Online Prescribing

A health care practitioner may establish a practitioner-patient relationship through either a synchronous telehealth interaction or an asynchronous telehealth interaction, if the health care practitioner:

• Verifies the identity of the patient receiving health care services through telehealth;
• Discloses to the patient the health care practitioner’s name, contact information, and type of health occupation license held by the health care practitioner; and
• Obtains oral or written consent from the patient or from the patient’s parent or guardian.

SOURCE: MD Code Health Occupations Sec. 1-1002. (Accessed Feb. 2026).

A health care practitioner shall perform a clinical evaluation that is appropriate for the patient and the condition with which the patient presents before providing treatment or issuing a prescription through telehealth.

A health care practitioner may use a synchronous telehealth interaction or an asynchronous telehealth interaction to perform the clinical evaluation required under paragraph (1) of this subsection.

A health care practitioner may not prescribe a Schedule II controlled substance that is an opiate for the treatment of pain through telehealth unless:

• The individual receiving the prescription is a patient in a health care facility;
• The governor has declared a state of emergency due to a catastrophic health emergency; or
• There is an established bona fide practitioner-patient relationship in which the health care practitioner has an ongoing responsibility for the assessment, care, and treatment of the patient and the health care practitioner, or another health care practitioner in the same group practice, previously conducted an in-person assessment of the patient.

A health care practitioner who through telehealth prescribes a controlled substance is subject to any applicable regulation, limitation, and prohibition in federal and state law relating to the prescription of controlled substances.

SOURCE: MD Code Health Occupations Section 1-1003 as amended by HB 869/SB 372 (2025 Session). (Accessed Feb. 2026).

Before performing telehealth services, a telehealth practitioner shall develop and follow a procedure to:

• Verify the identification of the patient receiving telehealth services;
• Except for interpretive services, obtain oral or written acknowledgement from a patient or person in interest as defined by Health-General Article, §4-301(m), Annotated Code of Maryland, to perform telehealth services;
• Prevent access to data by unauthorized persons through encryption or other means;
• Notify patients in the event of a data breach;
• Ensure that the telehealth practitioner provides a secure and private telehealth connection that complies with federal and state privacy laws; and
• Establish safety protocols to be used in the case of an emergency.

Except when providing store and forward telehealth services, remote patient monitoring, or other asynchronous telehealth services, a telehealth practitioner shall:

• Obtain or confirm an alternative method of contacting the patient in case of a technological failure;
• Confirm whether the patient is in Maryland and identify the practice setting in which the patient is located;
• For an initial patient-telehealth practitioner interaction only, disclose the telehealth practitioner’s name, contact information, and medical specialty; and
• Identify all individuals present at each location and confirm they are allowed to hear personal health information.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.32.05.04. (Accessed Feb. 2026).

A telehealth practitioner shall perform a synchronous, audio-visual patient evaluation adequate to establish diagnoses and identify underlying conditions or contraindications to recommended treatment options before providing treatment or prescribing medication. A telehealth practitioner may use a surrogate examiner; or a patient evaluation performed by another licensed health care practitioner providing coverage.

These requirements do not apply to:

• Interpretive services where a prior patient evaluation was performed by another provider;
• Remote patient monitoring; or
• Asynchronous telehealth services for a patient who has had a prior synchronous, audio-visual telehealth patient evaluation or in-person patient evaluation that complies with the requirements of this regulation.

SOURCE:  Code of Maryland Admin. Regs. Sec. 10.32.05.05. (Accessed Feb. 2026).

A telehealth practitioner may not treat a patient or prescribe medication based solely on a static online questionnaire.

A telehealth practitioner may not prescribe an opiate described in the list of Schedule II substances under Criminal Law Article, §5-403, Annotated Code of Maryland for the treatment of pain through telehealth unless:

1. The patient is in a health care facility as defined in Health-General Article, §19-114(d)(1), Annotated Code of Maryland;
2. The Governor has declared a state of emergency due to a catastrophic health emergency; or
3. There is an established bona fide practitioner-patient relationship in which the telehealth practitioner has ongoing responsibility for the assessment, care, and treatment of the patient and the telehealth practitioner, or another health care practitioner in the same group practice, as defined in Health Occupations Article, §1-301, Annotated Code of Maryland, previously conducted an in-person assessment of the patient.

A telehealth practitioner shall comply with all State and federal laws and regulations related to dispensing including the prohibition on mail order dispensing.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.32.05.06 as amended by Final Rule (Jan. 2026). (Accessed Feb. 2026).

Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, Music Therapists

Except when providing asynchronous telehealth services or remote patient monitoring, a telehealth practitioner shall:

• Perform a clinical patient evaluation adequate to establish a diagnosis and identify underlying conditions or contraindications to recommended treatment options before providing treatment or services through telehealth; and
• If clinically appropriate for the patient, provide or refer a patient to:
  • In-person health care services; or
  • Another type of telehealth service.

