Last updated 07/13/2023
Consent Requirements
A physician providing services by means of telemedicine directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record;
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate; and
- Obtain oral or written consent from the patient or, if the patient is a minor, from the patient’s parent or guardian unless state or federal law allows a minor to consent to treatment without the consent of a parent or guardian, for the provision of services through telemedicine. For services delivered through telemedicine on an ongoing basis, the practitioner need obtain consent from the patient or parent or guardian only once.
SOURCE: NH Revised Statutes Annotated, 329:1-d-V(c) as amended by HB 500, (Accessed Jul. 2023).
Last updated 07/13/2023
Cross State Licensing
Unless otherwise prescribed by statute, an out-of-state healthcare professional providing services by means of telemedicine or telehealth shall be required to be licensed, certified, or registered by the appropriate New Hampshire licensing body if the patient is physically located in New Hampshire at the time of service. This paragraph shall not apply to out-of-state physicians who provide consultation services.
SOURCE: NH Revised Statutes Annotated Sec. 310-A:1-g, (Accessed Jul. 2023).
Physician and Physician Assistant Licensure Pursuant to Reciprocity Agreement. The office of professional licensure and certification shall seek reciprocity agreements with states that have licensure requirements for physicians and physicians’ assistants that are substantially equivalent to this state, as determined by the board of medicine. The office of professional licensure and certification shall issue licenses to individuals who demonstrate they have a license in good standing from a state that is a party to such agreement, and pay the requisite fee, in accordance with rules adopted by the executive director under RSA 541-A.
SOURCE: NH Revised Statutes Annotated Sec. 310 -A:1-ff (Accessed Jul. 2023).
An out-of-state physician providing services by means of telemedicine shall be deemed to be in the practice of medicine and shall be required to be licensed under this chapter. This paragraph shall not apply to out-of-state physicians who provide consultation services pursuant to RSA 329:21, II.
SOURCE: NH Revised Statutes Annotated, 329:1-d-II, (Accessed Jul. 2023).
Any out-of-state physician providing radiological services who performs radiological diagnostic evaluations or interpretations for New Hampshire patients by means of teleradiology shall be deemed to be in the practice of medicine and shall be required to be licensed under this chapter.
SOURCE: NH Revised Statutes Annotated, 329:1-b (Accessed Jul. 2023).
Licensing exceptions do not apply…
- To legally qualified physicians in other states or countries when called in consultation by an individual licensed to practice in the state who bears the responsibility for the patient’s diagnosis and treatment. However, regular or frequent consultation by such an unlicensed person, as determined by the licensing board, shall constitute the practice of medicine without a license.
- To any physician residing on the border of a neighboring state and duly authorized under the laws thereof to practice medicine therein, whose practice extends into this state, and who does not open an office or appoint a place to meet patients or to receive calls within this state; or
- To regular or family physicians of persons not residents of this state, when called to attend them during a temporary stay in this state, provided such family physicians are legally registered in some state; or
- To podiatry; or
- To simple treatments such as massage or baths; or
- To nurses in their legitimate occupations; or
- To cases of emergency; or
- To the administration of ordinary household remedies; or
- To the advertising or sale of patent medicines; or
- To those who endeavor to prevent or cure disease or suffering by spiritual means or prayer; or
- No physician assistants or other paramedical personnel shall engage in the practice of optometry as defined in RSA 327:1 or perform any service rendered by an optician.
- To such emergency medical services personnel as are approved and licensed by the commissioner of the department of safety under RSA 153-A.
- Midwives certified pursuant to RSA 326-D and practicing midwifery pursuant to RSA 326-D:2, V.
SOURCE: NH Revised Statutes Annotated, 329:21, (Accessed Jul. 2023).
Creates a commission on primary care workforce issues. The commission will collect and review data and information that informs decisions and planning for the primary care workforce and looking for innovative ways for expanding New Hampshire’s primary care resources including, but not limited to, interstate collaboration and the use of telehealth.
Note: Section effective through Nov. 1, 2024
SOURCE: NH Revised Statutes Annotated, Title X Chapter 126-T:3, (Accessed Jul. 2023).
