Pennsylvania Telehealth Laws: Act 42, Prescribing, and Coverage

Pennsylvania telehealth laws let any professional licensed by one of the state’s health-licensing boards deliver care remotely within their existing scope of practice, so long as the visit meets the same standard of care as an in-person one. Act 42 of 2024 is the anchor statute on the insurance side: commercial health insurers, Medical Assistance (Medicaid), and CHIP must cover telehealth services delivered by in-network providers whenever those same services would be covered in person.¹²

Who Can Legally Provide Telehealth in Pennsylvania

Anyone licensed under a Pennsylvania health-licensing board — physicians, nurse practitioners, psychologists, clinical social workers, physical therapists, and others — can treat Pennsylvania patients remotely within their authorized scope of practice.² If a service is within scope in person, it is within scope over video.

A separate Pennsylvania license is not always required. The Commonwealth participates in several interstate compacts that let qualifying professionals from member states treat Pennsylvania residents without applying for an individual state license:³

The Interstate Medical Licensure Compact, an expedited pathway for physicians practicing across multiple states.⁴
The Nurse Licensure Compact, which allows RNs and LPNs to practice across member states on a single multistate license.³
The Psychology Interjurisdictional Compact (PSYPACT), which Pennsylvania joined in 2020, letting psychologists licensed in other PSYPACT states provide telepsychology to Pennsylvania residents.⁵
The Physical Therapy Licensure Compact, which Pennsylvania fully implemented on July 7, 2025.⁶

A practitioner who holds neither a Pennsylvania license nor a qualifying compact privilege is practicing without a license when they treat a Pennsylvania patient remotely. The Bureau of Professional and Occupational Affairs can fine or revoke the privileges of providers who work outside their scope or without proper credentials.

The Same Standard of Care Applies

Pennsylvania holds telehealth to the same clinical standard as an office visit. A provider must gather enough clinical information to reach an accurate diagnosis and build an appropriate treatment plan, and if the technology cannot support that for a given complaint, the provider is expected to refer the patient in person rather than guess.²

This is where most discipline originates. Prescribing after a two-minute video call with no meaningful assessment carries the same risk over a screen as it would in a clinic. Boards can impose fines, order additional training, or suspend licenses.

Consent, Identity, Location, and Privacy

Before a telehealth encounter, providers should obtain informed consent covering how the session will work, what happens if the technology fails, and what remote care can and cannot do compared with an in-person visit. Consent becomes part of the medical record. Pennsylvania does not appear to require a fresh consent at every single visit, but documenting consent at the start of the relationship is standard practice.

The provider also needs to verify the patient’s identity and confirm the patient’s physical location at the start of each session. Location determines which state’s laws govern the encounter and tells emergency responders where to go if something goes wrong.

HIPAA applies to telehealth the same way it applies to office visits. Providers must use platforms that secure communications and protect stored health data.⁷ A consumer video chat app that does not meet HIPAA security standards can trigger federal enforcement no matter how good the clinical care was. HHS publishes guidance for both providers and patients on the privacy risks of telehealth.⁸

Prescribing by Telehealth

A provider must establish a legitimate practitioner-patient relationship and complete an appropriate medical evaluation before writing any prescription through telehealth. For non-controlled medications, a real-time audio-video visit generally satisfies this, provided the provider reviews the patient’s history, assesses current symptoms, and documents the clinical reasoning.

Controlled Substances

Controlled-substance prescribing carries an added layer of federal law. The Ryan Haight Online Pharmacy Consumer Protection Act generally requires at least one in-person evaluation before a provider can prescribe Schedule II through V medications.⁹ The DEA has extended COVID-era flexibilities through December 31, 2026, letting DEA-registered practitioners prescribe Schedule II through V controlled substances by audio-video telehealth without ever having conducted an in-person evaluation.¹⁰

For opioid use disorder specifically, buprenorphine (Schedule III through V) can be prescribed by audio-only encounter under those same temporary rules.¹⁰ The DEA finalized two permanent rules in January 2025 addressing buprenorphine prescribing and continuity of care for VA patients, both effective at the end of 2025.¹¹ The broader permanent replacement framework, including a proposed special registration for telemedicine prescribing, is not yet finalized. Providers relying on the current flexibilities should plan for stricter rules potentially returning in 2027.