If the evaluation is adequate to comply with §A of this regulation, a telehealth practitioner may use:

• Telehealth devices;
• Live synchronous audio-visual communication;
• Other methods of performing a patient examination remotely; or
• A patient evaluation performed by another licensed health care practitioner providing coverage.

A telehealth practitioner shall comply with all applicable laws and regulations governing referrals, testing, and evaluation of patients including, but not limited to, the requirements of:

• COMAR 10.41.08; and
• Health Occupations Article, §2-314.1, Annotated Code of Maryland.

A telehealth practitioner may not treat a patient based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.41.06.05. (Accessed Feb. 2026).

Podiatrists

Except when providing asynchronous telehealth services or remote patient monitoring, a telehealth practitioner shall:

• Perform a clinical patient evaluation adequate to establish a diagnosis and identify underlying conditions or contraindications to recommended treatment options before providing treatment or prescribing medication through telehealth; and
• If clinically appropriate for the patient, provide or refer a patient to:
  • In-person health care services; or
  • Another type of telehealth service.

If the evaluation is adequate to comply with §A of this regulation, a telehealth practitioner may use:

• Telehealth devices;
• Live synchronous audio-visual communication;
• Other methods of performing a medical examination remotely; or
• A patient evaluation performed by another licensed health care practitioner providing coverage.

A telehealth practitioner may not treat a patient or issue a prescription based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.40.12.05. (Accessed Feb. 2026).

Occupational and Physical Therapists

An occupational or physical therapist who practices telehealth shall:

• Perform a synchronous or asynchronous clinical patient evaluation that is appropriate for the patient and the condition with which the patient presents before providing a treatment plan through telehealth; and
• If clinically appropriate for the patient, provide or refer a patient to:
  • In-person treatment; or
  • Another type of telehealth service.

A telehealth practitioner may not treat a patient based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.46.08.05; 10.38.13.05. (Accessed Feb. 2026).

Massage Therapists

A telehealth practitioner shall:

• Perform a synchronous or asynchronous clinical client evaluation that is appropriate for the client and the condition with which the client presents before providing health care services through telehealth; and
• If clinically appropriate for the client, provide or refer a client to:
  • In-person treatment; or
  • Another type of telehealth service.

A telehealth practitioner may not treat a client based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.65.10.05. (Accessed Feb. 2026).

Chiropractors

A telehealth practitioner shall:

• Perform a synchronous or asynchronous clinical patient evaluation that is appropriate for the patient and the condition with which the patient presents before providing a treatment plan through telehealth; and
• If clinically appropriate for the patient, provide or refer a patient to:
  • In-person treatment; or
  • Another type of telehealth service.

A telehealth practitioner may not treat a patient based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.43.17.05. (Accessed Feb. 2026).

Professional Counselors and Therapists and Social Workers

A teletherapy practitioner shall:

• Perform a synchronous or asynchronous clinical client evaluation that is appropriate for the client and the condition with which the client presents before providing treatment or services through teletherapy; and
• If clinically appropriate for the client, provide or refer a client to:
  • In-person treatment; or
  • Another type of teletherapy service.

A teletherapy practitioner may not treat a client based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.58.06.05; 10.42.10.05. (Accessed Feb. 2026).

Dieticians

A dietician who practices telehealth shall:

• Perform a synchronous or asynchronous clinical patient evaluation that is appropriate for the patient and the condition with which the patient presents before providing a treatment plan through telehealth; and
• If clinically appropriate for the patient, provide or refer a patient to:
  • In-person treatment; or
  • Another type of telehealth service.

A telehealth practitioner may not treat a patient based solely on an online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.56.10.05. (Accessed Feb. 2026).

Optometrists

Subject to the provisions of Health Occupations Article, §11-208, Annotated Code of Maryland, a telehealth practitioner shall:

• Perform a synchronous or asynchronous clinical patient evaluation that is appropriate for the patient and the condition with which the patient presents before providing treatment or issuing a prescription through telehealth; and
• If clinically appropriate for the patient, provide or refer a patient to:
  • In-person health care services; or
  • Another type of telehealth service.

A telehealth practitioner may not treat a patient or issue a prescription based solely on a static online questionnaire.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.28.01.05. (Accessed Feb. 2026).

Psychologists

Before engaging in the practice of psychology using telepsychology, a psychologist or psychology associate shall evaluate the client to determine that delivery of telepsychology is appropriate considering at least the following factors:

• The client’s:
  • Diagnosis;
  • Symptoms;
  • Medical and psychological history; and
  • Preference for receiving services via telepsychology; and
• The nature of the services to be provided, including anticipated:
  • Benefits;
  • Risks; and
  • Constraints resulting from their delivery via telepsychology.

The client evaluation set forth in §A of this regulation shall take place at an initial in-person session, unless the psychologist or psychology associate documents in the record the reason for not meeting in person.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.36.10.05. (Accessed Feb. 2026).