> ## 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.

# Telehealth rules by state

> The state-level variables that govern virtual care, and where to look each one up.

<Warning>
  Telehealth rules changed constantly through and after the pandemic waivers.
  Verify current rules in the patient's state before relying on anything here.
  The authoritative tracker is the
  [Center for Connected Health Policy](https://www.cchpca.org/), which maintains
  a current 50-state survey.
</Warning>

Telehealth has no single rulebook. Five variables vary by state, and the
patient's state is the one that counts
([why](/concepts/practice-models-telehealth)):

| Variable          | The question                                                                                           | Where to check                                                                                       |
| ----------------- | ------------------------------------------------------------------------------------------------------ | ---------------------------------------------------------------------------------------------------- |
| Licensure         | Must the clinician hold this state's license? (Almost always yes; compacts like IMLC and NLC speed it) | State board + [imlcc.org](https://www.imlcc.org/), [nursecompact.com](https://www.nursecompact.com/) |
| Modality rules    | Is audio-only allowed? Can you prescribe from a video-only visit? Is an in-person exam required first? | CCHP state page                                                                                      |
| Prescribing       | State telehealth-prescribing rules, plus federal Ryan Haight / DEA rules for controlled substances     | CCHP + current DEA guidance                                                                          |
| Payment parity    | Must private payers cover and pay telehealth at parity with in-person?                                 | CCHP; also check each contract's telehealth fee schedule ([contracting](/guides/payer-contracting))  |
| Medicaid coverage | Each state's Medicaid covers different services and modalities                                         | State Medicaid manual ([enrollment](/guides/medicaid-enrollment))                                    |

## Billing mechanics that don't vary

Place-of-service codes 02 (telehealth, other) and 10 (telehealth in patient's
home) with modifier 95 are the standard commercial pattern; Medicare has its
own evolving list of covered telehealth services. Get each payer's telehealth
policy in writing during contracting, coverage and parity are contract terms,
not assumptions.

## Related

* [Practice model: telehealth](/concepts/practice-models-telehealth)
* [Expand out of state](/guides/expand-out-of-state)
* [Payer contracting and fee schedules](/guides/payer-contracting)
* [Medicaid enrollment](/guides/medicaid-enrollment)