Iowa

At A Glance

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MEDICAID REIMBURSEMENT

Live Video: Yes
Store-and-Forward: Yes
Remote Patient Monitoring: Yes*
Audio Only: Yes

PRIVATE PAYER LAW

Law Exists: Yes
Payment Parity: Yes

PROFESSIONAL REQUIREMENTS

Licensure Compacts: AT, ASLP-IC, CC, DDH, DTC, EMS, IMLC, NLC, OT, PA, PTC, RCIC, SW (View full list of acronym names)
Limited licensure Exceptions: Yes (See section for applicable profession and requirements)
Telehealth License/Registration Process: No
Consent Requirements: Yes

FQHCs

Originating sites explicitly allowed for Live Video: Yes
Distant sites explicitly allowed for Live Video: Yes
Store and forward explicitly reimbursed: Yes
Remote patient monitoring explicitly reimbursed: No
Audio-only explicitly reimbursed: No
Allowed to collect PPS rate for telehealth: No

STATE RESOURCES

Medicaid Program: Iowa Medicaid
Administrator: Iowa Health and Human Services
Regional Telehealth Resource Center: Great Plains Telehealth Resource Center

Private Payer

Last updated 04/22/2026

Definitions

“Telehealth” means the delivery of health care services through the use of real-time interactive audio and video, or other real-time interactive electronic media, regardless of where the health care professional and the covered person are each located. “Telehealth” does not include the delivery of health care services delivered solely through an audio-only telephone, electronic mail message, or facsimile transmission.

SOURCE: IA Code 514C.34(1)(f) (Accessed Sept. 2026).

Last updated 09/18/2026

Parity

SERVICE PARITY

Health care services that are delivered by telehealth must be appropriate and delivered in accordance with applicable law and generally accepted health care practices and standards prevailing at the time the health care services are provided, including all rules adopted by the appropriate professional licensing board having oversight of the health care professional providing the health care services.

A health carrier shall reimburse a health care professional and a facility for health care services provided by telehealth to a covered person for a mental health condition, illness, injury, or disease on the same basis and at the same rate as the health carrier would apply to the same health care services for a mental health condition, illness, injury, or disease provided in person to a covered person by the health care professional or the facility.

SOURCE: IA Code 514C.34(3) & 4a (Accessed Sept. 2026).

PAYMENT PARITY

As a condition of reimbursement pursuant to paragraph “a”, a health carrier shall not require that an additional health care professional be located in the same room as a covered person while health care services for a mental health condition, illness, injury, or disease are provided via telehealth by another health care professional to the covered person.

SOURCE: IA Code 514.34(4a), (Accessed Sept. 2026).

Last updated 09/18/2026

Requirements

Policies, contracts, or plans providing third-party payment or prepayment of health or medical expenses shall not discriminate between coverage benefits for health care services that are provided in-person and the same health care services provided through telehealth.

Health care services that are delivered by telehealth must be appropriate and delivered in accordance with applicable law and generally accepted health care practices and standards prevailing at the time the health care services are provided, including all rules adopted by the appropriate professional licensing board, pursuant to chapter 147, having oversight of the health care professional providing the health care services.

A health carrier shall not exclude a health care professional who provides services for mental health conditions, illnesses, injuries, or diseases and who is physically located out-of-state from participating as a provider, via telehealth, under a policy, plan, or contract offered by the health carrier in the state if all of the following requirements are met:

The health care professional is licensed in this state by the appropriate professional licensing board and is able to deliver health care services for mental health conditions, illnesses, injuries, or diseases via telehealth in compliance with paragraph “a”.
The health care professional is able to satisfy the same criteria that the health carrier uses to qualify a health care professional who is located in the state, and who holds the same license as the out-of-state professional, to participate as a provider, via telehealth, under a policy, plan, or contract offered by the health carrier in the state.

SOURCE: IA Code 514.34(2) and 4b (Accessed Sept. 2026).

Medicaid

Last updated 09/16/2026

Definitions

Telecommunication is defined as the transmission of information over distances without loss due to noise and interference. For the purposes of Iowa Medicaid this is primarily the Telehealth Services program. Telehealth Services allow the health care provider to complete ‘a visit’ with a patient by telephone, smartphone, computer, tablet, or telemedicine exam equipment.

Telemedicine focuses on the use of high-quality medical grade technology to conduct remote patient visits for diagnosis and treatment from a distance.

SOURCE: IA Health and Human Services, Telecommunication Technology Guide (3/27/2026), p. 1, 3. (Accessed Sept. 2026).

Crisis Response Services

“Telehealth” is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

SOURCE: Iowa Admin Code 441—24.20(225C) Definitions, p. 2 (Accessed Sept. 2026)

Last updated 09/16/2026

Email, Phone & Fax

When a telephone is the only means of the exchange of information between the health care provider and the patient this is called audio only.

Allowable as Audio – Only? ‘Yes’ indicates Audio Only – Modifier 93 is required. A telephone or non-video device is satisfactory to exchange information for the health care provider and patient ‘visit’.

SOURCE: IA Health and Human Services, Telecommuncations Technology Guide (3/27/2026), p. 1. (Accessed Sept. 2026).

See approved procedure code list. Includes column that identifies if codes can be provided via audio-only interaction. Certain codes include telephone services in their descriptions as well.

SOURCE: IA Medicaid. Telehealth Approved Codes, 3/26/26, (Accessed Sept. 2026).

Note that in almost all program-specific manuals, telephonic interpretive services are allowed.

SOURCE: Iowa Dep. of Human Services. Provider Manual. Ch. III Provider Specific Policies. Physician Services. Dec. 3, 2021, p. 64 . For other manuals, see: Medicaid Provider Manuals. (Accessed Sept. 2026).

Targeted Case Management, Case Management, and Care Coordination

Case management can occur by face-to-face contact or by telephone.

This contact may be face-to-face or by telephone. The contact may also be by written communication, including letters, email, and fax, when the written communication directly pertains to the needs of the member. A copy of any written communication must be maintained in the case file.

SOURCE: Iowa Dep. of Human Services. Provider Manual. Ch. III Provider Specific Policies. Targeted Case Management. May 1, 2018, p. 10 (Accessed Sept. 2026).

Home and Community-Based Services (HCBS)

BI case management services shall consist of the following components as detailed in IAC Chapter 90: …

One contact per month with the member, the member’s legally authorized representative, this contact may be face-to-face or by telephone.

SOURCE: Iowa Dep. of Human Services. Provider Manual. Ch. III Provider Specific Policies. Home- and Community-Based Services (HCBS) . June 24, 2022, p. 36 & 38 (Accessed Sept. 2026).

Hospice

A hospice claim will be eligible for a SIA payment if the following criteria are met: …

The service is not provided by a social worker via telephone.

SOURCE: Iowa Dep. of Human Services. Provider Manual. Ch. III Provider Specific Policies. Hospice. Oct. 2, 2020, p. 13 (Accessed Sept. 2026).

Community Support Services (CSS)

High Intensity CSS is provided through 5-12 member contacts per month. Contacts may be face-to-face or by telephone.

Low Intensity CSS is provided through 2-4 member contacts per month, with episodes of increased frequency, as needed. Contacts may be face-to-face or by telephone.

SOURCE: Iowa Medicaid B3 Provider Manual (Guide) p. 11 (1/15/2026). (Accessed Sept. 2026).

