Online Prescribing

Temporary Rule

DEA and HHS are further delaying the effective date of the two final rules published in the January 17, 2025, issue of the Federal Register titled “Expansion of Buprenorphine Treatment via Telemedicine Encounter”10 and “Continuity of Care via Telemedicine for Veterans Affairs Patients”11 to December 31, 2025.

During this period, a DEA-registered practitioner is authorized to prescribe schedule II-V controlled substances via telemedicine, as defined in 21 CFR 1300.04(i), to a patient without having conducted an in-person medical evaluation of the patient if all of the conditions listed in paragraph (e) of this section are met.

SOURCE:  21 CFR Part 1306, Drug Enforcement Agency, Dep. of Justice, (accessed Jul. 2025).

Controlled Substance Act

No controlled substance that is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act [21 U.S.C. 301 et seq.] may be delivered, distributed, or dispensed by means of the Internet without a valid prescription. … Nothing in this subsection shall apply to the delivery, distribution, or dispensing of a controlled substance by a practitioner engaged in the ‘practice of telemedicine’ [see definition in section above].

SOURCE:  21 USCS Sec. 829, (Accessed Jul. 2025).

Note that the practice of telemedicine is allowed to be used in prescribing controlled substances during a public health emergency declared by the Secretary under section 247d of title 42; and involves patients located in such areas, and such controlled substances, as the Secretary, with the concurrence of the Attorney General, designates, provided that such designation shall not be subject to the procedures prescribed by subchapter II of chapter 5 of title 5.

SOURCE:  21 USCS Sec. 802, (Accessed Jul. 2025).

See Definitions section for all telemedicine exceptions.

The Attorney General may issue to a practitioner a special registration to engage in the practice of telemedicine for purposes of section 802(54)(E) of this title if the practitioner, upon application for such special registration—

• demonstrates a legitimate need for the special registration; and
• is registered under section 823(g) of this title in the State in which the patient will be located when receiving the telemedicine treatment, unless the practitioner—
  • is exempted from such registration in all States under section 822(d) of this title; or
  • is an employee or contractor of the Department of Veterans Affairs who is acting in the scope of such employment or contract and is registered under section 823(g) of this title in any State or is utilizing the registration of a hospital or clinic operated by the Department of Veterans Affairs registered under section 823(g) of this title.

Regulations. Not later than 1 year after October 24, 2018, in consultation with the Secretary, the Attorney General shall promulgate final regulations specifying—

• the limited circumstances in which a special registration under this subsection may be issued; and
• the procedure for obtaining a special registration under this subsection.

SOURCE:  21 USCS Sec. 831, (Accessed Jul. 2025).

Buprenorphine Treatment via Telemedicine Encounter – Effective Dec. 31, 2025

A practitioner may issue a prescription for schedule III-V controlled substances listed in 42 CFR 8.12(h)(2) as approved by the Food and Drug Administration (FDA) for use in the treatment of Opioid Use Disorder (OUD), defined as the use of an effective medication such as buprenorphine to treat OUD, pursuant to a communication between the prescribing practitioner and the patient using an interactive telecommunications system, including an audio-only telecommunications system, as described in 42 CFR 410.78(a)(3), if the following conditions are met:

• Prescription drug monitoring program review. The prescribing practitioner must be authorized to access the applicable prescription drug monitoring program (PDMP) data of the state in which the patient is located at the time of the telemedicine encounter. The prescribing practitioner shall review such data regarding any controlled substance prescriptions issued to the patient in the last year, or, if less than one year of data is available, in the entire available period. The prescribing practitioner shall ensure the date and time of such a review is annotated in the patient’s electronic health record (EHR) or paper record. This review, or attempted review, must be conducted prior to issuing a prescription in a manner authorized under this section.
• Time limit. The practitioner may issue prescriptions to the patient pursuant to this section for a period not to exceed six calendar months beginning on the date the first prescription is issued. The practitioner may issue additional prescriptions to the patient for schedule III-V controlled substances approved by the FDA for use in the treatment of OUD either:
  • After the prescribing practitioner has conducted at least one in-person medical evaluation of the patient, as defined in 21 U.S.C. 829(e)(2)(B); or
  • As otherwise authorized by 21 U.S.C. 829(e), including pursuant to any other form of telemedicine as defined in 21 U.S.C. 802(54) or pursuant to practices as determined by regulation issued pursuant to 21 U.S.C. 829(e)(3)(B).
• PDMP inaccessible or unavailable. If the PDMP data is inaccessible or unavailable for any reason, the prescribing practitioner shall annotate in the patient’s EHR or paper record the date and time that an attempt to view the PDMP data was made and the reason the data could not be reviewed. A practitioner may prescribe a seven-day supply of medication and must perform another PDMP review before prescribing another seven-day supply. Each time the PDMP is reviewed or attempted to be reviewed, the date and time must be annotated in the patient’s EHR. A seven-day supply prescribed pursuant to this paragraph (b)(3) counts toward the time limit described in paragraph (b)(2) of this section.
• Pharmacy identification requirement. The pharmacist shall verify the identity of the patient prior to filling a controlled substance prescription issued under the authority of this section. The pharmacist shall verify the identity of the patient with a state or Federal Government-issued photographic identification card or other form of identification. For the purposes of verifying the identity of the patient, the pharmacist may accept identification in the manner described herein from any qualifying “ultimate user” as defined in 21 U.S.C. 802(27) prior to filling the prescription.
• Prescription only for treatment of OUD. Controlled substance prescriptions issued pursuant to this section may only be issued for the treatment of OUD, and subject to the requirements of this section.
• Authorization to prescribe. The practitioner must be:
  • Authorized under §§ 1301.11, 1301.12(a), and 1301.13(e)(1)(iv) of this chapter to prescribe the basic class of controlled substance specified on the prescription; or
  • Exempt from obtaining a registration to dispense controlled substances under 21 U.S.C. 822(d).
• Consistent with general prescription requirements. The issuance of the controlled substance prescription otherwise complies with the requirements set forth in this part.

