Texas Telehealth Laws

Does Texas have a telehealth registration for out-of-state clinicians?

Texas has no telehealth registration. Physicians providing telemedicine to patients in Texas need a full Texas license; only out-of-state telemedicine licenses held as of September 1, 2022 remain valid.

• No telehealth-specific registration: a clinician needs the full license or an exception.

Citation: 22 Tex. Admin. Code § 175.1; Tex. Occ. Code § 155.001

When can an out-of-state clinician treat Texas patients without a Texas license?

An out-of-state specialist giving only episodic consultation on request to a Texas physician in the same specialty is exempt, as are consults to Texas medical schools and certain UT institutions. The statute lists no follow-up care exception.

• Exception for consultation with a licensed physician

Citation: Tex. Occ. Code § 151.056(b)

Can a patient relationship start by telehealth in Texas?

A valid relationship can be formed by synchronous video, or by store-and-forward (alone or with a live audio call) if the practitioner uses clinically relevant images or the patient's records. Guidance on follow-up care is required, and a report goes to the primary care physician within 72 hours if the patient consents.

• Asynchronous care can establish the relationship

Citation: Tex. Occ. Code § 111.005

Does Texas require telehealth consent?

The treating physician or health professional must obtain informed consent from the patient or an authorized decision-maker before telemedicine services. Licensing boards must standardize consent records for treatment, data collection and data sharing, including audio-only consent.

• Consent required

Citation: Tex. Occ. Code §§ 111.002, 111.004

What limits does Texas put on prescribing by telehealth?

Telemedicine prescriptions are valid under the same standards as in person. For chronic pain with scheduled drugs, physicians must use two-way audio and video unless the patient is an established pain patient getting an identical refill and was seen in person or by video in the last 90 days.

• Chronic pain: audio-video required unless an established pain patient receives an identical prescription and was seen in person or by video within 90 days (22 Tex. Admin. Code § 175.3; nursing rule 22 Tex. Admin. Code § 217.24 for APRNs). No valid relationship exists for prescribing an abortifacient (Tex. Occ. Code § 111.005).

Citation: Tex. Occ. Code §§ 111.005, 111.006; 22 Tex. Admin. Code § 175.3

Does Texas require its own controlled-substance registration?

Texas ended its separate DPS controlled substances registration on September 1, 2016 (SB 195, 2015). DEA registration and PDMP rules still apply.

• No separate state controlled-substance registration

Do private payers in Texas have to cover telehealth?

• Private-payer telehealth coverage law
• No payment parity law

Citation: Tex. Ins. Code §§ 1455.004, 1455.006

How does Texas treat the corporate practice of medicine?

Does Texas have a consumer health data law?

The TDPSA, in effect since July 1, 2024, covers sensitive health data. SB 1188 requires electronic health records of Texas residents held by entities handling PHI to be physically stored in the United States from January 1, 2026, and limits EHR access.

• Texas Data Privacy and Security Act; SB 1188 (2025) EHR rules