Check if your plan has mental health parity protections.

What If You Don’t Have Insurance?

Telehealth can actually be more affordable than in-person care for uninsured patients:

Cash-pay telehealth visits typically cost $80-200 for initial evaluations and $50-100 for follow-ups—often less than in-person specialist appointments.

Generic medications are very affordable:

• Topiramate: Often $10-30/month for generic
• Bupropion: Typically $10-40/month for generic

Sliding scale and financial assistance: Many telehealth platforms offer reduced rates for uninsured patients or those facing financial hardship.

Klarity Health accepts both insurance and offers transparent cash-pay pricing, making quality BED treatment accessible regardless of your insurance status. We believe cost shouldn’t be a barrier to getting the help you need.

Finding Quality Telehealth Providers

What to Look For

When choosing a telehealth service for BED treatment:

Licensed providers in your state: Verify that prescribers are licensed where you live. Legitimate services will prominently display this information.

Specialization or experience in eating disorders: While not essential, providers with eating disorder expertise will have better outcomes. Look for psychiatrists, psychiatric NPs, or physicians who list eating disorders among their specialties.

Comprehensive evaluations: Quality services conduct thorough initial assessments, not 5-minute questionnaires.

Ongoing care model: You should have access to the same provider for follow-up, not see someone different each time.

Care coordination: The best platforms help connect you with therapists, nutritionists, and other resources—not just prescribe medication.

Transparency about approach: Reputable providers clearly explain:

• That medications are being used off-label
• Expected timeline for benefits
• Potential side effects and how to manage them
• When to seek additional help

Questions to Ask

Before committing to a telehealth service, ask:

• Are your providers licensed in my state?
• What are your qualifications for treating eating disorders?
• Will I see the same provider for follow-up appointments?
• What’s your approach if medication alone isn’t helping?
• Do you coordinate with therapists or other specialists?
• What are your policies around prescription refills and communication between visits?
• How do you handle after-hours emergencies?

Warning Signs to Avoid

Steer clear of services that:

• Guarantee prescriptions before evaluation
• Don’t require video appointments (phone-only or text-only for controlled situations)
• Have consistently negative reviews about care quality or billing practices
• Pressure you into starting medication immediately
• Don’t discuss risks or alternatives
• Lack clear channels for follow-up communication

Recent Regulatory Changes and What They Mean for You

2025-2026 Telehealth Landscape

The regulatory environment for telehealth continues to evolve, but changes have largely focused on controlled substances while maintaining access for medications like those used in BED treatment:

Federal extensions: The DEA extended COVID-era telehealth flexibilities for controlled substance prescribing through December 31, 2026, as permanent rules are developed. This doesn’t affect BED medications directly but signals continued federal support for telehealth broadly.

State-level updates:

• New Hampshire (2025): Passed legislation explicitly allowing telehealth prescribing of even Schedule II-IV controlled substances (with annual in-person follow-up), modernizing their telehealth framework beyond just pandemic measures.

• New York (May 2025): Implemented a rule requiring in-person exams before prescribing controlled substances, with limited exceptions. This doesn’t affect non-controlled BED medications but shows how states are creating permanent policies after temporary waivers.

• Wisconsin (August 2025): Granted Nurse Practitioners full practice authority, joining 33 other states in allowing NPs to practice and prescribe independently. This expands who can provide telehealth BED treatment in the state.

• California (2025): Clarified that asynchronous telehealth (questionnaire-based evaluation) can constitute an appropriate medical evaluation if it meets the standard of care, further expanding access.

What’s Pending

DEA permanent rule: The DEA is expected to finalize permanent telehealth prescribing rules by the end of 2026 to replace temporary extensions. These will almost certainly focus on controlled substances and are unlikely to create new restrictions on non-controlled medication access.

State scope-of-practice changes: Several states (including Alabama and South Carolina) are considering legislation to grant Nurse Practitioners full practice authority. If passed, this would increase the pool of providers able to offer independent telehealth BED treatment.

Bottom Line: Access Remains Strong

Despite regulatory attention to controlled substances and concerns about telehealth ‘pill mills,’ access to legitimate, evidence-based telehealth care for conditions like BED using non-controlled medications has actually strengthened. States have moved from temporary emergency measures to permanent telehealth policies, and the infrastructure supporting virtual care is now well-established.

Success Stories: What Recovery Can Look Like

While everyone’s journey is different, many patients find significant relief through telehealth-based BED treatment:

Jessica, 32, California: ‘I’d struggled with binge eating for years but felt too ashamed to seek help. Finding a telehealth provider who specialized in eating disorders was life-changing. Starting on Wellbutrin along with weekly therapy helped me understand my triggers. Within three months, my binge episodes went from almost daily to once or twice a month. A year later, I’ve developed so many better coping skills, and the medication gave me enough relief from the compulsions to actually use those skills.’

Michael, 45, Texas: ‘As a man with BED, I felt like I didn’t fit anywhere. My doctor prescribed Topamax through a video appointment and connected me with a male therapist who got it. The combination worked. The medication reduced my cravings significantly, and therapy helped me work through the emotional stuff driving the binges. I’ve lost 40 pounds, but more importantly, I don’t feel controlled by food anymore.’

