MEDICAID
In 2025, CCHP tracked 25 enacted state bills (slightly down from 28 bills in 2024) related to Medicaid reimbursement and telehealth, reflecting continued interest in leveraging telehealth to expand access, support chronic disease management, and modernize service delivery for Medicaid enrollees. Much of the legislative activity centered around remote patient monitoring (RPM), self-measured blood pressure monitoring (SMBP), audio-only telehealth, and provider transparency requirements within managed care networks.
Several states advanced legislation aimed at expanding access to remote patient monitoring services for patients with chronic or complex health needs. Louisiana SB 70 updated RPM qualifications, allowing participation for patients that meet certain criteria, including having one or more chronic conditions, a history of costly healthcare usage due to chronic conditions, being a pregnant or postpartum woman, or being an infant needing neonatal intensive care. Texas HB 1620 directs the state Medicaid agency to determine eligible conditions for RPM based on cost and clinical effectiveness (instead of a fixed list of certain conditions), while also incorporating reporting and physician coordination requirements. Virginia SB 843 directs Medicaid to develop a plan and cost estimate for expanding RPM eligibility under Medicaid, reflecting ongoing consideration of long-term integration. Virginia also passed HB 1976 directing the Department of Medical Assistance Services to clarify that remote patient monitoring services for high-risk pregnant patients are available to patients with maternal hypertension and maternal diabetes and to report on the number of persons receiving, as well as the cost of providing remote patient monitoring services for such conditions.
Self-Measured Blood Pressure Monitoring (SMBP) also saw focused legislative support. Maryland HB 553/SB 94 and Arkansas SB 213/HB 1427 required Medicaid coverage for SMBP for individuals who are pregnant, postpartum, or have qualifying chronic conditions. The Arkansas legislation also mandates Medicaid reimbursement for remote ultrasound procedures, provided the standard of care is met and the technology meets HIPAA and FDA requirements.
California SB 530 imposed new transparency obligations on Medi-Cal managed care plans, requiring them to inform beneficiaries of their option to use, or not use, telehealth, if the health care provider is located outside of the specified time or distance standards. California AB 688, meanwhile, mandates biennial, publicly available Medi-Cal telehealth analyses starting in 2028. The analyses, which are authorized to be included as part of current Medi-Cal Biennial Telehealth Utilization Reports, must include telehealth usage metrics disaggregated by geography, demographics, and social determinants of health to identify and address disparities.
Minnesota HF 2 clarified that audio-only services may be reimbursed under Medicaid when clinically appropriate and the standard of care can be met through audio-only communication, or when used for behavioral health or substance use disorder treatment during emergencies. Although most Medicaid programs expanded telehealth coverage administratively rather than through legislation, a few states enacted explicit allowances for specific services. For example, Minnesota HF 3 permits the monthly required Early Intensive Developmental and Behavioral Intervention (EIDBI) session to be conducted via telehealth, provided that no more than two consecutive observation and direction sessions are delivered this way.
PRIVATE PAYER
In 2025, CCHP tracked 16 enacted state laws addressing telehealth reimbursement policies in the private payer space (down from 19 in 2024). Similar to previous years, states continued to refine coverage requirements, bolster parity protections, and ensure that telehealth services remain a reimbursable and viable option for insured individuals. Some states focused on removing sunset provisions that would have otherwise ended payment parity mandates. For instance, Maryland’s HB 869/SB 372 permanently removed the June 30, 2025 expiration date on its requirement that insurers reimburse telehealth services at the same rate as in-person care. New Jersey A 3853 extended a similar requirement through July 1, 2026, and Mississippi SB 2415 extended their payment parity telehealth protection until July 1, 2028, ensuring ongoing parity protections.
Other states emphasized broadening telehealth access across geographic and licensure boundaries. Texas HB 1052 requires health benefit plans to provide coverage for telehealth services that involve either an originating site or distant site located outside the state on the same basis and to the same extent as the plan provides for telehealth services within the state. As a condition, they require that the patient primarily resides in Texas and the provider is both licensed and has a physical office in Texas. Colorado SB 48 clarified the definitions of “intensive behavioral or lifestyle therapy” and “medical nutrition therapy” under private payer reimbursement requirements for large group health benefit plans, which must cover these services for the treatment of obesity and pre-diabetes. Tennessee’s HB 296/SB 231 targeted rehabilitative speech therapy services, requiring coverage of speech therapy in person or via telehealth.