Last updated 09/16/2026

Live Video

POLICY

An in-person contact between a health care professional and a patient is not required as a prerequisite for payment for otherwise-covered services appropriately provided through telehealth in accordance with generally accepted health care practices and standards prevailing in the applicable professional community at the time the services are provided, as well as being in accordance with provisions under rule 653—13.11(147,148,272C). Health care services provided through in-person consultations or through telehealth shall be treated as equivalent services for the purposes of reimbursement

SOURCE: IA Admin Code Sec. 441, 78.54 (249A). (Accessed Sept. 2026).

To identify when using the specifically designed equipment and codes to complete comprehensive and efficient medical examinations, Iowa Medicaid is using the name Telemedicine Services.

SOURCE: IA Health and Human Services, Telecommunications Technology Guide, (3/27/2026), p. 1. (Accessed Sept. 2026).

Based on this rule [see above], there is no additional payment for the telehealth components of service, associated with the underlying service being rendered. Payment for a service rendered via telehealth is the same as payment made for that service when rendered in a face-to-face (i.e., in-person) setting.

SOURCE: IA Dep. of Human Services, Informational Letter No. 1815-MC-FFS, Aug. 10, 2017. (Accessed Sept. 2026).

Crisis Response Services and Subacute Mental Health Services.

“Face-to-face” means services provided in person or utilizing telehealth in conformance with the federal Health Insurance Portability and Accountability Act (HIPAA) privacy rules.

SOURCE: IA Admin Code Sec. 441-24.20; Subacute Mental Health Services. May 1, 2018, p. 9. (Accessed Sept. 2026).

ELIGIBLE SERVICES/SPECIALTIES

Iowa Medicaid has approved Procedure Codes for the purpose of member (patient) access to a health care provider using the electronic exchanges. The Procedure Codes are limited to which electronic equipment may be used. This approved procedure codes list is reviewed quarterly and updated as needed. The last updated date is identified at the top of the chart. This Iowa Telehealth List is independent from Centers for Medicaid and Medicare telehealth lists (CMS), it does not match the CMS list. Not every code on the CMS list is approved for the Iowa Telecommunication program. The approved procedure codes are retained on the Iowa Medicaid Website under the Iowa Medicaid Provider Fee Schedules.

Effective for the dates of service on or after 12/01/2025 there will be a reimbursement reduction for services rendered (site of service differential) with the place of service 02 and 10. As indicated in Iowa Administrative Code: 441-79.1(7)b. the fee schedule amount paid will be reduced by an adjustment factor, as determined by the Iowa Medicaid, to reflect the lower cost of providing services via telehealth opposed to providing services via ‘facility’ place of service opposed to the provider office.

Reimbursement for applicable telehealth/telemedicine services is subject to a site of service differential reduction as reflected on the applicable fee schedule. When a reduction applies, two reimbursement amounts may be listed for the same procedure code. The reduced reimbursement amount is identified by HHS factor code X on the fee schedule. Factor code X denotes the site of service–adjusted rate and applies to services billed with place of service code 02 or 10. Claims submitted with place of service code 02 or 10 will be reimbursed at the reduced rate associated with HHS factor code X.

SOURCE: IA Health and Human Services, Telecommunications Technology Guide, (3/27/2026), p. 1-3. (Accessed Sept. 2026).

See approved procedure code list.

SOURCE: IA Medicaid. Telehealth Approved Codes, 3/27/26, (Accessed Sept. 2026).

Please visit the Iowa Medicaid PHE unwind webpage for telehealth service codes continuing post-PHE. The effective date for the discontinued telehealth service codes is December 31, 2023. After this date, claims submitted with discontinued service codes, when billed as telehealth (place of service 02 or 10), will be denied.

SOURCE: IA Dep. of Human Services. Informational Letter No. 2457-MC-FFS, Jun. 2, 2023 (Effective Dec. 31, 2023), (Accessed Sept. 2026).

IA Medicaid covers teledentistry synchronous real time encounter.

SOURCE: IA Dep. of Human Services. Informational Letter No. 2124-MC-FFS, April 6, 2020, (Accessed Sept. 2026).

Please be aware that while some services such as teledentistry will continue after the PHE, billing requirements for some other services provided via telehealth may change when the PHE is lifted.

SOURCE: IA Dep. of Human Services. Informational Letter No. 2323-MC-FFS, Mar. 11, 2022 (Effective April 1, 2023), (Accessed Sept. 2026).

Pursuant to the authority of Iowa Code section 249A.4, HHS has amended the 1915(C) HCBS AIDS/HIV, Brain Injury (BI), Health and Disability (HD), Intellectual Disability (ID) and Physical Disability (PD) Waivers. The Centers for Medicaid and Medicare services approved these amendments on April 23, 2024, retroactive to November 1, 2023. As part of the amendments the Department has made the changes listed below to the waivers. …

“Telehealth” means the delivery of SCL services using real-time interactive audio and video, or other real-time interactive electronic media, regardless of where the health care professional and the covered person are each located.
“Telehealth” does not include the delivery of health care services delivered solely through an audio-only telephone, electronic mail message or facsimile transmission.
See letter for list of eligible codes.

SOURCE: IA Dep. of Human Services. Informational Letter No. 2588-MC-FFS, June 4, 2024, (Accessed Sept. 2026).

Case Management

Following the first three months, the Case Managers must complete at least one contact per month with the individual or their authorized representative. This contact may be face-to-face, virtual, or via telehealth.

All Case Managers must advise their individuals that face-to-face in-person contact in the individual’s place of residence is a requirement of HCBS eligibility. Individuals who have a medical condition or who reside with someone with a medical condition that warrants virtual or telehealth visits, the virtual/telehealth visit must be specifically requested by the individual or their authorized representative and must be supported by annual documentation from a physician attesting to the medical necessity of virtual/telehealth visits.

SOURCE: IA Dept of Human Services. Informational Letter No. 2695, July 17, 2025, (Accessed Sept. 2026).

Community Support Services (CSS)

Individual Peer Support, Family Peer Support or Recovery Coaching can be performed via telehealth or in person.

The list of approved telehealth services is found on the HHS Fee Schedule webpage.

SOURCE: Iowa Medicaid B3 Provider Manual (Guide) p. 16 & 28 (1/15/2026). (Accessed Sept. 2026).

Crisis Response Services & Subacute Mental Health Services

“Face-to-face” means services provided in person or using telehealth in conformance with the federal Health Insurance Portability and Accountability Act (HIPAA) privacy rules.

SOURCE: IA Dept of Human Services, Crisis Rsponse Services (May 1, 2018)., p. 19. & IA Dept. of Human Services, Subacute Mental Health Services (May 1, 2018), p. 9. (Accessed Sept. 2026).

ELIGIBLE PROVIDERS

The following providers may serve as the distant site provider:

Physicians
Nurse Practitioners
Physician Assistants
Nurse-Midwives
Clinical Nurse Specialists
Certified Registered Nurse Anesthetists
Clinical Psychologists
Clinical Social Workers
Federally Qualified Health Centers
Behavioral Health Service Providers
- Licensed Independent Social Workers
- Licensed Master Social Workers
- Licensed Marital and Family Therapists
- Licensed Mental Health Counselors
- Certified Alcohol and Drug Counselors

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2103-MC-FFS. (Feb. 20, 2020). (Accessed Sept. 2026).

ELIGIBLE SITES

All services delivered via telehealth audio or video must be included on the Iowa Medicaid approved and posted telehealth list, AND billed with one of the following POS codes:

02 – telehealth provided other than in the patient’s home
- The location where health services and health-related services are provided or received, through telecommunication technology. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
10 – telehealth provided in the patient’s home
- The location where health services and health-related services are provided or received through telecommunication technology. The patient is in their home (which is a location other than a hospital or other facility where the patient receives care) when receiving health services or health related services through telecommunication technology.

