Verified October 8, 2026 against the statutes and regulations cited below. Research, not legal advice. All states
What operators miss in Missouri
- A provider who evaluates a patient by internet or phone questionnaire must send a written report to the patient's primary care provider, if the patient names one, within 14 days (§ 191.1146(3)).
- Read § 334.108(3) with counsel: it bars prescribing based solely on a telemedicine evaluation without a previously established, ongoing relationship.
- Missouri requires BNDD registration before DEA registration, so plan the order of filings.
Does Missouri have a telehealth registration for out-of-state clinicians?
No telehealth registration. Providers treating Missouri patients by telehealth must be fully licensed in Missouri and are regulated by their own boards.
- No telehealth-specific registration: a clinician needs the full license or an exception.
Citation: Mo. Rev. Stat. § 191.1145(3)
When can an out-of-state clinician treat Missouri patients without a Missouri license?
The licensure rule does not cover uncompensated, informal consultation on an irregular basis, free emergency or disaster care, or episodic consultation requested by a Missouri physician.
- Exception for consultation with a licensed physician
Citation: Mo. Rev. Stat. § 191.1145(3)
Can a patient relationship start by telehealth in Missouri?
A physician-patient relationship may be established by a telemedicine encounter when the standard of care does not require in person. Missouri's definition of telehealth covers audiovisual, audio-only and asynchronous store-and-forward technology.
Citation: Mo. Rev. Stat. §§ 191.1145, 191.1146
Does Missouri require telehealth consent?
Board rules for APRN and assistant physician collaborative practice require consent before telehealth begins, documented in the chart. No general consent rule for physicians was found.
Citation: Mo. Rev. Stat. § 335.175; 20 CSR 2150-5.100; 20 CSR 2150-2.240
What limits does Missouri put on prescribing by telehealth?
From Aug. 28, 2026, a patient questionnaire can support a telemedicine relationship only if the treating clinician reviews it and it gives the information an in-person evaluation would. The provider must work for or contract with a business entity licensed to provide health care in Missouri.
- No provider may prescribe a drug, including a controlled substance, based solely on a telemedicine evaluation unless a previously established, ongoing physician-patient relationship exists. On-call designees and collaborating APRNs, PAs and assistant physicians are covered.
Citation: Mo. Rev. Stat. § 191.1146(2)-(3) (as amended by HB 2372, 2026); § 334.108(3)-(4)
Does Missouri require its own controlled-substance registration?
Practitioners must hold a Missouri BNDD registration before obtaining DEA registration for Missouri.
- Required, issued by Department of Health and Senior Services, Bureau of Narcotics and Dangerous Drugs (BNDD)
Do private payers in Missouri have to cover telehealth?
- Private-payer telehealth coverage law
- No payment parity law
Citation: Mo. Rev. Stat. § 376.1900
How does Missouri treat the corporate practice of medicine?
Adding Missouri to your telehealth practice?
A State Expansion Pack applies Missouri's rules to your service line and lists what changes in your workflow before the first visit.