Vermont’s S 30 reflected one of the most comprehensive private payer policies this year. It requires health insurance plans to cover services delivered via telemedicine, including store-and-forward, and audio-only modalities. Reimbursement rates must be at parity with in-person care for telemedicine and audio-only telephone, subject to plan terms and provider contracts. The bill also mandates reimbursement for both originating and distant site providers when substance use disorder treatment is delivered at a healthcare facility, unless both providers are employed by the same entity.
Overall, while the number of private payer telehealth laws were slightly lower in 2025 compared to 2024, states that did address the issue demonstrated a clear interest in entrenching long-term parity protections, supporting limited interstate access, and monitoring the evolving role of virtual care within commercial insurance markets.
LICENSING
In total, CCHP tracked 35 enacted cross-state licensing or licensure-related bills in 2025, a notable decrease from the 52 bills enacted in 2024. This decline could indicate a slowing of legislative interest in cross-state licensing activity, or perhaps that those states open to expansions feel they have already appropriately addressed the issue and/or joined available licensure compacts. Even so, states continued pursuing ways to ease licensure burdens for telehealth providers while maintaining appropriate oversight, advancing a mix of targeted exceptions, telehealth-specific pathways, and reciprocity measures.
Several states introduced narrowly tailored exceptions to traditional licensing requirements, often tied to specific populations. New Hampshire’s HB 701 permitted healthcare providers to conduct telehealth prescreening with out-of-state patients who have been diagnosed with life-threatening conditions, establishing unique parameters for cross-border virtual care in high-need scenarios. Utah’s SB 17 created licensing exemptions for U.S. Department of Defense employees and their spouses who hold valid licenses in other jurisdictions.
Some states revised or clarified existing telehealth licensing frameworks. Nevada’s AB 319 updated the terminology around its special purpose license for out-of-state physicians providing telehealth, changing its name to “telemedicine license”. Maryland enacted several licensing-related bills, including HB 602/SB 407, which required the state’s nursing board to explore reciprocity agreements with neighboring states, and HB 1474, which establishes a temporary telehealth license authorizing the provision of clinical professional counseling services by out-of-state providers to students attending an institution of higher education who have a previously established therapeutic relationship that has existed for at least six months. Other legislative activity focused on affirming legal protections and aligning with broader regulatory frameworks. Colorado’s SB 129 clarified that requirements for out-of-state telehealth providers do not alter protections related to legally protected health-care activities.
As in previous years, these developments reflect a persistent tension between state-based licensure models and the borderless nature of telehealth. While few bills tackled large-scale licensure reform, the continued emergence of targeted exceptions, registration mechanisms, and reciprocity efforts signals incremental progress toward more flexible interstate practice in the telehealth space.
Interstate licensure compacts remain the most common approach states use to address cross-state licensing challenges. Over the past year, all 13 compacts tracked by CCHP saw new states join through enacted legislation, with the exception of the Advanced Practice Registered Nurse Compact. Compacts that added new member states include: Audiology and Speech Language Pathology Compact, Professional Counseling Compact, Dietitian Compact, Emergency Medical Services Personnel Licensure Interstate Compact (REPLICA), Interstate Medical Licensure Compact, Nurse Licensure Compact, Occupational Therapy Compact, Physical Therapy Compact, Physician Assistant Compact, Interjurisdictional Psychology Compact (PSYPACT), and Social Work Compact. The largest increases in participation this year occurred in the Dietitian Compact and the Physician Assistant Compact. Additionally, this year a new compact, the School Psychology Compact, was added to CCHP’s tracking, with six states enacting legislation to join. The compact requires at least seven member states before it can become operational. Because several compacts are still relatively new, not all are currently active or issuing licenses at this time.
PROFESSIONAL REGULATION
In 2025, 52 enacted bills (up from 45 in 2024) addressed professional practice requirements related to telehealth, continuing a trend of states clarifying and expanding which licensed healthcare professionals may deliver services remotely. Often, these laws serve to explicitly authorize the use of telehealth within a provider’s scope of practice, helping to eliminate ambiguity and ensure consistent standards of care across modalities.
