> ## Documentation Index
> Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Practice model: telehealth

> Virtual-first practices, multi-state licensure, where the 'visit' legally happens, telehealth billing, and platform choices.

A telehealth practice delivers care virtually, often across state lines. The
clinical delivery is the easy part; the regulatory geometry is the model.

## The one rule that drives everything

**Care legally happens where the patient is.** That single fact generates most
telehealth compliance: the treating clinician must be licensed in the
patient's state, the entity must be able to practice there (CPOM again, see
[The PC and corporate practice of medicine](/concepts/cpom-and-the-pc)),
prescribing rules are the patient state's, and payer enrollment is
state-by-state. Expanding your patient map is really [expanding out of
state](/guides/expand-out-of-state), one state at a time.

## Licensure at scale

Physicians: the Interstate Medical Licensure Compact accelerates (but doesn't
replace) per-state licenses. Nurses: the NLC gives true multistate practice
for RNs/LPNs. NPs and PAs have their own compacts in various stages of
adoption. Dentists largely have no compact. Budget both dollars and calendar
time per state, and track renewal cycles somewhere that isn't a clinician's
memory.

## Getting paid virtually

Insurance-based telehealth bills with place-of-service codes (02/10) and
modifier 95, against coverage rules that vary by state and payer, verify
telehealth-specific fee schedules during [contracting](/guides/get-credentialed).
Cash-pay telehealth runs on the [cash-pay payment
stack](/guides/choose-your-pos) with checkout embedded in the booking flow.
Controlled-substance prescribing via telehealth sits under the Ryan Haight
Act and its shifting DEA waivers, if that's your specialty, this is attorney
territory, not blog-post territory.

## Related

* [Expand out of state](/guides/expand-out-of-state)
* [Telehealth rules by state](/reference/telehealth-by-state)
* [The PC and corporate practice of medicine](/concepts/cpom-and-the-pc)
* [Practice model: cash-pay only](/concepts/practice-models-cash-pay)
* [Practice model: hybrid and membership](/concepts/practice-models-hybrid)