Telehealth Payment Parity Laws: What They Require of Payers

"Parity" means two different things in telehealth law, and practices that confuse them misprice a service line. Coverage parity requires a health plan to cover a service delivered by telehealth if it covers the same service in person. Payment parity requires the plan to pay the same amount for it. Most states now have some private-payer telehealth law, CCHP counts 44 states plus DC, Puerto Rico and the Virgin Islands in its Fall 2025 summary, but only some require payment parity. CCHP counts explicit payment parity in 24 states and Puerto Rico. The rest leave rates to the contract.

Which states require payers to pay telehealth at the in-person rate?

From the statutes we have verified, these states require payment at the in-person rate, or at least at it, for covered telehealth services, generally subject to the plan's terms and the conditions noted:

• Arizona (A.R.S. § 20-841.09 and companion sections): parity for audio-video visits for all services, and for audio-only only for behavioral health and substance use disorder services. It does not apply to visits on a payer-sponsored platform.
• California (Cal. Health & Safety Code § 1374.14; Cal. Ins. Code § 10123.855). Payers also may not limit telehealth coverage to selected third-party corporate telehealth vendors.
• Colorado (C.R.S. § 10-16-123). Payers may not require a prior relationship with a specific provider or restrict the HIPAA-compliant technology used.
• Connecticut (Conn. Gen. Stat. §§ 38a-499a, 38a-526a).
• Delaware (18 Del. C. §§ 3370, 3571R): same basis and at least the in-person rate.
• Georgia (O.C.G.A. § 33-24-56.4): at least the in-person rate, but audio-only is required only for mental or behavioral health.
• Hawaii (HRS § 431:10A-116.3 and companions), with the sections scheduled for repeal and reenactment on December 31, 2027 under SB 1281 (2025). Check status before relying on it past 2027.
• Illinois (215 ILCS 5/356z.22): rate parity for in-network telehealth through interactive systems lapses January 1, 2028, except for mental health and substance use disorder services.
• Kentucky (KRS 304.17A-138): payment must equal in-person payment unless the provider signs a contract agreeing to a lower telehealth rate.
• Maryland (Md. Code, Ins. § 15-139): same basis and same rate, excluding most facility fees.
• Minnesota (Minn. Stat. § 62A.673).
• New Mexico (N.M. Stat. Ann. § 59A-22-49.3): at least the in-person rate.
• New York (N.Y. Ins. Law §§ 3217-h, 4306-g): commercial rate parity runs to April 1, 2028 under the current extension.
• Oklahoma (36 Okla. Stat. § 6803). Insurers may not limit coverage to a particular vendor or platform.
• Oregon (Or. Rev. Stat. § 743A.058).
• Vermont (8 V.S.A. §§ 4098a, 4098b), except services under a plan's contract with a third-party telemedicine vendor or under value-based contracts.

Which states have conditional or partial parity?

• Behavioral health only. Iowa (Iowa Code § 514C.34) and Massachusetts (ch. 175, § 47MM and companions) require rate parity for mental or behavioral health; other services are paid at negotiated rates.
• Provider type. Rhode Island limits rate parity to in-network primary care, registered dietitian nutritionists and behavioral health providers (R.I. Gen. Laws § 27-81-4).
• In-state presence. Nebraska's parity applies only if the clinician also sees patients in person at a Nebraska location or works at or has privileges at a Nebraska facility, though mental health services get parity regardless (Neb. Rev. Stat. §§ 44-312, 44-793). New Jersey's parity, extended to December 31, 2027 by P.L.2026, c.29 (signed June 30, 2026), does not cover telehealth companies with no in-person care in New Jersey, and does not extend to audio-only physical health visits.
• Opt-outs. Washington lets hospitals, hospital systems, telemedicine companies and provider groups of 11 or more negotiate different telemedicine rates (RCW 48.43.735).
• Established patients. West Virginia requires in-person rates for telehealth to established patients and for consults to patients in acute care facilities; other encounters are negotiated (W. Va. Code § 33-57-1).
• Narrow statutes. Louisiana's statutory parity covers physical and occupational therapy, not telehealth generally.

Arkansas and New Hampshire require reimbursement "on the same basis" with combined distant-site and originating-site payment at least equal to the in-person amount (Ark. Code Ann. § 23-79-1602; N.H. Rev. Stat. Ann. § 415-J:3), yet CCHP does not score them as explicit payment parity. Read the text, not the scorecard.