Physical therapy saw notable developments this year. Illinois’s SB 2153 amended the state’s Physical Therapy Act to explicitly allow initial evaluations via telehealth. This is permitted as long as the patient has a referral for in-person services, there is an established relationship with the physical therapist, or the therapist is able to perform—or arrange for—an in-person hands-on examination or re-examination at any point during the course of care, if needed. Other allied health professions also saw updates. Montana’s HB 806, for example, defines the “practice of nutrition” to include the provision of services via telehealth.
Dentistry continued to gain telehealth-specific standards. Georgia’s HB 567 authorized and regulated teledentistry by licensed dentists, while West Virginia’s SB 710 created telehealth practice standards for dental providers. Veterinary telemedicine saw robust activity, continuing a trend from recent years. Georgia’s SB 105 provided a comprehensive framework authorizing veterinary teleadvice, teletriage, and telemedicine. North Dakota (SB 2129) and Arkansas (SB 61) also created or expanded standards to support veterinary telehealth. Optometry saw updates as well, with Nevada’s AB 183 clarifying that the practice of optometry includes telemedicine, and North Dakota’s HB 1267 establishing practice standards for optometric telemedicine and the establishment of a provider patient relationship in the profession.
Medical recordkeeping and standards in the context of telehealth were also addressed. Texas’s HB 1700 required health professional regulatory agencies to adopt rules standardizing formats and retention of telehealth-related records.
These legislative developments reflect states’ ongoing efforts to integrate telehealth into the regulatory frameworks of a wide array of professions, ensuring that telehealth services meet established standards of care and are clearly authorized within each scope of practice.
PRESCRIBING
17 enacted bills—nearly double the 9 passed in 2024—focused specifically on online prescribing requirements in the 2025 legislative session, often addressing controlled substances, reproductive health, and medical cannabis. Several states updated statutory language and requirements to better align with clinical practice and evolving telehealth models. California passed AB 1503, which replaced the term “good faith prior examination” with “appropriate prior examination” (something needed in order to prescribe) for internet-based prescribing. Delaware addressed a longstanding regulatory conflict by enacting SB 101, which amends its Uniform Controlled Substances Act to clarify that a patient-practitioner relationship needed to provide opioid use disorder (OUD) treatment via telehealth using FDA-approved Schedule III-V medications, can be established either in-person or through telehealth and telemedicine if certain conditions are met. Similarly, Indiana’s SB 473 allows prescribers to use telehealth for initiating agonist opioid prescriptions—an expansion from prior law that permitted only partial agonists—further enabling treatment access for opioid dependence.
Connecticut passed several measures influencing prescribing. HB 7287, part of the state budget bill, restricts telehealth prescribing of Schedule I–III controlled substances but allows certain exceptions for psychiatric and substance use treatment, provided the prescriptions are consistent with the federal Ryan Haight Act. Hawaii also passed HB 951, permitting a physician to prescribe a short, three-day opiate supply via telehealth if the patient was seen in-person by another provider in the same medical group.
West Virginia’s SB 299 prohibits telehealth prescribing or dispensing of gender-altering medications. Meanwhile Illinois’ HB 3709 requires all public higher education institutions with student health services to ensure access to contraception-prescribing providers starting in the 2025–2026 school year, through student health services, telehealth services or other external licensed providers. Other states focused on enabling remote prescribing under specific patient circumstances. Mississippi’s SB 2748 allows marijuana certification via telehealth for patients who are homebound or bedbound. Connecticut’s HB 7181 addressed telehealth’s role for hybrid retailers that sell cannabis products.
PILOT PROGRAMS
15 bills were enacted related to telehealth-related pilot program or grant initiative bills in 2025, up slightly from the 14 enacted in 2024. These measures targeted rural access, behavioral health, Medicaid cost savings, and services for vulnerable populations. California passed SB 338, establishing the Mobile Health for Rural Communities Pilot Program to improve farmworker access to care in two rural counties through mobile units equipped for both in-person and telemedicine visits. Mental and behavioral health remained a major focus. Florida’s SB 168 establishes guidelines for mental health diversion programs, allowing certain necessary assessments for defendants who may have a mental illness intellectual disability or autism to be conducted using telehealth. Texas HB 6 allows the Texas Child Mental Health Care Consortium to make available mental health services to a school district through the Texas Child Health Access through Telemedicine program, and establishes requirements for the school district such as obtaining informed consent from student’s parents. Additionally, Minnesota HF 2115 created a school-linked telehealth behavioral health program.