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2472-MC-FFS. (Sept. 11, 2023) & IA Depat of Health and Human Services, Telecommunications Technology Guide (3/27/2026), p. 3-4. (Accessed Sept. 2026).

Effective for the dates of service on or after December 1, 2025 a payment reduction will apply for services rendered in place of service (POS) codes 02 and 10 due to the site-of-service differential.

As indicated in Iowa Administrative Code: 441-79.1(7)b., the fee schedule amount paid to physicians is based on the most recent edition of Physician’s Current Procedural Terminology and will be reduced by an adjustment factor. The adjustment factor is determined by the department and published with the Iowa Medicaid fee schedule, to reflect the lower cost of providing services via ‘facility’ place of service opposed to a physician’s office. Telehealth facility place of service is POS 02.

All services delivered via telehealth audio or video must be included on the Iowa Medicaid approved and posted telehealth list, AND billed with one of the following POS codes:

02 – telehealth provided other than in the patient’s home
- The location where health services and health-related services are provided or received, through telecommunication technology. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
10 – telehealth provided in the patient’s home
- The location where health services and health-related services are provided or received through telecommunication technology. The patient is in their home (which is a location other than a hospital or other facility where the patient receives care) when receiving health services or health related services through telecommunication technology.

Implementation of Fee For Service claims will occur at a later date and additional guidance will be provided.

SOURCE: Iowa Dep of Human Services. Informational Letter 2711-MC, Dec. 9, 2025, (Accessed Sept. 2026).

The following locations may serve as the originating site:

The offices of physicians and other practitioners (psychologists, social workers, behavioral health providers, habilitation services providers, and advanced registered nurse practitioners (ARNPs)).
Hospitals
Critical Access Hospitals
Community Mental Health Centers
Federally Qualified Health Centers
Rural Health Clinics
Area Education Agencies (AEAs) and Local Education Agencies

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2103-MC-FFS. (Feb. 20, 2020). (Accessed Sept. 2026).

For the purpose of this provision, a “facility” place of service (POS) is defined as any of the following (consistent with “POS” definitions under Medicare, per the Medicare Claims Processing Manual, Chapter 12, Section 20.4.2, revised as of May 2017):

Telehealth (POS 02).

SOURCE: IA Statute 441.79.1, (Accessed Sept. 2026).

The Centers for Medicare and Medicaid (CMS) has added a new POS for telehealth to identify when individuals are receiving services via telehealth in their homes. Iowa Medicaid will adopt this POS effective April 1, 2022. The provider will bill the applicable Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) codes with POS code 02 (telehealth) if the member is receiving services anywhere other than home. The provider will bill the applicable HCPCS/CPT codes with POS code 10 (telehealth patient in home) if the member is in their home. An originating site charge will not be applicable with a POS code 10. However, a distant site charge may be applicable.

POS 02: Telehealth Provided Other than in Patient’s Home Descriptor: The location where health services and health-related services are provided or received, through telecommunication technology. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
POS 10: Telehealth Provided in Patient’s Home Descriptor: The location where health services and health-related services are provided or received through telecommunication technology. The patient is located in their home (which is a location other than a hospital or other facility where the patient receives care) when receiving health services or health related services through telecommunication technology.

SOURCE: IA Dep. of Human Services. Informational Letter No. 2323-MC-FFS, Mar. 11, 2022 (Effective April 1, 2023), (Accessed Sept. 2026).

Effective March 13, 2020, the site of service differential was removed from place of service 02 (please refer to Informational Letter 1815-MC-FFS2 [see below). As discussed during the April 27, 2023, provider town hall event, the site of service differential with the place of service 02 and 10 will not be applied to telehealth claims.

SOURCE: IA Dep. of Human Services. Informational Letter No. 2457-MC-FFS, Jun. 2, 2023 (Effective Dec. 31, 2023), (Accessed Sept. 2026).

POS code 02 is defined as, “the location where health services and health related services are provided or received, through a telecommunication system”. POS code 02 is used to report that a billed service was furnished as a telehealth service from a distant site. The only portion that is considered telehealth services is when the patient was present and interacting with the distant site physician or practitioner.

An originating site is the location of a Medicaid member at the time the telehealth service is furnished. CMHCs can be an originating site. Other originating sites can include: physician offices, hospitals, and critical access hospitals (CAHs). The “telehealth” POS code (i.e., “02”) would not be used by an originating site that can bill a facility fee (i.e., Q3014), instead the originating site would continue to use the POS code that applies to the type of facility where the patient is located. Under these circumstances, a CMHC would bill POS 53 (CMHC).

CMHCs billing for services under the CMHC provider category will not have payments cut back for the SoS differential, in cases where the service is provided at POS 02 (Telehealth). Consistent with the immediately preceding paragraph, the “distant” provider would bill POS 02 for the telehealth service and the CMHC would bill POS 53. In these cases, under Medicaid, there is no separate facility bill to account for the overhead, and therefore no SoS cut would be taken, consistent with the intent of this policy.

SOURCE: IA Dep. of Human Services. Informational Letter No. 1815-MC-FFS, Aug. 10, 2017, (Accessed Sept. 2026).

GEOGRAPHIC LIMITS

No Reference Found

FACILITY/TRANSMISSION FEE

Originating sites are paid a facility fee for telehealth services. FQHCs and RHCs would not bill Q3014 as a separate service because reimbursement for the related costs would occur through the annual cost settlement process.

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2103-MC-FFS. (Feb. 20, 2020). (Accessed Sept. 2026).

Last updated 09/18/2026

Miscellaneous

Requirements to use In-patient Telemedicine (Beginning May 1, 2026)

A private quiet space to ensure provisional HIPAA compliance.
A guarantee of stable internet connection to complete the assessment.
All Video Conferencing Software including Transmission Equipment is High Quality Medical Grade.Video Camera, Microphones, Headsets, Speakers, touchscreens (any audio devices) are high quality for interactive compacity.
All high-quality medical grade assessment equipment such as BP cuffs, glucometers, digital stethoscopes, otoscopes, scales, etc. are internet compatible.

Documentation, the record of the provided services:

As always, documentation may and will be audited at any time.

If a post payment audit is conducted and the record does not meet the expectations of the documentation for the level of reimbursement previously paid, the recoupment may occur.

Documentation requirements:

Clearly explain why this Telemedicine Visit needed to be completed by using digital communication technologies.
The provider completing the real-time, interactive, Telemedicine Visit, will record the results and responses identified from the Telemedicine tools in the patient record.
The patient record will identify all of the requirements of the code for which it is being submitted for reimbursement.
Documentation will occur during the Telemedicine Visit.

Q&A:

Can we just do Telemedicine visits if the provider is in the hospital on a different unit?

If it is at all possible to have the visit be conducted in person, the visit should be in person.

Do we have to use a Telemedicine Cart?

Telemedicine Cart is not required, but encouraged, as these ‘all in one’ mobile workstations are designed to contain all the transmission and assessment equipment in one location.

If this patient is seen in the ED and then admitted using the telemedicine how does the claim submission different than when we use in-person visits?

If the patient is seen in the hospital emergency department and then admitted to the hospital, the initial hospital care code is used with the admission to the hospital the fee schedule identifies the established rate of reimbursement.

Is a consultation by a specialist considered an initial visit or subsequent visit?