The PDMP Check

Pennsylvania requires providers to check the state’s Prescription Drug Monitoring Program before prescribing certain medications, particularly opioids and other controlled substances. That obligation applies equally whether the visit is in person or remote. The PDMP surfaces patterns of overuse or drug interactions that may not show up in a single encounter.¹¹

What Insurers Must Cover Under Act 42 of 2024

Act 42 of 2024 is the core coverage rule. For health insurance policies with forms or rates filed on or after March 31, 2025, insurers must cover medically necessary services provided through telemedicine by in-network providers. In practice, that reaches most group plans issued or renewed in late 2025 and all individual policies starting in January 2026.² Key points:

Coverage parity. If a service is covered in person, the insurer cannot exclude it just because it was delivered by telehealth.¹²
No proprietary platform mandates. Insurers cannot require providers to use a specific vendor’s telehealth platform as a condition of payment.¹²
Reimbursement is contract-based. The law does not guarantee telehealth rates will match in-person rates, but it does prohibit denying payment solely because a service was delivered remotely.²

One boundary to be clear about: the mandate applies to in-network providers. Insurers may cover out-of-network telehealth but are not required to.² If you deliberately choose an out-of-network provider, the federal No Surprises Act’s balance billing protections generally do not apply either.¹³

Medical Assistance and CHIP are covered on a slightly different timeline. Beginning January 1, 2026, Medicaid and CHIP managed care plans must reimburse medically necessary services delivered by telemedicine when certain conditions are met.² Medical Assistance continues to reimburse behavioral health services delivered by telehealth, and providers must use standard billing codes to get paid.¹

Audio-Only Visits

Not every patient has reliable internet or a camera-equipped device. Act 98 of 2022 permanently removed two Department of Human Services regulations that had blocked payment for audio-only telehealth in outpatient psychiatric clinics and outpatient drug and alcohol clinic services.² Federal DEA rules also permit audio-only encounters for certain opioid use disorder prescribing through the end of 2026.¹⁰ For other care, whether an insurer will pay for a phone-only visit turns on the provider’s contract and the member’s specific plan. Act 42 does not categorically exclude audio-only encounters, though it does require HIPAA-compliant technology.

Liability Exposure

Because the standard of care is the same, a provider who delivers substandard care remotely faces the same malpractice exposure as one who does so in an office. Telehealth adds specific risks worth documenting against. Misdiagnosis is more likely without a physical exam, and technical failures can interrupt care at a bad moment. Providers should record when they recommended in-person follow-up, when technical problems occurred, and what clinical limitations the remote format imposed. That documentation is often the difference between a defensible chart and a hard case.

1
Commonwealth of Pennsylvania. Governor Shapiro Signs Telemedicine Bill into Law, Expanding Access to Health Care, Especially in Rural Communities
2
Department of State. Frequently Asked Questions About Telemedicine in Pennsylvania
3
Telehealth.HHS.gov. Licensure Compacts
4
Interstate Medical Licensure Compact. Physician License
5
ASPPB The Centre. PSYPACT
6
Commonwealth of Pennsylvania. Physical Therapy Compact
7
Telehealth.HHS.gov. Privacy Laws and Policy Guidance
8
U.S. Department of Health and Human Services. HIPAA and Telehealth
9
Department of Justice. Ryan Haight Online Pharmacy Consumer Protection Act of 2008
10
Drug Enforcement Administration. DEA Extends Telemedicine Flexibilities to Ensure Continued Access to Care
11
Drug Enforcement Administration. DEA Announces Three New Telemedicine Rules that Continue to Open Access to Telehealth Treatment while Protecting Patients
12
Pennsylvania General Assembly. Pennsylvania Consolidated Statutes Title 40 Insurance Section 4803
13
Pennsylvania Insurance Department. The No Surprises Act