Maryland’s HB 675/SB 669 expanded the Rape Kit Testing Grant Fund to support peer-to-peer telehealth, and Indiana’s HB 1391 established the Medicaid Diversion Pilot Program to study the impact of home modifications and telehealth chronic care services on reducing Medicaid costs. Colorado HB 1132 created a veterans mental health services program to promote access to mental health services for eligible veterans by reimbursing health care professionals for sessions with the eligible veterans. The bill allows for reimbursement if services are delivered in-person or via telehealth. These initiatives reflect sustained state interest in telehealth as a tool for innovation, access expansion, and targeted health system improvements—particularly when deployed through carefully designed pilot frameworks.
BROADBAND
CCHP tracked 4 enacted broadband-related bills in 2025, up from 3 in 2024, reflecting continued state efforts to support telehealth infrastructure and digital equity goals. Hawaii HB 934 amended rules related to the Hawaii Broadband and Digital Equity Office within the Office of Enterprise Technology Services. The statute explicitly includes telehealth, digital literacy, distance education, and remote work in its scope, laying a data-driven foundation for infrastructure deployment and policy planning. Utah SB 3 provided funding support for the Utah Education and Telehealth Network, which continues to be a critical backbone for rural telehealth access and educational connectivity across the state. In Virginia, SB 842 directed the Department of Housing and Community Development to prioritize broadband access for mobile health clinics under federal BEAD (Broadband Equity, Access, and Deployment Program) funding. Connecticut SB 1295 created a number of broadband requirements, including requiring affordable broadband internet access service to have speeds and latencies sufficient to support distance learning and telehealth services. These examples showcase how states are explicitly integrating telehealth delivery models into broadband deployment criteria, reflecting growing state recognition that broadband infrastructure is fundamental to equitable telehealth access, particularly in rural and underserved areas.
AI & TELEHEALTH REGULATION
In 2025, CCHP identified 10 enacted AI-related bills with direct implications for healthcare and telehealth. Legislative efforts concentrated on establishing safeguards around utilization review and prior authorization, regulating mental health AI tools, and advancing broader transparency and ethical standards. This is the first year AI has been formally included in the roundup, and thus, year-to-year comparisons are not yet available.
Arizona HB 2175 requires that any denials of prior authorization of a service requested by a provider must be individually reviewed by the medical director. During each review, the medical director must exercise independent medical judgement and may not rely on recommendations from any other source, effectively barring AI from the process. Maryland HB 820 took a related approach by requiring insurers, pharmacy benefit managers (PBMs), and private review agents to ensure that any AI or algorithmic tools used in utilization review adhere to appropriate safeguards, not basing its determinations solely on a group dataset, and instead basing its determinations on the enrollee’s medical or clinical history, individual circumstance or other relevant information contained in the enrollee’s medical record.
Texas enacted two major bills. SB 815 specifically restricted utilization review agents from making adverse determinations in whole or in part through automated systems, although such tools may still be used for administrative or fraud detection purposes. HB 149, meanwhile, establishes disclosure requirements for AI systems that interact with consumers, prohibits harmful uses such as discriminatory or violent applications, and restricts government use of AI for biometric data collection without consent. The bill also introduces an AI regulatory sandbox program and creates the Texas Artificial Intelligence Council to guide statewide policy, reflecting a balance of innovation and consumer protection. Outside of payer oversight, some states moved into more novel spaces. Utah HB 452 enacted provisions to regulate mental health chatbots that use AI, acknowledging both their growing role in patient support and the need for appropriate consumer protections. Similarly, California AB 489 sought to ensure that AI cannot be used to falsely indicate itself as an actual and appropriately licensed healthcare provider.
Collectively, these bills show a clear pivot toward regulating AI in sensitive healthcare and insurance contexts where automated decisions could impact access to care. For telehealth, this represents an important new frontier—ensuring that algorithmic tools complement, rather than replace, clinical judgment and patient protections.
CONCLUSION
In 2025, state legislatures continued to refine and expand telehealth policies, emphasizing broader access alongside clearer standards for specific modalities and clinical specialties, as reflected in the increase of enacted bills related to professional regulation and online prescribing. The developments of 2025 reflect a continued commitment to solidifying telehealth as a core component of modern healthcare delivery. As states refine oversight frameworks while preserving the flexibility needed |
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