When the initial visit has been completed buy a provider, and a specialist is consulted, the specialist consultation is a subsequent visit, .

If a patient has had a visit in the office and then the same provider admits the patient as an inpatient, how is this billed with Telemedicine?

An office visit code and an initial hospital care code should be used, with appropriate modifiers to indicate the unrelated nature of the services.

SOURCE: IA Health and Human Services, Telecommunications Technology Guide (3/27/2026), p. 4-6. (Accessed Sept. 2026).

Last updated 09/18/2026

Out of State Providers

No Reference Found

Last updated 09/18/2026

Overview

Iowa Medicaid pays for telehealth, including audio-only interactions, for certain service codes as long as it meets accepted health care practices and standards. Managed care plans in Iowa’s Healthy and Well Kids in Iowa (Hawki) program, may cover telehealth and telemonitoring services, but do not appear to be mandated. Asynchronous telehealth for teledentistry is covered.

A list of approved reimbursable codes for telehealth in Iowa Medicaid is available and includes a variety of monitoring codes, such as remote physiologic and therapeutic codes, as well as specific codes covering services provided via phone and store-and-forward (i.e. e-visits). Additionally, there is a column in the code list that generally identifies codes eligible for audio-only reimbursement.

Last updated 09/18/2026

Remote Patient Monitoring

POLICY

Remote physiologic monitoring codes are included as permanent codes in Medicaid’s approved telehealth codes list.

SOURCE: IA Medicaid. Telehealth Approved Codes, 3/26/26, (Accessed Sept. 2026).

CONDITIONS

No Reference Found

PROVIDER LIMITATIONS

No Reference Found

OTHER RESTRICTIONS

No Reference Found

Last updated 09/18/2026

Store and Forward

POLICY

No Reference Found

ELIGIBLE SERVICES/SPECIALTIES

Certain communication technology-based codes that include store and forward (such as online digital evaluation and management services, or ‘e-visits’) are included as permanent codes in Medicaid’s approved telehealth codes list.

SOURCE: IA Medicaid. Telehealth Approved Codes, 3/26/26, (Accessed Sept. 2026).

All Iowa Medicaid recipients are eligible to receive services via asynchronous teledentistry. See informational letter for billing codes.

SOURCE: Informational Letter 2224-MC-FFS-D-CVD “Asynchronous Teledentistry” (3/15/2021) (Accessed Sept. 2026)

GEOGRAPHIC LIMITS

No Reference Found

TRANSMISSION FEE

No Reference Found

Professional Requirements

Last updated 09/22/2026

Consent Requirements

The parent or guardian of a student shall consent prior to the student receiving behavioral health services via telehealth under this chapter after a provider-patient relationship is established pursuant to this section. The school district shall maintain any such consent form completed by a parent or guardian.

SOURCE: IA Code Title VII Subtitle 6 Chapter 280A.3, (Accessed Sept. 2026).

Medicine & Physician Assistants

A licensee who uses telemedicine shall ensure that the patient provides appropriate informed consent for the medical services provided, including consent for the use of telemedicine to diagnose and treat the patient, and that such informed consent is timely documented in the patient’s medical record.

See rule for more information about how professions must disclose limitations about telemedicine.

SOURCE: SOURCE: IA Admin Code Sec. 481-655.9 & Sec. 481-781.6. (Accessed Sept. 2026).

Speech Pathology and Audiology

Prior to the first telehealth visit, a licensee will obtain informed consent from the patient specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent will specifically inform the patient of the following:

The risks and limitations of the use of technology to provide speech pathology or audiology services;
The potential for unauthorized access to protected health information; and
The potential for disruption of technology during a telehealth visit.

SOURCE: Iowa Admin Code, Sec. 481-741.1, (Accessed Sept. 2026).

Board of Dietetics

Prior to the first telehealth visit, a licensee is to obtain informed consent from the individual or group specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the individual or group of the following:

The risks and limitations of the use of technology to provide dietetics services;
The potential for unauthorized access to protected health information; and
The potential for disruption of technology during a telehealth visit.

SOURCE: Iowa Admin Code Sec. 481-921.10. (Accessed Sept. 2026).

Hearing Aid Specialists

Prior to the first telehealth appointment with a client, the licensee will obtain informed consent from the client that is specific to the service or services that will be provided in the telehealth appointment. The informed consent will specifically inform the client of, at a minimum, the following:

The risks and limitations of the use of technology to the specific service;
The potential for unauthorized access to protected health information; and
The potential for disruption of technology during a telehealth appointment.

SOURCE: Iowa Admin Code, Sec. 481-2062.5, (Accessed Sept. 2026).

Nursing – ARNPs

Prior to providing services via telehealth, the licensee shall obtain consent from the patient, or the patient’s legal guardian or legal representative, to receive services via telehealth.

SOURCE: IA Admin Code Sec. 481-621.9, (Accessed Sept. 2026).

Nursing – Midwives

Prior to providing services via telehealth, the CPM shall obtain consent from the client, or the client’s legal guardian or legal representative, to receive services via telehealth

SOURCE: IA Admin Code Sec. 481-623.7, (Accessed Sept. 2026).

Physical/Occupational Therapy

Prior to the first telehealth visit, a licensee shall obtain informed consent from the patient specific to the physical therapy services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the patient of the following:

The risks and limitations of the use of technology to provide physical therapy services;
The potential for unauthorized access to protected health information; and
The potential for disruption of technology during a telehealth visit.

SOURCE: IA Admin Code Sec. 481-801.3 & 481-806.3, (Accessed Sept. 2026).

Teledentistry

When teledentistry will be utilized, a dentist, in addition to the requirements of rule 481—574.8(153), is responsible for ensuring informed consent covers the following:

A description of the types of dental care services provided via teledentistry, including limitations on services;
The identity, contact information, practice location, licensure, credentials, and qualifications of all licensees and registrants involved in the patient’s dental care, which should be publicly displayed on a website or provided in writing to the patient; and
Precautions for technological failures or emergency situations.

SOURCE: Iowa Admin Code, Sec. 481-574.10, (Accessed Sept. 2026).

Psychology

A psychologist may practice telepsychology provided the following are met:

The psychologist must be licensed or be exempt from licensure in the jurisdiction where the patient or examinee is located.
Prior to initiating telepsychology with a new patient or examinee, a psychologist will take reasonable steps to verify the identity and location of the patient or examinee.
A psychologist will ensure informed consent for telepsychology includes a description of any limitations of services as a result of the technology utilized.
A psychologist will gain competency in the use of a particular technology prior to utilizing it in practice. A psychologist shall only use technologies that are secure and functioning properly.
A psychologist will apply the same ethical and professional standards of care and professional practice that are required when providing in-person psychological services. If the same standard of care cannot be met with telepsychology, a psychologist will not utilize telepsychology.

SOURCE: Iowa Admin Code, Sec. 481-884.2, (Accessed Sept. 2026).

If a client has difficulty communicating, a social worker will attempt to ensure the client’s comprehension. This may include providing the client with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible. A social worker will provide information in a manner that is understandable and culturally appropriate for the client. Clients will be given sufficient opportunity to ask questions and receive answers about social work services, including electronic delivery of services, if appropriate.

The provision of social work services to an individual in this state through any electronic means, including the Internet, telephone, or the Iowa communications network or any fiberoptic media, regardless of the location of the social worker, constitutes the practice of social work in the state of Iowa and will be subject to regulation in accordance with Iowa Code chapters 147 and 154C and the administrative rules of the board. A social worker who provides services via electronic media will inform recipients of the limitations and risks associated with such services.

