DEA Telehealth Prescribing Rules

Your guide on the telehealth prescribing law update

The public health emergency (PHE) declared in 2020 because of the COVID-19 pandemic expired on May 11, 2023. During the PHE, certain regulations were suspended which then allowed patients to be seen and to be prescribed non-controlled and controlled substances (Adderall, Xanax, Ritalin, etc.) via the Internet. Patients could be prescribed such medications after seeing a healthcare provider online. They were not required to have in-person visits during the PHE.

The updated regulations and previously suspended regulations regarding the prescribing of controlled substances via the Internet were scheduled to become effective on November 11, 2023. However, due to overwhelming public feedback the DEA (Drug Enforcement Administration) extended the date.

According to the latest information from the DEA, patients can continue receiving treatment online without the need for in-person doctor visits until December 31, 2026.

The legal framework: Ryan Haight Act

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 amended the federal Controlled Substances Act (21 U.S.C. § 829(e)). It generally requires at least one in-person medical evaluation before a practitioner may prescribe a controlled substance by means of the Internet — unless a recognized telemedicine exception applies.

During the COVID-19 PHE, the DEA and HHS used emergency authority to waive the in-person requirement so that patients could start controlled-substance treatment entirely by telehealth. The current DEA temporary rules extend that flexibility while the agency finalizes permanent telemedicine regulations.

Cross-state prescribing: the DEA/HHS Telemedicine Flexibility Waiver

The specific mechanism that allows cross-state prescribing without multiple DEA licenses is the DEA/HHS Telemedicine Flexibility Waiver, which has been officially extended under the Fourth Temporary Extension.

Under this specific federal waiver, a practitioner who holds a single DEA registration in one state is permitted to prescribe controlled substances to patients located in other states via telemedicine.

This waiver bypasses the strict federal requirement that would normally force a clinician to register a physical office address and pay a separate DEA fee for every state where they practice.

Current expiration date: As of late 2025, the DEA and HHS jointly extended these flexibilities. They are legally active and set to run through December 31, 2026.

Reference: Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications — Federal Register (Dec. 31, 2025)

What is in effect right now

• A DEA-registered practitioner may prescribe Schedule II–V controlled substances based on a telehealth evaluation, without a prior in-person visit, through December 31, 2026 (DEA & SAMHSA Third Temporary Extension of COVID-19 Telemedicine Flexibilities, published in the Federal Register).
• The clinician must hold an active DEA registration in the state where the patient is physically located at the time of the visit, in addition to being licensed in that state.
• Prescriptions must still satisfy 21 C.F.R. § 1306.04 — issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice.
• State law may be stricter than federal law. Some states require an in-person visit, a separate telehealth registration, or limit which controlled substances may be prescribed remotely. MindCare follows whichever rule is more protective.

DEA registration & clinician requirements

• Every prescriber of controlled substances must hold a current DEA registration under 21 U.S.C. § 822 for each state in which they prescribe.
• Mid-level practitioners (including PMHNPs) prescribe under state-granted authority plus their individual DEA number; collaborative or supervisory requirements vary by state.
• Electronic prescribing of controlled substances (EPCS) must use a DEA-certified platform that meets 21 C.F.R. Part 1311 (identity proofing, two-factor authentication, audit logging).
• Schedule II prescriptions cannot be refilled; new prescriptions are required and are subject to state quantity and day-supply limits.

How MindCare complies

• Your clinician verifies your identity and physical location in the United States before every visit and confirms licensure in your state.
• Controlled substances are prescribed only when clinically appropriate, documented, and permitted under both federal and your state's law.
• All controlled-substance prescriptions are sent through a DEA-certified EPCS pharmacy network.
• If federal or state rules change — including any new DEA final rule on telemedicine prescribing — we will update our practices and notify affected patients.

References

• Ryan Haight Online Pharmacy Consumer Protection Act, 21 U.S.C. § 829(e).
• DEA & SAMHSA, “Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” 89 Fed. Reg. (2024).
• 21 C.F.R. § 1306.04 — Purpose of issue of prescription.
• 21 C.F.R. Part 1311 — Requirements for Electronic Orders and Prescriptions.
• DEA Diversion Control Division — deadiversion.usdoj.gov.

This page is general information, not legal advice. Rules change; the DEA may issue a final telemedicine rule before the current extension expires.