States With a Telehealth Registration for Out-of-State Clinicians

The standard rule in American telehealth is that the clinician needs authority to practice in the state where the patient is sitting. A full license is the default way to get it, and the compacts speed that up for some professions. A minority of states offer a third route: a registration or limited license that authorizes telehealth only. According to CCHP's Fall 2025 summary of state telehealth laws, 18 states plus Puerto Rico and the U.S. Virgin Islands have some form of telehealth-specific registration or license. For a practice expanding state by state, those are often the fastest doors in. They are also easy to misread, because the label "telehealth registration" covers very different things.

Which states offer a registration open to physicians, NPs and PAs?

These cover the core prescribing professions and allow ongoing direct-to-patient care:

• Florida (Fla. Stat. § 456.47(4)). Out-of-state practitioners in the chapter 456 professions, which include physicians, PAs and APRNs, register with their Florida board. Conditions: an active, unencumbered license, no discipline in the prior five years, a Florida registered agent and malpractice coverage. No Florida office and no in-person care. Details in Florida's registration for physicians, NPs and PAs.
• Arizona (A.R.S. § 36-3606). Any profession Arizona licenses, registered with the comparable Arizona board. Requires a statutory agent, liability insurance, no past or pending discipline, PDMP registration before prescribing controlled substances, and an annual report of patients and encounters. An office is allowed only within a multistate group that includes an Arizona licensee. See Arizona's registration.
• Delaware (24 Del. C. § 6002(c)). Providers under twelve Delaware boards, but only if licensed in a state that has not adopted an applicable compact in which Delaware participates. Delaware's relationship rules, including a written visit summary, apply. See Delaware's interstate registration.
• Colorado (C.R.S. § 12-30-124). Out-of-state credential holders register with the Colorado regulator for their profession. Registrants may not open a Colorado office, see Colorado patients in person or prescribe any controlled substance, and must keep a written emergency protocol.
• West Virginia (W. Va. Code § 30-1-26). An interstate telehealth registration for clinicians licensed elsewhere, including physicians, DOs, PAs and APRNs, through the relevant West Virginia board. It does not allow practice from a physical location in the state.

Which states offer a physician-only telehealth license or registration?

• Minnesota (Minn. Stat. § 147.032). An annual interstate telehealth registration for physicians, with no Minnesota office, no in-person visits and no taking patient calls in the state. Minnesota's separate in-person exam rule for many controlled substances (Minn. Stat. § 151.37) still applies.
• Kansas (K.S.A. 65-28,135). A telemedicine waiver from the State Board of Healing Arts for physicians with an unrestricted license elsewhere and no investigation or discipline. The statute caps fees at $100 initially and $100 a year to renew, and requires the Board to act within 15 days of a complete application.
• Louisiana (La. R.S. 37:1271). A telemedicine permit for MDs and DOs. Holders may not open an office, meet patients in Louisiana or supervise or collaborate with Louisiana NPs and PAs.
• New Mexico (N.M. Stat. Ann. § 61-6-11.1). A telemedicine license from the Medical Board, and a limited telemedicine license from the osteopathic board, for physicians with a full license elsewhere.
• Nevada (Nev. Rev. Stat. § 630.261). A special purpose license for telehealth from the Board of Medical Examiners, for MDs with an unrestricted license elsewhere, no disciplinary history and ABMS board certification.
• Oregon (Or. Rev. Stat. § 677.139). A license for the practice of medicine across state lines for physicians and physician associates. Holders may not dispense, practice in person, or prescribe controlled substances for chronic pain to Oregon patients.
• Georgia (O.C.G.A. § 43-34-31.1). A telemedicine license issued at the Composite Medical Board's discretion, limited to telemedicine.
• Vermont (26 V.S.A. § 3054). A telehealth registration for up to 10 patients over 120 days and a telehealth license for up to 20 patients per two-year term, for physicians, PAs and podiatrists through the Board of Medical Practice. Other professions, including nursing and osteopathy, use an interim registration until the Office of Professional Regulation's rules take effect. See Vermont's telehealth license and registration.