A social worker will obtain a client’s informed consent before audiotaping or videotaping the client or permitting a third party to observe services provided to the client.

A social worker will develop policies regarding the sharing, retention, and storage of digital and other electronic communications and records and will inform clients of applicable policies.

SOURCE: Iowa Admin Code Sec. 481-884.4. (Accessed Sept. 2026).

Last updated 09/22/2026

Cross State Licensing

Persons considered not engaged in practice: Physicians and surgeons or osteopathic physicians and surgeons of the United States army, navy, air force, marines, public health service, or other uniformed service when acting in the line of duty in this state, and holding a current, active permanent license in good standing in another state, district, or territory of the United States, or physicians and surgeons or osteopathic physicians and surgeons licensed in another state, when incidentally called into this state in consultation with a physician and surgeon or osteopathic physician and surgeon licensed in this state.

SOURCE: Iowa Code, Ch. 148.2 (2026 Edition p. 1362), (Accessed Sept. 2026).

Medicine

A physician who uses telemedicine in the diagnosis and treatment of a patient located in Iowa shall hold an active Iowa medical license consistent with state and federal laws. Nothing in this rule shall be construed to supersede the exceptions to licensure contained in 481—subrule 652.2(2).

SOURCE: IA Admin Code Sec. 481-655.9(3), (Accessed Sept. 2026).

Physician Assistants

License Required: A physician assistant who uses telemedicine in the diagnosis and treatment of a patient located in Iowa will hold an active Iowa physician assistant license consistent with state and federal laws. Nothing in this rule will be construed to supersede the exceptions to licensure contained in rule 481—780.17(148C).

SOURCE: Iowa Admin Code, Sec. 481-781.6(4) (Accessed Sept. 2026).

Hearing Aid Specialists

Conducting a telehealth appointment with a client who is physically located in Iowa during the appointment, regardless of the location of the hearing aid specialist, requires Iowa licensure.

SOURCE: Iowa Admin Code, Sec. 481-2062.5, (Accessed Sept. 2026).

Nursing – Registered Nurses/Licensed Practical Nurses

A registered nurse or licensed practical nurse who provides services through telehealth to a patient physically located in Iowa must hold an active license issued by the board or have an active privilege to practice in Iowa pursuant to the nurse licensure compact.

SOURCE: IA Admin Code Sec. 481-620.4, (Accessed Sept. 2026).

Board of Nursing – ARNP

An advanced registered nurse practitioner who provides services through telehealth to a patient physically located in Iowa must be licensed by the board. A licensee who provides services through telehealth to a patient physically located in another state shall be subject to the laws and jurisdiction of the state where the patient is physically located.

SOURCE: IA Admin Code Sec. 481-621.9, (Accessed Sept. 2026).

Board of Nursing – Midwives

A CPM who provides services through telehealth to a client physically located in Iowa must be licensed by the board. A CPM who provides services through telehealth to a client physically located in another state shall be subject to the laws and jurisdiction of the state where the client is physically located.

SOURCE: IA Admin Code Sec. 481-623.7, (Accessed Sept. 2026).

Dietitian

Any licensee who provides a telehealth visit to an individual or a group located in Iowa shall be licensed in Iowa

SOURCE: Iowa Admin Code Sec. 481-921.10. (Accessed Sept. 2026).

Occupational Therapy

Any occupational therapist or occupational therapy assistant who provides an occupational therapy telehealth visit to a patient located in Iowa shall be licensed in Iowa.

SOURCE: IA Admin Code 481-806.3, (Accessed Sept. 2026).

Physical Therapy

Any physical therapist or physical therapist assistant who provides a physical therapy telehealth visit to a patient located in Iowa shall be licensed in Iowa or have a compact privilege issued by the physical therapy compact commission.

SOURCE: IA Admin Code Sec. 481-801.3 (Accessed Sept. 2026).

Speech Language Pathology/Audiology

Speech pathology or audiology services in Iowa through telephonic, electronic, or other means constitute the practice of speech pathology or audiology and require Iowa licensure, regardless of the location of the speech/language pathologist or audiologist.

SOURCE: Iowa Admin Code, Sec. 481-741.1, (Accessed Sept. 2026).

Teledentistry

Only dentists, dental hygienists, or dental assistants currently licensed or registered by the board may use teledentistry to provide dental care to patients located in Iowa.

SOURCE: Iowa Admin Code, Sec. 481-574.10, (Accessed Sept. 2026).

Psychology

A psychologist may practice telepsychology provided the following are met:

The psychologist must be licensed or be exempt from licensure in the jurisdiction where the patient or examinee is located.

SOURCE: Iowa Admin Code, Sec. 481-884.2(4), (Accessed Sept. 2026).

Last updated 09/18/2026

Definitions

Telecommunications and Technology Commission

“Telemedicine means use of a telecommunications system for diagnostic, clinical, consultative, data, and educational services for the delivery of health care services or related health care activities by licensed health care professionals, licensed medical professionals, and staff who function under the direction of a physician, a licensed health care professional, or hospital, for the purpose of developing a comprehensive, statewide telemedicine network or education.”

SOURCE: IA Admin. Code, 751 7.1(8D). (Accessed Sept. 2026).

Multiple Professions Regulations

“Asynchronous store-and-forward transmission” means the collection of a patient’s relevant health information and the subsequent transmission of the data from an originating site to a health care provider at a distant site without the presence of the patient.

“Telemedicine” means the practice of medicine using electronic audiovisual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telemedicine includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telemedicine, for the purposes of this rule establishing standards of practice, does not include the provision of medical services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof.

SOURCE: Iowa Admin Code, 481, Sec. 655.9, & Sec. 481-781.6, [listed in multiple other sections], (Accessed Sept. 2026).

Registered Nurses & APRNs

“Telehealth” means the practice of nursing using electronic audiovisual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telehealth includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telehealth, for the purposes of this rule, does not include the provision of nursing services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof.

SOURCE: IA Admin Code 481-620.1, & IA Admin Code Sec. 481-621.1 (Accessed Sept. 2026).

Psychologists

“Telepsychology” means the provision of psychological services using telecommunication technologies.

SOURCE: Iowa Admin Code, Sec. 481-884.1, (Accessed Sept. 2026).

Physical & Occupational Therapy

Telehealth visit means the provision of occupational/physical therapy services by a licensee to a patient using technology where the licensee and the patient are not at the same physical location for the physical/occupational therapy session.

SOURCE: IA Admin Code Sec. 481-801.3 & 481-806.3, (Accessed Sept. 2026).

Dietitians

“Telehealth visit” means the provision of dietetic services by a licensee to an individual or a group using technology where the licensee and the individual or group are not at the same physical location for the therapy session.

SOURCE: Iowa Admin Code Sec. 481-921.10. (Accessed Sept. 2026).

Speech Pathology and Audiology

“Telehealth visit” means the provision of speech pathology or audiology services by a licensee to a patient using technology where the licensee and the patient are not at the same physical location during the appointment.

SOURCE: Iowa Admin Code, Sec. 481-741.1, (Accessed Sept. 2026).

Hearing Aid Dispenser

A “telehealth appointment” is one wherein the licensee provides testing or adjustment services to a client using technology where the hearing aid specialist and the client are not at the same physical location during the appointment.

SOURCE: Iowa Admin Code, Sec. 481-2062.5, (Accessed Sept. 2026).

Teledentistry

“Teledentistry” means a dentist is providing or supervising dental services using technology when the patient is in another location.