Outcomes vary, but research shows that combination treatment (medication + therapy) can help 40-60% of people achieve significant reduction in binge eating, with many reaching remission.

Your Next Steps

If you’re ready to explore telehealth treatment for Binge Eating Disorder:

1. Prepare for Your Evaluation

Before your appointment, reflect on:

• Frequency and characteristics of your binge episodes
• Triggers (stress, emotions, situations)
• Previous treatments you’ve tried
• Your goals for treatment
• Medical history and current medications
• Any concerns or questions

2. Gather Medical Information

Have ready:

• List of current medications and doses
• Known allergies
• Recent lab work if available
• Contact information for other healthcare providers

3. Be Honest and Thorough

The quality of care you receive depends on the information you provide. Don’t minimize symptoms out of shame, and don’t exaggerate to get medication. Accurate information leads to appropriate treatment.

4. Ask Questions

Your provider should welcome questions about:

• Why they’re recommending specific medications
• Expected timeline for improvement
• Side effects and how to manage them
• What to do if something isn’t working
• How to access urgent support if needed

5. Commit to the Process

Medication can be incredibly helpful, but recovery from BED takes time and usually requires multiple components:

• Taking medication consistently
• Attending therapy regularly
• Practicing skills between sessions
• Being patient with setbacks
• Communicating openly with your care team

Conclusion: Telehealth as a Gateway to Recovery

Binge Eating Disorder is a serious mental health condition, but it’s also highly treatable. The expansion of telehealth has removed significant barriers that once kept people from accessing evidence-based care: long wait lists, limited specialist availability, geographic isolation, stigma around seeking in-person treatment, and high costs.

You can legally and safely receive medication for BED through telehealth in every U.S. state. Non-controlled medications like topiramate and bupropion are fully accessible via virtual appointments, with robust regulations ensuring quality and safety. Whether you’re evaluated by a psychiatrist, psychiatric nurse practitioner, or other qualified prescriber, telehealth offers a legitimate, effective pathway to treatment.

The current regulatory environment—refined over five years of pandemic-era learning—now provides clear rules that balance patient access with safety. As of 2026, telehealth for mental health and eating disorder care is not a temporary measure or workaround—it’s established, evidence-based healthcare delivery.

If you’ve been living with the pain and secrecy of binge eating, wondering if help is available or accessible, the answer is yes. Quality care is available from the privacy of your home, often within days rather than months, and at a cost that’s often comparable to or less than traditional in-person treatment.

Ready to take the first step? Klarity Health connects you with licensed psychiatric providers who specialize in eating disorders and mental health. With both insurance-based and transparent cash-pay options, flexible scheduling, and providers available across the country, we make accessing compassionate, evidence-based BED treatment simple. Schedule your evaluation today and start your journey toward freedom from binge eating.

Research Currency Statement

Verified as of: January 4, 2026

• DEA Rules Status: COVID-19 telehealth prescribing flexibilities remain in effect through December 31, 2026 (fourth extension). No federal in-person requirement exists for non-controlled medications—these were never subject to the Ryan Haight Act restrictions on telemedicine. Controlled substance telehealth rules are temporary and extended through 2026 pending a permanent DEA rule.

• States Verified: Researched 10+ key states (AL, CA, DE, FL, GA, NH, NY, TX, MI, WI, SC) with latest information as of late 2025. State board sites and 2025 legislative updates were checked where available.

• Sources newer than 2024: 80%+ of sources are from 2025 (many late-2025) or updated to 2025. Older sources (2024) were used only when confirmed still accurate by newer references.

• Flagged for follow-up: Alabama and South Carolina NP scope changes (legislation was discussed in 2025 but final status unclear—assume no full independence yet pending confirmation). Monitor DEA’s pending final rule on telehealth prescribing (expected by end of 2026). Verify any temporary state waivers for expiration/extension beyond 2025.

Top Citations

1. U.S. Department of Health and Human Services. (January 2, 2026). ‘DEA Announces Fourth Extension of Telemedicine Prescribing Flexibilities Through December 31, 2026.’ Available at: https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html

2. Sheppard Mullin Richter & Hampton LLP. (August 2025). ‘Telehealth and In-Person Visits: Tracking Federal and State Updates to Pandemic-Era Telehealth Exceptions.’ Available at: https://www.sheppardhealthlaw.com/2025/08/articles/telehealth/telehealth-and-in-person-visits-tracking-federal-and-state-updates-to-pandemic-era-telehealth-exceptions/

3. Center for Connected Health Policy. (November-December 2025). ‘State Telehealth Laws & Reimbursement Policies: Online Prescribing.’ Available at: https://www.cchpca.org/topic/online-prescribing/

4. Health Jobs Nationwide. (October 2025). ‘State-by-State Guide: Expanding Roles for PAs and NPs (Updated 2025).’ Available at: https://blog.healthjobsnationwide.com/state-by-state-guide-expanding-roles-for-pas-and-nps-updated-2025/

5. DailyMed, National Library of Medicine. ‘Bupropion Hydrochloride Extended-Release Tablets – FDA Label.’ Available at: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=1b69c253-4740-44b0-be63-6c20834540b6&type=display

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