Telemedicine: Cross-State Licensure

Telemedicine Cross-State Licensure

What is Telemedicine?

Telemedicine is often used when referring to any of the traditional clinical diagnosis and monitoring that is delivered by technology. However, the term “Telehealth” is now more commonly used as it describes the wide range of diagnosis and management, education, and other related fields of health care.


This subset deals with Transmitting radiological patient images, x-rays, CTs, and MRIs, between locations to share studies with other radiologists and physicians. With approximately 15% increase annually, this technology is growing.


Another Telemedicine subset, Telepsychiatry, involves a range of services like evaluations, therapy (individual, group, family), patient education and medication management. This may involve interactions between the psychiatrist and patient directly. Supporting primary care providers with mental health care consultation.

Other examples of telehealth include:

  • Consumer and professional education
  • Counseling
  • Dentistry
  • Disaster management
  • Home Health
  • Physical Therapy


Each state’s requirements for physician licensing may differ, however, in general, to practice with telehealth technologies across state lines, physicians must have a valid state license in the state, in every state they have patient contact.

The originating site or the location of the patient, is also known as the place of service. Thus, the physician must adhere to the rules and regulations of the patient’s location. These laws and regulations around licensing are typically enforced by the state medical board, for which most state medical boards enforce strict licensure rules.

That being said, there are some limited exceptions.


If the physician electronically interacts with patients in other states or prescribes medication across state lines, you should establish licensure in those other states. However, some state medical boards will issue special licenses or certificates related in some way to telemedicine. Other states have laws that don’t specify telemedicine licensing but make allowances for certain situations, like temporary licenses, with the proper conditions being met.

The most common licensure exceptions are the following:

    • Physician-to-physician consultations (not between practitioner and patient)
    • Educational purposes
    • Residential training
    • Border states
    • U.S. Military
    • Public health services
    • Medical emergencies (Good Samaritan) or natural disasters

Have a question as to how the telemedicine portion of your practice will affect your Medical Professional Liability policy? Give us a call directly at 1-800-317-6411 or email us at

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