Recent Articles

As many know, the telehealth flexibilities were extended through September 30, 2025, due to a continuing resolution. As the future of the telehealth landscape in the U.S. continues to take shape, the DEA (Drug Enforcement Agency) published a final rule and two proposed rules regarding the prescribing of controlled substances while providing telehealth services.

The final rule involves the prescribing of Buprenorphine for Opioid Use Disorder (OUD) during the practice of telemedicine without the establishment of an inperson evaluation (Expansion of Buprenorphine Treatment via Telemedicine Encounter, 2025). The first of the two proposed rules involves a special registration for prescribing during telehealth visits, creating an exception on the special registrations, and waving the Ryan Haight Act (Special Registrations for Telemedicine and Limited State Telemedicine Registrations, 2025). The second proposed rule delineates Veteran Affairs practitioners as the exception to special registrations requiring them to continue their compliance with the Ryan Haight Act. If you have questions about the Veteran Affairs proposed rule, please reach out to us.

The Final Rule: Prescribing Buprenorphine to treat OUD through Telemedicine

The Final rule provides provisions in place to help safeguard the prescribing of buprenorphine while allowing the flexibility of prescribing without an in-person evaluation to prevent access from being a concern during the OUD pandemic (Expansion of Buprenorphine Treatment via Telemedicine Encounter, 2025). This rule was a collaborative effort between the DEA, SAMHSA, and the Department of Health and Human Services

(Expansion of Buprenorphine Treatment via Telemedicine Encounter, 2025). The requirements that must be met to continue prescribing buprenorphine to treat OUD without an in-person evaluation are as follows:

1.) A DEA-registered practitioner meets state and Federal registration requirements for prescribing controlled substances and practicing telemedicine.

2.) Review the state PDMP (Prescription Drug Monitoring Program) data and annotate that they performed the review or explain why they might have been unable to due to technical issues within the patient’s EHR.

3.) Limiting the prescription to a six-month supply until the practitioner conducts an in-person medical evaluation or engages in other forms of authorized telemedicine.

4.) The pharmacist filling the script confirms the patient's identity using a valid government ID or other acceptable form of ID. (Expansion of Buprenorphine Treatment via Telemedicine Encounter, 2025)

Essentially, by following these procedures, a patient can be treated remotely for OUD either by audio-only or audio/video for the first 6 months but will then require an evaluation, whether in person or through an authorized form of telemedicine (Expansion of Buprenorphine Treatment via Telemedicine Encounter, 2025). This rule was scheduled to take effect on February 18, 2025. However, the DEA and HHS decided to delay the effective date to December 31, 2025. For more information, please review the Final Rule published in the Federal Register and the DEA fact sheet below: Federal Register Final Rule: Federal Register :: Expansion of Buprenorphine Treatment via Telemedicine Encounter

Federal Register Notice of New Effective Date for Final Rule: Federal Register :: Expansion of Buprenorphine Treatment via Telemedicine Encounter and Continuity of Care via Telemedicine for Veterans Affairs Patients DEA Press Release: DEA Announces Three New Telemedicine Rules that Continue to Open Access to Telehealth Treatment while Protecting Patients

Proposed Rule: Special Registration

These proposed rules by the DEA mark the ongoing progress of prescribing controlled substances while providing telehealth services. The DEA, through listening sessions and annual extensions, has continued to waive the Ryan Haight Act, which required an in-person visit before a patient was prescribed controlled substances during a telehealth visit. The DEA recently extended the waiver of this act through December 31, 2025. The first proposed rule establishes special DEA registration requirements for:

A.) Telemedicine Prescribing Registration: Providers who plan to prescribe (Schedules III-V) through telemedicine without an in-person medical evaluation as it could impose significant burdens to patients to maintain a practitioner-patient relationship.

B.) Advanced Telemedicine Prescribing Registration: Providers who plan to prescribe (Schedule II-V) controlled substances via telemedicine without an in-

person medical evaluation as it could impose significant burdens to patients to maintain a practitioner-patient relationship.

C.) Telemedicine Platform Registration: A covered online telemedicine platform, in their capacity as platform practitioners to dispense (Schedule II-V) controlled substances. (Special Registrations for Telemedicine and Limited State Telemedicine Registrations, 2025)

We will continue to monitor the proposed rule and provide a finalized update as more information becomes available. For more information, please see review the proposed rule found on the Federal Register at: Federal Register :: Special Registrations for Telemedicine and Limited State Telemedicine Registrations

References:

1. Expansion of Buprenorphine Treatment via Telemedicine Encounter, 21 CFR Part 1306 and 42 CFR Part 12 (2025). https://www.govinfo.gov/content/pkg/FR-2025-01-17/pdf/2025-01049.pdf

2. Special Registrations for Telemedicine and Limited State Telemedicine Registrations, 21 CFR pts. 1300,1301, 1304, and 1306 (2025). https://www.govinfo.gov/content/pkg/FR-2025-01-17/pdf/2025-01099.pdf

Last Revised: 08/28/2025

Filter by Category

Resources