Tennessee telehealth laws apply the same professional standards to remote care as to in-person visits, with the main rules found in Tennessee Code § 63-1-155 (licensing, provider-patient relationship, standard of care, and prescribing) and § 56-7-1002 (insurance coverage). Any provider treating a patient located in Tennessee needs a Tennessee license, must meet the ordinary standard of care, and must obtain informed consent before the visit; insurers generally have to cover telehealth on the same terms as in-person services.
What Counts as Telehealth in Tennessee
State law uses “telehealth” and “telemedicine” interchangeably to describe real-time audio, video, or other electronic communication that lets a provider and patient interact for diagnosis, consultation, or treatment when they are not in the same room.1Justia. Tennessee Code 63-1-155 – Telehealth and Telemedicine Services The definition also covers store-and-forward services, where images or records are transmitted for a provider to review later without a live interaction. If the transmitted information is not sufficient for the provider to form an adequate opinion, the provider has to decline to diagnose and either refer the patient for an in-person exam or ask for more data.2Legal Information Institute. Tennessee Compilation of Rules and Regulations 0880-02-.16 – Telemedicine
Patients can be at any location they consider appropriate as long as they have the technology to connect. There is no requirement to travel to a clinic or hospital to receive telehealth care.
Audio-Only Calls Are Treated Differently
A plain phone call generally does not count as “telehealth” for insurance-coverage purposes. There are two exceptions: behavioral health services when video technology is unavailable, and other healthcare services when video is similarly unavailable. To bill for an audio-only encounter, the provider must document that the patient either lacks the necessary video technology, is in a location without sufficient service for video, or has a physical disability that prevents using video. The provider also has to notify the patient before the encounter that the financial responsibility will be the same as for a video or in-person visit.
Who Can Legally Provide Telehealth in Tennessee
Any healthcare provider delivering telehealth services to a patient in Tennessee must hold a valid Tennessee license, regardless of where the provider is physically sitting during the encounter.1Justia. Tennessee Code 63-1-155 – Telehealth and Telemedicine Services A physician licensed only in Georgia who treats a Tennessee patient by video is practicing medicine in Tennessee and needs Tennessee credentials. Practicing without proper authorization exposes a provider to disciplinary action and civil penalties from the relevant licensing board.
Interstate Compacts
Tennessee participates in two compacts that make multi-state practice easier. The Interstate Medical Licensure Compact, effective in Tennessee January 1, 2019, gives physicians an expedited pathway to obtain licenses in multiple member states through a single application.3Justia. Tennessee Code 63-6-402 – Interstate Medical Licensure Compact The compact does not create a single multi-state license; it speeds up getting individual state licenses.4Interstate Medical Licensure Compact. Physician License Tennessee also joined the Nurse Licensure Compact in January 2018, which lets RNs and LPNs with a multi-state license from their home state practice in all other compact states without additional licenses. Advanced practice registered nurses and physician assistants do not have an equivalent compact for telehealth practice and still face the standard state-by-state licensing process.
The Provider-Patient Relationship and Standard of Care
A telehealth provider-patient relationship forms through mutual consent and communication. Consent can be express or implied, but the relationship does not come into existence merely because a provider receives someone’s health information. The provider’s duties begin only when the provider affirmatively undertakes to diagnose or treat the patient, or participates in that diagnosis or treatment.1Justia. Tennessee Code 63-1-155 – Telehealth and Telemedicine Services The provider must verify the patient’s identity and gather enough clinical information to make an appropriate diagnosis.
The statute is explicit that telehealth creates no new or different standard of care. The same clinical judgment and the same level of documentation that would apply in person apply to the virtual visit. A provider who cuts corners because the visit is remote faces the same disciplinary exposure as one who cuts corners in the office.
Informed Consent Before the Visit
Providers must obtain consent after telling the patient how the remote delivery model works and what its limitations are. Individual licensing boards set the specifics for their disciplines, but the typical disclosures cover the risks and benefits of telehealth treatment, how to get follow-up care, and what happens if the technology fails mid-encounter.5Legal Information Institute. Tennessee Compilation of Rules and Regulations 1045-02-.18 – Telehealth in the Practice of Optometry Evidence of informed consent must be documented in the patient’s record. If a provider skips this step and dives straight into treatment, that is worth reporting to the relevant licensing board.
