The Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) have jointly issued a fourth temporary extension (the “Extension”) permitting health care practitioners to prescribe Schedule II–V controlled substances via audio-video telemedicine encounters without first conducting an in-person evaluation. The Extension, effective through December 31, 2026, continues to afford the DEA time to finalize permanent regulations governing controlled substance prescribing through telemedicine.
Despite the Extension, health care providers must continue to assess whether state law imposes stricter requirements, including mandates for in-person evaluations. For example:
- Connecticut permits telehealth prescribing of Schedule II and III controlled substances only for the treatment of a psychiatric disability, substance use disorder, or medication-assisted treatment.
- In contrast, New Jersey generally requires an in-person evaluation before issuing any Schedule II prescription, unless the prescription is for a Schedule II stimulant prescribed to a minor and the minor’s parent or guardian has provided written consent to waive the in-person examination requirement.
- In New York, the Department of Health finalized regulations in early 2025 allowing controlled substances to be prescribed without an initial in-person evaluation only when such an evaluation is not otherwise required under state or federal law.
Finally, providers should be aware that other telehealth flexibilities implemented by the Centers for Medicare & Medicaid Services (CMS) during the COVID-19 public health emergency, most notably those related to the definition of “originating” and “distant” sites for non-behavioral health telehealth services, are currently scheduled to expire on January 30, 2026. Absent further legislative or regulatory action, Medicare coverage will revert to the more restrictive telehealth requirements that were in effect prior to the pandemic.
Should you have any questions regarding these changes, please contact the authors, the Garfunkel Wild attorney with whom you regularly work, or email us at [email protected].