Which states have a registration that does not fit direct-to-consumer care?

• Maine (32 M.R.S. § 3300-D) offers a telemedicine registration for out-of-state physicians, but only for consultative services requested by a Maine clinician who keeps responsibility for the patient.
• Tennessee issues an osteopathic telemedicine license limited to the holder's specialty. The medical board no longer issues new MD telemedicine licenses, and legacy ones cover medical interpretation without prescriptive authority.
• Texas requires a full license; only out-of-state telemedicine licenses held as of September 1, 2022 remain valid (22 Tex. Admin. Code § 175.1).
• Idaho (Idaho Code § 54-5714) and South Carolina (S.C. Code § 40-75-800) offer telehealth registrations only for mental and behavioral health professions.

Which registrations have ended?

Pathways close. Indiana ended its out-of-state telehealth certifications on July 1, 2024, according to the Indiana Professional Licensing Agency, and now requires an Indiana license. Connecticut's temporary registration for out-of-state behavioral health providers ended June 30, 2025. Vermont's pandemic-era temporary telehealth registrations have all expired. Any registration strategy needs a date check before each filing.

Do some states register the company instead?

Yes, and these are in addition to whatever the clinician needs:

• Alaska requires businesses delivering telemedicine to Alaska patients to join the Telemedicine Business Registry, tied to an Alaska business license (AS 44.33.381).
• Mississippi requires organizations offering telehealth to Mississippi patients to register with the State Department of Health and list each clinician by name and license number.
• New Jersey requires telemedicine and telehealth organizations to register annually with the Department of Health (N.J. Stat. Ann. § 45:1-64).

What do the registrations have in common?

Read side by side, the statutes repeat a pattern worth designing for once:

• Clean license history. Florida looks back five years; Arizona says "past or pending"; Delaware, Kansas and Vermont bar pending investigations.
• Prompt discipline reporting. Florida and Vermont require notice within five business days, Arizona within five days.
• No in-person care, usually no office.
• Consent to the state's jurisdiction and its standard of care.
• A local agent and malpractice coverage that names the state (Florida and Arizona).
• State prescribing rules follow the registrant, sometimes with extra limits: Colorado bars controlled substances entirely.

What does a registration not change?

A registration answers one question: may this clinician practice on a patient located in this state. Everything else still has to be arranged separately:

• DEA registration. A clinician prescribing controlled substances needs a DEA registration for the patient's state; see what changes on January 1, 2027 for the federal telemedicine rules.
• State controlled substance registrations in states that require them, such as Delaware.
• PDMP enrollment. Arizona makes it a condition of the registration before any controlled substance prescription; elsewhere the state's PDMP mandate applies. See PDMP checks for telehealth prescribers.
• Payer enrollment. Medicare, Medicaid and commercial plans enroll clinicians separately, and some Medicaid programs limit out-of-state providers.
• State practice rules. Consent, relationship, prescribing and records rules apply to registrants exactly as they apply to local licensees.

When is a registration the wrong tool?

• When the clinician will ever see patients in person in the state.
• When the clinician needs to supervise or collaborate with local NPs or PAs (Louisiana says so expressly).
• When volume will exceed a cap (Vermont).
• When the service line depends on controlled substances in a state that bars registrants from prescribing them (Colorado).
• When the clinician's profession has a compact both states have joined. White Glove IMLC explains the physician compact in IMLC for telemedicine, White Glove APRN covers NPs in NP telehealth licensing across states, and White Glove PA covers telehealth across state lines as a PA.

Every state's pathway, with its citation, is in our telehealth law index. Our Telehealth Registration Filing service ($395 per clinician, per state, plus state fees) prepares registrations for physicians, NPs and PAs, and the State Expansion Pack ($595 per state) decides, for each new state, whether registration, licensure or a compact is the right route. CCHP's Fall 2026 report is expected around November; we will update the counts when it is out. This is research for your counsel, not legal advice.