Telepsychology, telehealth, and telemedicine services, as provided by psychologists, include those psychology services that utilize electronic means, including audio, video, or other electronic media, to engage in visual or virtual presence in contemporaneous time. A New Hampshire tele-pass license shall be required for provision of such care to people in New Hampshire. Contacts that are exempt from this requirement are:
- Persons exempted by 329-B:28.
- Screenings for inclusion in voluntary research projects that have been properly approved by a New Hampshire based institutional review board.
- Psychologists licensed by the board, who may provide tele-psychology services to a person within the state of New Hampshire without acquiring a tele-pass psychology license.
- Persons exempted by RSA 329-D.
The tele-pass psychology licensee shall agree to conditions including, but not limited to, conditions stipulated by the board that the licensee shall:
- Conform to all New Hampshire statutes and rules.
- Agree that electronic attendance for appearances shall be deemed adequate for regulatory enforcement purposes and that in-person appearances by the licensee are optional and such associated costs for in-person attendance are the full responsibility of the tele-pass psychology licensee.
- Understand that false statements or failure to comply with official requests and official orders shall constitute sufficient cause for revocation of the tele-pass psychology license.
- Understand that all conditions of tele-pass psychology license to practice and enforcement shall be pursuant to New Hampshire law.
- Grant the New Hampshire board of psychologists and its investigators authority to disclose to law enforcement and related regulatory authorities, at their discretion, information including but not limited to status of application, actions and information pertinent to investigations and enforcement of the laws and rules pertaining to the licensee’s conduct.
- Not conduct face-to-face in-person psychological services in New Hampshire.
SOURCE: NH Revised Statutes Annotated 329-B:16, (Accessed Jul. 2023).
Last updated 07/13/2023
Definitions
Telemedicine means the use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment.
SOURCE: NH Revised Statutes 330-A:15-b, NH Revised Statutes 327:1, NH Revised Statutes 326-B:2, NH Revised Statutes 326-D:12-a, NH Revised Statutes Annotated 318:16-e, NH Revised Statutes Annotated, 317-A:7-B, NH Revised Statutes 328-F:11-b, NH Revised Statutes 330-C:14-a, NH Revised Statutes 315:6a , NH Revised Statutes 316-A:15-a, (Accessed Jul. 2023).
Telepsychology, telehealth, and telemedicine services, as provided by psychologists, include those psychology services that utilize electronic means, including audio, video, or other electronic media, to engage in visual or virtual presence in contemporaneous time.
SOURCE: NH Revised Statutes 329-B:16. (Accessed Jul. 2023).
” Telemedicine ” means the use of audio, video, or other electronic media and technologies by a physician [or a health care professional] in one location to a patient in a different location for the purpose of diagnosis, consultation, or treatment, including the use of synchronous or asynchronous interactions.
SOURCE: NH Revised Statutes Annotated, 329:1-d-I; NH Revised Statutes Annotated. 310-A:1-g, (Accessed Jul. 2023).
Last updated 07/13/2023
Licensure Compacts
Member of the Nurse Licensure Compact.
SOURCE: Current NLC States and Status. Nurse Licensure Compact. (Accessed Jul. 2023).
Member of the Physical Therapy Compact.
SOURCE: Compact Map. Physical Therapy Compact. (Accessed Jul. 2023).
Member of the Interstate Medical Licensure Compact.
SOURCE: The IMLC. Interstate Medical Licensure Compact. (Accessed Jul. 2023).
Member of the Psychology Interjurisdictional Compact.
SOURCE: PSYPACT. Legislative Updates. (Accessed Jul. 2023).
Member of Audiology and Speech Language Pathology Compact.
SOURCE: ASLP-IC, Compact States, (Accessed Jul. 2023).
Member of Occupational Therapy Compact.
SOURCE: Occupational Therapy Licensure Compact, Compact Map, (Accessed Jul. 2023).
Member of Counseling Compact.
SOURCE: Compact Map, Counseling Compact, (Accessed Jul. 2023).
* See Compact websites for implementation and license issuing status and other related requirements.
Last updated 07/13/2023
Miscellaneous
A Commission was created to study telehealth services and report to the legislature by December 1, 2022.
SOURCE: NH Revised Statutes 329:1-f. (Accessed Jul. 2023).