SOURCE: Iowa Admin Code, Sec. 481-574.10, (Accessed Sept. 2026).

Accreditation of Providers of Services to Persons with Mental Illness, Intellectural Disabiliteis, or Development Disabilities

“Telehealth” is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

SOURCE: Iowa Admin Code, Sec. 441-24.1 (Accessed Sept. 2026).

Last updated 09/23/2026

Licensure Compacts

Member of Audiology and Speech Language Pathology Interstate Compact.

SOURCE: ASLP-IC Compact, Compact Map, (Accessed Sept. 2026).

Member of Counseling Compact.

SOURCE: Counseling Compact, Compact Map, (Accessed Sept. 2026).

Member of Dentist and Dental Hygienist Compact

SOURCE: Dentist and Dental Hygienist Compact, Compact Map, (Accessed Sept. 2026).

Member of Dietitian Compact

SOURCE: Dietitians Compact, Compact Map, (Accessed Sept. 2026).

Member of the EMS Compact.

SOURCE: Interstate Commission for EMS Personnel Practice. The EMS Compact. (Accessed Sept. 2026).

Member of the Interstate Medical Licensure Compact.

SOURCE: Interstate Medical Licensure Compact. The IMLC. (Accessed Sept. 2026).

Member of Nurse Licensure Compact.

SOURCE: Nurse Compact. NCSBN. (Accessed Sept. 2026).

Member of Occupational Therapy Licensure Compact.

SOURCE: Occupational Therapy Compact, Compact Map, (Accessed Sept. 2026).

Member of Physician Assistant Compact

SOURCE: PA Compact, Compact Map, (Accessed Sept. 2026).

Member of Physical Therapy Compact.

SOURCE: Physical Therapy Compact. Compact Map. (Accessed Sept. 2026).

Member of Respiratory Care Interstate Compact

SOURCE: Respiratory Care Interstate Compact, Compact Map, (Accessed Sept. 2026).

Member of Social Worker Compact

SOURCE: Social Work Compact, Compact Map, (Accessed Sept. 2026).

Member of the Athletic Trainer Compact

SOURCE: Athletic Trainer Compact Map. (Accessed Sept. 2026).

* See Compact websites for implementation and license issuing status and other related requirements.

Last updated 09/22/2026

Miscellaneous

The following persons and entities may use or access the network for data and video services including access to the Internet if the use is for telemedicine or educational purposes:

Licensed health care professionals or licensed health care professionals who function under the direction of or in collaboration with a physician or a hospital, or both, for example, other doctors, students, nurses, physician’s assistants, therapists, clinical social workers, psychologists;
Hospital or physician clinic staff members;
Professional boards on which health professionals serve, for example, a nurse serving on the board of the American Cancer Society;
Patients acting under the direction of a licensed health care professional;
Health care employees of facilities that have a contractual agreement with the hospital or physician;
Health care employees of facilities that do not have a contractual agreement with the hospital or physician clinic;
Employees of health care associations for various health care employees, for example, Association of Iowa Hospitals and Health Systems, Iowa Medical Society, Iowa Osteopathic Medical Association, Iowa Chiropractic Society, Iowa Nurses Association;
Professional board members where a health care professional serves as a member of a board, for example, a physician serving on the board of the American Cancer Society

SOURCE: IA Admin. Code, 751 7.11(8D). (Accessed Sept. 2026).

Level II maternal care hospital. … Types of health care providers. In addition to meeting the health care provider requirements of a Level I maternal care hospital, a Level II maternal care hospital will have: …

Access to a maternal-fetal medicine subspecialist for consultation, available on site, by telephone, or by telemedicine as needed.

Level III maternal care hospital. Provider of subspecialty care. A Level III maternal care hospital provides care to women that includes all Level I and Level II services and has subspecialists available on site, by telephone, or by telemedicine to assist in providing care for more complex maternal and fetal conditions.

Types of health care providers. In addition to meeting the health care provider requirements of a Level II maternal care hospital, a Level III maternal care hospital will have: …

A maternal-fetal medicine subspecialist with inpatient privileges, available at all times, either on site, by telephone, or by telemedicine.

Level II neonatal care hospital. Medical personnel. In addition to having the medical personnel of a Level II neonatal care hospital, a Level III neonatal care hospital will …

Provide prompt and readily available access to the following, either on site or by prearranged consultative agreement. Using telemedicine technology or telephone consultation, a prearranged consultation can be performed from a distant location by:
- Pediatric medical subspecialists,
- A pediatric surgical specialist,
- A pediatric anesthesiologist, and
- A pediatric ophthalmologist.

SOURCE: IA Admin. Code, 641-150.6 to 150.8. (Accessed Sept. 2026).

Last updated 09/22/2026

Online Prescribing

Generally, a licensee shall perform an in-person medical interview and physical examination for each patient. However, the medical interview and physical examination may not be in-person if the technology utilized in a telemedicine encounter is sufficient to establish an informed diagnosis as though the medical interview and physical examination had been performed in-person. Prior to providing treatment, including issuing prescriptions, electronically or otherwise, a licensee who uses telemedicine shall interview the patient to collect the relevant medical history and perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. An Internet questionnaire that is a static set of questions provided to the patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview, does not constitute an acceptable medical interview and physical examination for the provision of treatment, including issuance of prescriptions, electronically or otherwise, by a licensee.

Under the following circumstances, whether or not such circumstances involve the use of telemedicine, a licensee may treat a patient who has not been personally interviewed, examined and diagnosed by the licensee:

Situations in which the licensee prescribes medications on a short-term basis for a new patient and has scheduled or is in the process of scheduling an appointment to personally examine the patient;
For institutional settings, including writing initial admission orders for a newly hospitalized patient;
Call situations in which a licensee is taking call for another licensee who has an established physician-patient relationship with the patient;
Cross-coverage situations in which a licensee is taking call for another licensee who has an established physician-patient relationship with the patient;
Situations in which the patient has been examined in person by an advanced registered nurse practitioner or a physician assistant or other licensed practitioner with whom the licensee has a supervisory or collaborative relationship;
Emergency situations in which the life or health of the patient is in imminent danger;
Emergency situations that constitute an immediate threat to the public health including but not limited to empiric treatment or prophylaxis to prevent or control an infectious disease outbreak;
Situations in which the licensee has diagnosed a sexually transmitted disease in a patient and the licensee prescribes or dispenses antibiotics to the patient’s named sexual partner(s) for the treatment of the sexually transmitted disease as recommended by the U.S. Centers for Disease Control and Prevention; and
For licensed or certified nursing facilities, residential care facilities, intermediate care facilities, assisted living facilities and hospice settings.

Prescribing to a patient based solely on an Internet request or Internet questionnaire (i.e., a static questionnaire provided to a patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview) is prohibited. Absent a valid physician-patient relationship, a licensee’s prescribing to a patient based solely on a telephonic evaluation is prohibited, with the exception of the circumstances described in subrule 655.9(20).

SOURCE: IA Admin Code Sec. 481-655.9(8) & (20) (Accessed Sept. 2026).

A physician shall not induce an abortion by providing an abortion-inducing drug unless the physician has first reviewed the lab results, ultrasound images, and medical history provided by the patient to determine, and document in the woman’s medical record, the gestational age and intrauterine location of the pregnancy. A physician may utilize telemedicine pursuant to rule 481—655.9(147,148,272C).

SOURCE: IA Admin. Code, 481-655.8, (Accessed Sept. 2026).