See regulations for related definitions

SOURCE:  Federal Register, Sec. 1306.51: Special Circumstances for Telemedicine Prescribing, rule issued 1/17/25, effective date delayed to Dec. 31 2025 by Docket No. DEA-948, (Accessed Jul. 2025).

Continuity of Care via Telemedicine for Veterans Affairs Patients

A practitioner may prescribe controlled substance(s) to a patient via the practice of telemedicine under § 1300.04(i)(7) of this chapter if all the following conditions are met:

• An employee or contractor of the Department of Veterans Affairs (VA) who is acting in the scope of such employment or contract, and registered under section 303(g) of the Act (21 U.S.C. 823(g)) (§ 1301.13 of this chapter) in any state or is utilizing the registration of a hospital or clinic operated by the VA registered under section 303(f);
• Prescribing to a VA patient who has previously received, at any time, an in-person medical evaluation by any VA practitioner who at the time of the in-person medical evaluation was acting within the scope of their VA employment or contract and had prescribing authority, or would reasonably be expected to have prescribing authority based on their credentials ( e.g., medical doctor) or organizational role ( e.g., primary care provider), as described in paragraph (a)(1) of this section;
• Not a contracted practitioner located outside a VA facility or clinic providing care via the community care network or conducting disability compensation evaluations; and
• Prescribing a controlled substance(s) for a legitimate medical purpose in the usual course of professional practice, and in accordance with applicable Federal and State law(s).

Prior to prescribing, the practitioner must conduct a review of both the VA EHR, to include the VA’s internal prescription database, and the PDMP data of the state in which the patient is located at the time of the telemedicine encounter (if the state has such a program) for controlled substance prescription(s) for the patient’s previous twelve (12) months preceding the controlled substance prescription(s), or if less than a year of data is available, for the entire prescription period.

• Should either the patient’s VA electronic health record, to include the VA’s internal prescription database, or the PDMP of the state in which the patient is located at the time of the telemedicine encounter (if the state has such a program) be unavailable or non-operational, for any reason, the VA practitioner must limit the prescription to a 7-day supply. Once the VA’s internal prescription database and the PDMP are available or operational, a review of the databases as outlined in this paragraph (b) must be completed to continue prescribing the controlled substance(s) to the VA patient.
• If no PDMP exists in the state in which the patient is located at the time of the telemedicine encounter, the VA practitioner must review the VA internal prescription database prior to issuing a controlled substance prescription. A prescription may extend beyond 7 days under this circumstance.
• The VA practitioner must annotate in the VA patient’s EHR their attempts to access the PDMP data of the state in which the patient is located, and VA internal prescription database data. If no PDMP exists in the state in which the patient is located at the time of the telemedicine encounter, the prescribing practitioner must annotate that in the VA patient’s EHR. If the prescribing VA practitioner fails to access the PDMP data of the state in which the patient is located or VA internal prescription database data as described in paragraph (b)(1) of this section, the VA practitioner must annotate in the VA patient’s EHR the dates and times that the VA practitioner attempted to gain access, the reason why the VA practitioner was unable to gain access, and any follow-up attempts made to gain access to the system. The attempts must be recorded in accordance with the VA’s internal policies and recordkeeping requirements.

The controlled substance prescription(s) must be otherwise in conformity with the requirements of the Controlled Substances Act and this chapter.

SOURCE:  Federal Register, Sec. 1306.52 & sec. 12.4: Continuity of Care via Telemedicine for Veterans Affairs Patients, rule issued 1/17/25, effective date delayed to Dec. 31 2025 by Docket No. DEA-407VA, (Accessed Jul. 2025).

* The US Health and Human Services Administration maintains a website that summarizes information related to prescribing controlled substances.