Last updated 07/13/2023
Online Prescribing
” Physician-patient relationship ” means a medical connection between a licensed physician and a patient that includes an in-person exam or an exam using telemedicine, as defined in RSA 310-A:1-g, I-b, provided the physician:
- verifies the identity of the patient receiving health care services through telemedicine; (ii) discloses to the patient the physician’s name, contact information, and the type of health occupation license held by the physician;
- discloses to the patient the physician’s name, contact information, and the type of health occupation license held by the physician;
- obtains oral or written consent from the patient or from the patient’s parent or guardian, if state law requires the consent of a parent or guardian for use of telemedicine services; and
- meets the standard of care.
A physician shall complete or review a history, a diagnosis, a treatment plan appropriate for the licensee’s medical specialty, and documentation of all prescription drugs including name and dosage. A licensee may prescribe for a patient whom the licensee does not have a physician-patient relationship under the following circumstances: writing admission orders for a newly hospitalized patient; for a patient of another licensee for whom the prescriber is taking call; for a patient examined by a physician assistant, nurse practitioner, or other licensed practitioner; or for medication on a short-term basis for a new patient prior to the patient’s first appointment or when providing limited treatment to a family member in accordance with the American Medical Association Code of Medical Ethics. Prescribing drugs to individuals without a physician-patient relationship shall be unprofessional conduct subject to discipline under RSA 329:17, VI. The definition of a physician-patient relationship shall not apply to a physician licensed in another state who is consulting to a New Hampshire licensed physician with whom the patient has a relationship.
SOURCE: NH Revised Statutes Annotated, Sec. 329:1-c. (Accessed Jul. 2023).
It is unlawful to prescribe through telemedicine a controlled drug classified in schedule II through IV, except substance use disorder (SUD) treatment as permitted in locations enumerated in paragraph IV. Methadone hydrochloride, as defined in RSA 318-B:10, VII(d)(2) shall not be included in the exemption.
The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a).
Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.
The prescribing of an opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a).
The prescription authority under this paragraph shall be limited to a practitioner licensed to prescribe the drug and in compliance with all federal laws, including the United States Drug Enforcement Agency registration or waiver when required.
A physician providing services by means of telemedicine directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record; and
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate.
A physician issuing a prescription for spectacle lenses, as defined in RSA 327-A:1, III, or a prescription for contact lenses, as defined in RSA 327-A:1, IV, by means of telemedicine directly to a patient shall:
- Obtain an updated medical history at the time of prescribing;
- Make a diagnosis at the time of prescribing;
- Conform to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition;
- Not determine an ophthalmic prescription solely by use of an online questionnaire; and
- Upon request, provide patient records in a timely manner in accordance with the provisions of RSA 332-I and all other state and federal laws and regulations.
SOURCE: NH Revised Statutes Annotated, 329:1-d, (Accessed Jul. 2023).
An APRN licensed under this chapter may prescribe non-opioid and opioid controlled drugs classified in schedule II through IV by means of telemedicine after establishing an advanced practice registered nurse-patient relationship with the patient. When prescribing a non-opioid or opioid controlled drug classified in schedule II through IV by means of telemedicine a subsequent in-person exam shall be conducted by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually. The prescription authority under this paragraph shall be limited to an APRN licensed under this chapter, and all prescribing shall be in compliance with all federal and state laws and regulations. An APRN licensed under this chapter shall obtain oral or written consent from the patient or, if the patient is a minor, from the patient’s parent or guardian unless state or federal law allows a minor to consent to treatment without the consent of a parent or guardian, for the provision of services through telemedicine. For services delivered through telemedicine on an ongoing basis, the practitioner need obtain consent from the patient or parent or guardian only once.
SOURCE: NH Revised Statutes Annotated, 326-B:2 as amended by HB 500, (Accessed Jul. 2023).
An individual providing services by means of telemedicine or telehealth directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record; and
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate; and
Provide meaningful language access if the individual is practicing in a facility that is required to ensure meaningful language access to limited-English proficient speakers pursuant to 45 C.F.R. section 92.101 or RSA 354-A, or to deaf or hard of hearing individuals pursuant to 45 C.F.R. section 92.102, RSA 521-A, or RSA 354-A.
SOURCE: NH Revised Statutes Annotated Sec. 310-A:1-g, (Accessed Jul. 2023).
The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a).
Subsequent in-person exams must be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.