Specific requirements apply for mental health professionals establishing a provider-patient relationship in a school-based setting. See full law text for details.

A mental health professional with prescribing authority who provides telehealth services in accordance with this section shall not prescribe any new medication to a student during a telehealth session. However, a mental health professional with prescribing authority may initiate new prescriptions, alter the dosage of an existing medication, or discontinue an existing medication for the treatment of the student’s behavioral health condition after consultation with the student’s parent or guardian.

SOURCE: IA Code Chapter 280A.4 (Accessed Sept. 2026).

If a mental health professional provides behavioral health services via telehealth on school/AEA premises, the mental health professional will first establish a valid provider-patient relationship. The provider-patient relationship is established when:

The student, with the consent of the student’s parent or guardian when the student has not yet reached the age of majority, seeks help from a mental health professional;
The mental health professional agrees to provide treatment of the student; and
The student’s parent or guardian agrees to have the student treated by the mental health professional.

If a provider-patient relationship is established and the student has not yet reached the age of majority, parent or guardian consent will be obtained prior to the student receiving behavioral health services via telehealth in a school or AEA setting and is necessary each academic year that the student receives telehealth services.

SOURCE: IA Admin Code 281.14.22, (Accessed Sept. 2026).

Behavioral health services provided via telehealth in a school setting: Iowa Code section 280A.4 is incorporated by this reference.

[see code above]

SOURCE: IA Admin Code 281.14.23, (Accessed Sept. 2026).

Physician Assistant-Patient Relationship

A licensee who uses telemedicine will establish a valid physician assistant-patient relationship with the person who receives telemedicine services. The physician assistant-patient relationship begins when:

The person with a health-related matter seeks assistance from a licensee;
The licensee agrees to undertake diagnosis and treatment of the person; and
The person agrees to be treated by the licensee whether or not there has been an in-person encounter between the physician assistant and the person.

A valid physician assistant-patient relationship may be established by:

In-person encounter. Through an in-person medical interview and physical examination where the standard of care would require an in-person encounter;
Consultation with another licensee. Through consultation with another licensee (or other health care provider) who has an established relationship with the patient and who agrees to participate in, or supervise, the patient’s care; or
Telemedicine encounter. Through telemedicine, if the standard of care does not require an in-person encounter, and in accordance with evidence-based standards of practice and telemedicine practice guidelines that address the clinical and technological aspects of telemedicine.

Generally, a licensee will perform an in-person medical interview and physical examination for each patient. However, the medical interview and physical examination may not be in person if the technology utilized in a telemedicine encounter is sufficient to establish an informed diagnosis as though the medical interview and physical examination had been performed in person. Prior to providing treatment, including issuing prescriptions, electronically or otherwise, a licensee who uses telemedicine will interview the patient to collect the relevant medical history and perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. An Internet questionnaire that is a static set of questions provided to the patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview, does not constitute an acceptable medical interview and physical examination for the provision of treatment, including issuance of prescriptions, electronically or otherwise, by a licensee.

See rule for circumstances where the standard of care may not require a licensee to personally interview or examine a patient.

Prescribing to a patient based solely on an internet request or internet questionnaire (i.e., a static questionnaire provided to a patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview) is prohibited. Absent a valid physician associate-patient relationship, a licensee’s prescribing to a patient based solely on a telephonic evaluation is prohibited, with the exception of the circumstances described in subrule 781.9(21).

SOURCE: Iowa Admin Code, Sec. 481-781.6, (Accessed Sept. 2026).

Nursing – ARNPs

Prior to providing services through telehealth, the licensee shall first establish a practitioner-patient relationship. A practitioner-patient relationship is established when:

The person with a health-related matter seeks assistance from the licensee;
The licensee agrees to provide services; and
The person agrees to be treated, or the person’s legal guardian or legal representative agrees to the person’s being treated, by the licensee regardless of whether there has been a previous in-person
encounter between the licensee and the person.

A practitioner-patient relationship can be established through an in-person encounter, consultation with another licensee or health care provider, or telehealth encounter.

Notwithstanding paragraphs 621.9(5) “a” and “b,” services may be provided through telehealth without first establishing a practitioner-patient relationship in the following settings or circumstances:

Institutional settings;
Licensed or certified nursing facilities, residential care facilities, intermediate care facilities, assisted living facilities, and hospice settings;
In response to an emergency or disaster;
Informal consultations with another health care provider performed by a licensee outside of the context of a contractual relationship, or on an irregular or infrequent basis, without the expectation or exchange of direct or indirect compensation;
Episodic consultations by a specialist located in another jurisdiction who provides consultation services upon request to a licensee;
A substitute licensee acting on behalf and at the designation of an absent licensee or other health care provider in the same specialty on an on-call or cross-coverage basis; or
When a sexually transmitted disease has been diagnosed in a patient, a licensee prescribes or dispenses antibiotics to the patient’s named sexual partner(s) for the treatment of the sexually transmitted disease as recommended by the U.S. Centers for Disease Control and Prevention.

A licensee providing services through telehealth may issue a prescription to a patient as long as the issuance of such prescription is consistent with the standard of care applicable to the in-person setting.

SOURCE: IA Admin Code Sec. 481-621.9, (Accessed Sept. 2026).

Nursing – Midwives

Prior to initiating contact with a client for the purpose of providing services to the client using telehealth, a CPM shall:

Review the client’s history and all relevant medical records; and
Determine as to each unique client encounter whether the CPM will be able to provide the same standard of care using telehealth as would be provided if the services were provided in person

Prior to providing services through telehealth, the CPM shall first establish a CPM-client relationship. A CPM-client relationship is established when:

The client seeks assistance from the CPM;
The CPM agrees to provide services; and
The client agrees to be treated, or the client’s legal guardian or legal representative agrees to the client being treated, by the CPM regardless of whether there has been a previous in-person encounter between the CPM and the client.

A CPM-client relationship can be established through an in-person encounter, consultation with another CPM or health care provider, or telehealth encounter.

Notwithstanding paragraphs 623.7(5)“a” and “b,” services may be provided through telehealth without first establishing a CPM-client relationship in the following settings or circumstances:

In response to an emergency or disaster;
Via informal consultations with another health care provider performed by a CPM outside of the context of a contractual relationship, or on an irregular or infrequent basis, without the expectation or
exchange of direct or indirect compensation;
A substitute CPM acting on behalf and at the designation of an absent CPM in the same specialty on an on-call or cross-coverage basis

SOURCE: IA Admin Code Sec. 481-623.7, (Accessed Sept. 2026).

A licensee under the purview of the board who provides treatment for the correction of malpositions of human teeth or the initial use of orthodontic appliances shall not begin orthodontic treatment on a new patient unless one of the following conditions is met:

The licensee performs an initial in-person or teledentistry examination of the teeth and supporting structures of the new patient prior to beginning orthodontic treatment.
The new patient provides the licensee with the portion of the dental record taken within the prior six months of an in-person or teledentistry examination of the teeth and supporting structures of the new patient prior to the licensee beginning orthodontic treatment.

SOURCE: Iowa Annotated Statute Sec. 153.24, (Accessed Sept. 2026).

Teledentistry

A dentist may not provide teledentistry services to a patient based solely on the responses to an electronic questionnaire consisting of a static set of questions.

When teledentistry will be utilized, a dentist, in addition to the requirements of rule 481—574.8(153), is responsible for ensuring informed consent covers the following:

A description of the types of dental care services provided via teledentistry, including limitations on services;
The identity, contact information, practice location, licensure, credentials, and qualifications of all licensees and registrants involved in the patient’s dental care, which should be publicly displayed on a website or provided in writing to the patient; and
Precautions for technological failures or emergency situations.

