Introduction
Telehealth has become an integral part of healthcare delivery, offering patients convenient access to medical services. As of January 2026, understanding the telehealth regulations in each state is crucial for healthcare providers to ensure compliance and deliver optimal care.
Federal Telehealth Policies in 2025
In 2025, several federal initiatives have influenced telehealth practices:
- Medicare Telehealth Services Extension: The Full-Year Continuing Appropriations and Extensions Act (H.R.1968) extended Medicare telehealth services until September 30, 2025. This extension allows Medicare beneficiaries to access most telehealth services from any location, including their homes, without geographic limitations. (kiplinger.com)
- Telehealth Modernization Act of 2024: This act proposed further extensions to telehealth services but did not permanently remove geographic restrictions, indicating ongoing challenges in fully expanding telehealth access under Medicare. (kiplinger.com)
- Audio-Only Services: Forty-six states and the District of Columbia reimburse for audio-only telephone services to some extent, though often with limitations. (telehealthresourcecenter.org)
- Comprehensive Modalities: Thirty-two state Medicaid programs, including Alaska, Arizona, California, and others, reimburse for all four telehealth modalities: live video, store-and-forward, remote patient monitoring, and audio-only, subject to certain limitations. (telehealthresourcecenter.org)
- Reimbursement Laws: Forty-four states, the District of Columbia, Puerto Rico, and the Virgin Islands have private payer laws addressing telehealth reimbursement. Not all these laws require reimbursement or payment parity. (telehealthresourcecenter.org)
- Payment Parity: Twenty-four states and Puerto Rico have explicit payment parity laws, ensuring telehealth services are reimbursed at the same rate as in-person services. (telehealthresourcecenter.org)
- Consent and Licensing: Forty-five states, the District of Columbia, and Puerto Rico include some form of consent requirement in their statutes, administrative codes, or Medicaid policies. Additionally, thirty-eight states, along with the District of Columbia and Puerto Rico, offer exceptions to licensing requirements for telehealth services. (telehealthresourcecenter.org)
- Interstate Compacts: Thirteen different compacts, such as the Interstate Medical Licensure Compact (IMLC) and the Nurse Licensure Compact (NLC), facilitate cross-state practice for healthcare professionals. Participation varies by state and profession. (cchpca.org)
- Nevada: On July 1, 2025, Nevada became the first U.S. state to ban the use of AI in psychotherapeutic services and decision-making. Assembly Bill 406 prohibits AI providers from offering software designed to provide services that would constitute the practice of professional mental or behavioral health care if provided by a natural person. (en.wikipedia.org)
- Illinois: On August 1, 2025, Illinois passed the Wellness and Oversight for Psychological Resources Act, effectively banning therapist chatbots in the state. The Act prohibits the provision and advertisement of AI mental health services, including the use of chatbots for the diagnosis or treatment of an individual’s condition. (en.wikipedia.org)
- Stay Informed: Regularly consult state health department websites and resources like the Center for Connected Health Policy’s Telehealth Policy Finder for the latest updates. (phi.org)
- Ensure Compliance: Verify that telehealth practices align with both federal and state regulations, including licensure, reimbursement, and consent requirements.
- Consult Legal Experts: Engage with legal professionals specializing in healthcare to navigate complex regulatory landscapes and mitigate compliance risks.
- Medicare Extension: Medicare telehealth services extended until September 30, 2025, allowing beneficiaries to access services from any location.
- State Variability: State regulations on telehealth modalities, reimbursement, and licensure vary significantly, requiring providers to stay informed.
- AI Restrictions: Nevada and Illinois have enacted laws banning the use of AI in psychotherapeutic services and decision-making.
- Center for Connected Health Policy, 2025 State Telehealth Laws and Medicaid Program Policies Report, (cchpca.org)
- Nevada Assembly Bill 406, July 1, 2025, (en.wikipedia.org)
- Illinois Wellness and Oversight for Psychological Resources Act, August 1, 2025, (en.wikipedia.org)
- Center for Connected Health Policy’s Telehealth Policy Finder, (phi.org)
State-Specific Telehealth Regulations
State regulations vary significantly, affecting telehealth modalities, reimbursement policies, and licensure requirements. Below is an overview of key state policies as of late 2025:
Medicaid Reimbursement
Private Payer Laws
Professional Requirements
Notable State Developments in 2025
Navigating State Regulations
Given the complexity and variability of state telehealth regulations, healthcare providers should:
Conclusion
As telehealth continues to evolve, staying abreast of state-specific regulations is essential for healthcare providers to deliver compliant and effective care. By proactively monitoring policy changes and seeking expert guidance, providers can navigate the dynamic telehealth landscape of 2025 and beyond.