The prescribing of an opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a).
The prescription authority under this paragraph shall be limited to a practitioner licensed to prescribe the drug and in compliance with all federal laws, including the United States Drug Enforcement Agency registration or waiver when required.
SOURCE: NH Revised Statutes Annotated 318-B:2(XVI). (Accessed Jul. 2023).
A physician providing services by means of telemedicine directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record;
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate; and
- Obtain oral or written consent from the patient or, if the patient is a minor, from the patient’s parent or guardian unless state or federal law allows a minor to consent to treatment without the consent of a parent or guardian, for the provision of services through telemedicine. For services delivered through telemedicine on an ongoing basis, the practitioner need obtain consent from the patient or parent or guardian only once.
A physician issuing a prescription for spectacle lenses, as defined in RSA 327-A:1, III, or a prescription for contact lenses, as defined in RSA 327-A:1, IV, by means of telemedicine directly to a patient shall:
- Obtain an updated medical history at the time of prescribing;
- Make a diagnosis at the time of prescribing;
- Conform to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition;
- Not determine an ophthalmic prescription solely by use of an online questionnaire; and
- Upon request, provide patient records in a timely manner in accordance with the provisions of RSA 332-I and all other state and federal laws and regulations.
SOURCE: NH Revised Statutes Annotated, 329:1-d as amended by HB 500, (Accessed Jul. 2023).
Last updated 07/13/2023
Professional Board Standards
Explicit permission is given to specific professionals to provide services through use of telemedicine. These professionals include:
- Podiatrists
- Chiropractic Examiners
- Midwifery
- Optometry
- Ophthalmic dispensers
- Naturopathic Medicine
- Allied Health professionals
- Acupuncture
- Psychologists
- Pharmacists and pharmacies
- Dentists and dentistry
- Alcohol and other drug use professional
- Nurses (APRNs)
- Mental Health Practice
- Physicians and Surgeons
- Medical technicians
- Medical Imaging and Radiation Therapy
SOURCE: NH Revised Statutes 315:6a , NH Revised Statutes 316-A:15-a, NH Revised Statutes 326-D:12-a, NH Revised Statutes 327:25-c, NH Revised Statutes 327-A:12-a, NH Revised Statutes 328-E:4, NH Revised Statutes 328-F:11-b, NH Revised Statutes 328-G:10, NH Revised Statutes 329-B:16, NH Revised Statutes Annotated 318:16-e , NH Revised Statutes Annotated, 317-A:7-B. NH Revised Statutes 330-C:14-a , NH Revised Statutes 326-B:2, NH Revised Statutes 330-A:15-b, NH Revised Statutes 329:1-d, NH Revised Statutes 328-I:16, NH Revised Statutes 328-J:12-a, (Accessed Jul. 2023),
Individuals licensed, certified, or registered pursuant to RSA 137-F; RSA 151-A; RSA 315; RSA 316-A; RSA 317-A; RSA 326-B; RSA 326-D; RSA 326-H; RSA 327; RSA 328-E; RSA 328-F; RSA 328-G; RSA 329-B; RSA 330-A; RSA 330-C; RSA 327-A; RSA 329; RSA 326-B; RSA 318; RSA 328-I; RSA 328-J may provide services through telemedicine or telehealth, provided the services rendered are authorized by scope of practice. Nothing in this provision shall be construed to expand the scope of practice for individuals regulated under this chapter.
An individual providing services by means of telemedicine or telehealth directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record; and
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate.
- Provide meaningful language access if the individual is practicing in a facility that is required to ensure meaningful language access to limited-English proficient speakers pursuant to 45 C.F.R. section 92.101 or RSA 354-A, or to deaf or hard of hearing individuals pursuant to 45 C.F.R. section 92.102, RSA 521-A, or RSA 354-A.
Under this section, Medicaid coverage for telehealth services shall comply with the provisions of 42 C.F.R. section 410.78 and RSA 167:4-d.
SOURCE: NH Revised Statute 310-A:1-g, (Accessed Jul. 2023).
A board of medical imaging professionals and radiation therapists shall adopt rules relative to standards of care for the practice of telemedicine or telehealth.
SOURCE: NH Revised Statutes Annotated, 328-J:7-XIII. (Accessed Jul. 2023).