SOURCE: Iowa Admin Code, Sec. 481-574.10, (Accessed Sept. 2026).

Opioid Treatment Program

The screening and full examination may be completed via telehealth for those patients being admitted for treatment at the OTP with either buprenorphine or methadone if a practitioner or primary care provider determines that an adequate evaluation of the patient can be accomplished via telehealth. When using telehealth, the following caveats apply:

In evaluating patients for treatment with Schedule II medications (such as methadone), audiovisual telehealth platforms must be used, except when not available to the patient, in which case, it is acceptable to use audio-only devices but only when the patient is in the presence of a licensed practitioner who is registered to prescribe (including dispense) controlled medications. The OTP practitioner shall review the examination results and order treatment medications as indicated.
In evaluating patients for treatment with Schedule III medications or medications not classified as a controlled medication, audiovisual or audio-only platforms may be used. The OTP practitioner shall review the examination results and order treatment medications as indicated.

SOURCE: Iowa Admin Code Sec 641-155.1. (Accessed Sept. 2026).

Last updated 09/22/2026

Professional Boards Standards

Board of Dentistry

SOURCE: Iowa Admin Code, Sec. 481-574.10, (Accessed Sept. 2026).

IA Board of Medicine

SOURCE: IA Admin Code Sec. 481-655.9, (Accessed Sept. 2026).

IA Board of Physical and Occupational Therapists

SOURCE: IA Admin Code Sec. 481-801.3 & 481-806.3, (Accessed Sept. 2026).

IA Board of Nursing

SOURCE: IA Admin Code Sec. 481-620.4, (Accessed Sept. 2026).

IA Board of Dietetics

SOURCE: Iowa Admin Code Sec. 481-921.10. (Accessed Sept. 2026).

Education Department Standards

SOURCE: IA Code 281.14.22, (Accessed Sept. 2026).

Board of Physician Associates

SOURCE: Iowa Admin Code, Sec. 481-781.6, (Accessed Sept. 2026).

Board of Speech Pathology and Audiology

SOURCE: Iowa Admin Code, Sec. 481-741.1, (Accessed Sept. 2026).

Hearing Aid Specialists

SOURCE: Iowa Admin Code, Sec. 481-2062.5, (Accessed Sept. 2026).

Board of Nursing – ARNP

SOURCE: IA Admin Code Sec. 481-621.9, (Accessed Sept. 2026).

Board of Nursing – Midwives

SOURCE: IA Admin Code Sec. 481-623.7, (Accessed Sept. 2026).

Board of Psychology

SOURCE: Iowa Admin Code, Sec. 481-884.2, (Accessed Sept. 2026).

Social Workers

SOURCE: Iowa Admin Code Sec. 481, Sec. 884.4, (Accessed Sept. 2026).

Telepharmacy

SOURCE: Iowa Admin Code Sec. 481-552.18. (Accessed Sept. 2026).

Registered Nurses/LIcensed Practical Nurses

SOURCE: Iowa Admin Code Sec. 481-620.4. (Accessed Sept. 2026).

Federally Qualified Health Center (FQHC)

Last updated 09/18/2026

Definition of Visit

No reference found.

Last updated 09/18/2026

Eligible Distant Site

FQHCs may serve as distant sites.

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2103-MC-FFS. (Feb. 20, 2020). (Accessed Sept. 2026).

See: IA Medicaid Live Video Distant Sites

Last updated 09/18/2026

Eligible Originating Site

FQHCs may serve as originating sites.

See: IA Medicaid Live Video Eligible Sites

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2103-MC-FFS. (Feb. 20, 2020). (Accessed Sept. 2026).

Last updated 09/18/2026

Facility Fee

FQHCs and RHCs would not bill Q3014 as a separate service because reimbursement for the related costs would occur through the annual cost settlement process.

SOURCE: Iowa Dep. of Human Services. Informational Letter No. 2103-MC-FFS. (Feb. 20, 2020). (Accessed Sept. 2026).

Last updated 09/18/2026

Home Eligible

FQHC services are provided to members who are patients of the center. Therefore, these services are reimbursable when furnished to a member at the center, at a hospital or other medical facility, or at the member’s place of residence, when the physician is compensated for the services by the center.

Physician Services

Covered services performed by a physician outside the center, including services to members in an inpatient hospital, are also covered FQHC services if the physician is compensated for the services by the center.

SOURCE: IA Department of Human Services, Provider Specific Policies Ch. III: Federally Qualified Health Centers, June 1, 2014, Pg. 32 & 44 (Accessed Sept. 2026).

Last updated 09/18/2026

Modalities Allowed

Live Video

FQHCs are listed as both an originating and distant site for live video telehealth services in an Informational Bulletin.

See: IA Medicaid Program Live Video

Store-and-Forward

An informational letter that includes FQHCs allows asynchronous teledentistry.

See: IA Medicaid Program Store-and-forward

Remote Patient Monitoring

No reference found.

See: IA Medicaid Remote Patient Monitoring

Audio-Only

Allows for telephonic interpretive services.

SOURCE: IA Department of Human Services, Provider Specific Policies Ch. III: Federally Qualified Health Centers, June 1, 2014, Pg. 41 (Accessed Sept. 2026).

See: IA Medicaid Email, Phone and Fax

Last updated 09/18/2026

Patient-Provider Relationship

No reference found.

Last updated 09/18/2026

PPS Rate

No reference found.

Last updated 09/18/2026

Same Day Encounters

IL No. 1719-MC-FFS3 stated that encounters with more than one Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC) or Indian Health Services (IHS) practitioner on the same day, or multiple encounters with the same FQHC, RHC or IHS practitioner on the same day, generally constitute a single FQHC, RHC or IHS visit and is payable as one (1) visit.

This policy applies regardless of the length or complexity of the visit, the number or type of practitioners seen, whether the second visit is a scheduled or unscheduled appointment, or whether the first visit is related or unrelated to the subsequent visit.
This would include situations where an FQHC, RHC or IHS member has a medically necessary face-to-face visit with an FQHC, RHC or IHS practitioner, and is then seen by another FQHC, RHC or IHS practitioner, including a specialist, for further evaluation of the same condition on the same day, or is then seen by another FQHC, RHC or IHS practitioner (including a specialist) for evaluation of a different condition on the same day.

As a reminder, T1015 must be billed on the first claim line, and the specific service on subsequent claim lines with $0.00 charge as “informational only.”

Iowa Medicaid clarifies several exemptions from the above-mentioned single encounter guidelines in the informational letter’s chart. See bulleting for exception details.

SOURCE: Iowa Medicaid, Informational Letter No. 2655-MC-FFS-D, June 10, 2025, (Accessed Sept. 2026).

Only one face-to-face encounter between a member and the center health professional can be billed per day, even though the member may encounter the professional more than once or may encounter more than one professional.

Any necessary services should be provided during one encounter whenever possible. When there is a need for services to be unbundled that would normally be provided during one encounter medical necessity must be documented and maintained in the record.

An exception to this is when the member suffers illness or injury requiring additional diagnosis or treatment after the first encounter on a particular day. In that situation, another encounter is reimbursable. Refer those claims to IME Provider Services for special handling.

SOURCE: IA Department of Human Services, Provider Specific Policies Ch. III: Federally Qualified Health Centers, June 1, 2014, Pg. 61 (Accessed Sept. 2026).