Which states require coverage but not payment parity?

Many. Florida, Texas, Ohio, Indiana, Michigan, Pennsylvania, Tennessee, Utah, Virginia and others require coverage of telehealth on some terms but leave rates to contract. Some add useful protections anyway:

• Florida makes telehealth contracts voluntary and requires the provider to initial any clause paying telehealth differently from in-person care (Fla. Stat. § 627.42396).
• Ohio bars higher cost-sharing for telehealth than for comparable in-person care while expressly not requiring equal rates, and bars telehealth providers from charging facility, origination or equipment fees (Ohio Rev. Code §§ 3902.30, 4743.09).
• Pennsylvania's Act 42 of 2024 requires coverage for in-network providers and bars conditioning payment on a particular vendor or platform (40 Pa.C.S. § 4803).
• Tennessee requires reimbursement regardless of the patient's geographic location.

Alabama, Idaho, North Carolina, South Carolina, Wisconsin and Wyoming have no private-payer telehealth coverage or parity statute in our research, so commercial terms are set entirely by contract.

What else do payer telehealth laws regulate besides rates?

Several statutes protect telehealth in ways that matter as much as the rate:

• Vendor and platform limits. California bars plans from limiting telehealth coverage to selected third-party corporate telehealth vendors; Oklahoma and Pennsylvania bar conditioning coverage or payment on a particular vendor or platform.
• Technology and relationship conditions. Colorado bars payers from requiring a prior relationship with a specific provider, restricting the HIPAA-compliant technology used, or adding certification, location or training conditions for telehealth payment.
• Prescribing. Georgia, Maine and Oklahoma bar insurers from restricting telehealth prescribing more than state and federal law restrict in-person prescribing.
• Facility fees. Maryland's parity excludes most facility fees; Connecticut bars telehealth providers and hospitals from charging a facility fee for telehealth; Ohio bars facility, origination and equipment fees.
• Network adequacy. In Arizona, telehealth-only providers outside the state do not count toward a payer's network adequacy unless they also provide in-person care in Arizona or within 50 miles of its border.

What does parity not reach?

• Self-funded employer plans. State insurance mandates apply to fully insured plans regulated by the state. Self-funded employer plans governed by ERISA generally are not subject to them. For many commercial patients, the state parity law does not apply at all.
• Medicare. Medicare telehealth payment is set federally under Social Security Act § 1834(m) and the physician fee schedule. Its flexibilities run through December 31, 2027; see the Medicare telehealth hub and what the 2026 spending law extended.
• Medicaid. Each state's Medicaid program sets its own telehealth payment policy, often separately from its commercial statute. See Medicaid telehealth coverage.
• Out-of-network care. Several statutes apply to in-network providers only.
• Non-covered services. Parity is about services the plan covers in person. It does not create coverage for services the plan excludes.
• Audio-only. Several parity laws exclude or limit audio-only, as Arizona, Georgia and New Jersey show. See audio-only telehealth rules.

How should a practice use parity in contracting?

1. Map patients by plan type and state. Fully insured, self-funded, Medicare Advantage, Medicaid managed care. Parity matters only for the first group in parity states.
2. Read the telehealth clause in each payer contract. In Kentucky a lower telehealth rate is valid only if you agreed to it in writing; in Florida only if you initialed it.
3. Check presence conditions. A virtual-only company without in-state clinics may fall outside Nebraska's and New Jersey's parity.
4. Calendar the sunsets. New Jersey (December 31, 2027), Hawaii (December 31, 2027), Illinois (January 1, 2028 for non-behavioral services), New York (April 1, 2028).
5. Price self-pay separately. Connecticut requires cost disclosure to self-pay patients and limits what uninsured patients may be charged unless a different amount is agreed.

Code-level billing questions go to our sister company, White Glove Medical Billing, and payer enrollment to White Glove Credentialing. On the policy side, the 50-State Telehealth Matrix ($2,950 for one service line) includes each state's coverage and parity rules with citations, and the Compliance Calendar & Rule Watch ($495 per month) tracks the sunset dates. CCHP's Fall 2026 report, expected around November, will update the national counts. This is research for your counsel, not legal advice.