Prescribing Through Telehealth
Before prescribing or dispensing any medication by any means, a Tennessee physician must perform an appropriate history and physical examination, make a diagnosis based on that examination and any indicated tests, formulate a therapeutic plan with the patient, and ensure follow-up care is available. A digital questionnaire alone does not satisfy these requirements. The provider needs a genuine clinical evaluation through interactive communication before writing any prescription.
Buprenorphine
Tennessee adds restrictions for buprenorphine prescribed by telehealth for opioid use disorder or medication-assisted treatment. A provider can only prescribe buprenorphine remotely if they work for or contract with a qualifying facility, such as a licensed opioid treatment program, a community mental health center, a federally qualified health center, a hospital, or TennCare’s comprehensive enhanced buprenorphine treatment network. The telehealth session must be provided on behalf of that employing or contracting entity.1Justia. Tennessee Code 63-1-155 – Telehealth and Telemedicine Services Independent practitioners without those affiliations cannot prescribe buprenorphine via telehealth in Tennessee.
Controlled Substances and the DEA Rules
Federal law adds another layer. The Ryan Haight Act generally requires at least one in-person medical evaluation before a practitioner can prescribe controlled substances via telemedicine.6Office of the Law Revision Counsel. 21 USC 831 – Additional Requirements Relating to Online Pharmacies The DEA has extended COVID-era flexibilities through December 31, 2026. During that window, DEA-registered practitioners may prescribe Schedule II through V controlled substances via audio-video telemedicine without having conducted an in-person evaluation, as long as the prescriptions comply with all other federal and state requirements. For opioid use disorder treatment, practitioners may prescribe Schedule III through V medications approved for maintenance and withdrawal management via audio-only encounters.7DEA. DEA Extends Telemedicine Flexibilities to Ensure Continued Access to Care
If the flexibilities expire without a permanent replacement, the standard Ryan Haight Act requirements would snap back, potentially requiring in-person visits before controlled substance prescriptions. Anyone relying on telehealth prescribing should track this as the end of 2026 approaches.
Insurance Coverage
Private Insurance Parity
Tennessee Code § 56-7-1002 requires health insurance entities to cover healthcare services delivered through telehealth if the same services would be covered in person. Insurers cannot deny a claim solely because the service was provided remotely, and they must reimburse without penalizing the provider or patient based on geographic location.8Justia. Tennessee Code 56-7-1002 – Telehealth Services Coverage must be provided in a manner consistent with what the policy provides for in-person encounters.
Parity does not override your plan’s normal cost-sharing. Deductibles, copayments, and coinsurance still apply, and if a service would not be covered in person, the insurer does not have to cover it just because it was delivered by telehealth. Anything the statute does not specifically address falls back to the terms of the individual insurance contract.
TennCare
TennCare covers telehealth services subject to federal Medicaid requirements and the state’s approved Medicaid plan. Each managed care organization publishes its own reimbursement policies, so providers billing TennCare for telehealth should check the specific guidelines of the relevant MCO rather than relying on the general statute alone.
Medicare
Through December 31, 2027, Medicare covers telehealth services for patients located anywhere in the United States, including their home, without the traditional geographic restrictions that previously limited coverage to rural areas. After meeting the Part B deductible, beneficiaries pay 20% of the Medicare-approved amount, the same cost-sharing as an in-person visit.9Medicare.gov. Telehealth Covered services include office visits, psychotherapy, consultations, advance care planning, depression screenings, diabetes self-management training, and speech therapy, among others. Medicare Advantage plans may offer additional telehealth benefits beyond Original Medicare.
HIPAA and Privacy
Federal HIPAA rules apply to every telehealth encounter. Providers and health plans must use technology vendors that comply with HIPAA and will sign a Business Associate Agreement before transmitting any protected health information.10HHS. HIPAA Rules for Telehealth Technology Consumer-grade video apps that will not sign a BAA are off-limits for regular telehealth visits. Platforms designed for healthcare offer the encryption and access controls that meet HIPAA standards.
For patients, HIPAA means your telehealth provider has to protect your health information during and after the visit with the same rigor as an in-person visit. If you are asked to use a platform that seems unusual, or the provider does not explain how your information will be protected, raise the question before the session begins. That ties back to informed consent: understanding how your data is handled should be part of the pre-visit disclosure.