Last updated on October 25, 2025
No, it is not allowed to practice medicine via telemedicine across state lines in the U.S. without holding a valid license in the patient’s state. Each state regulates medical licensure independently, and most require physicians to be licensed where the patient is physically located during the telehealth visit.
Telemedicine’s Legal Roadblocks
Telemedicine has revolutionized health care delivery, connecting patients and providers across vast distances with a click. But when it comes to crossing state lines, the legal landscape is far less seamless. In the United States, medical licensure is governed at the state level, and that means a physician in one state cannot legally treat a patient in another via telemedicine—unless they’re licensed in that second state.
The Pandemic Loophole—and Its Closure
During the COVID-19 pandemic, emergency waivers temporarily relaxed these rules. Physicians could treat patients remotely across state borders without obtaining additional licenses. This flexibility helped maintain continuity of care during lockdowns and overwhelmed hospital systems.
But those waivers have largely expired. Today, the default rule is back in place: the telehealth visit occurs where the patient sits. If a patient is in Ohio, the provider must be licensed in Ohio—even if they’re physically in California. This has led to frustrating scenarios where patients must physically cross state lines just to receive virtual care from their regular doctor.
The Patchwork Problem
The result is a fragmented system. Each state has its own definition of what constitutes “practicing medicine,” and its own requirements for telehealth licensure. Some states offer temporary or expedited licenses for telemedicine, but many do not. Providers must navigate a maze of applications, fees, and compliance rules to legally treat patients in multiple states.
This patchwork approach has created barriers for patients with chronic conditions, rare diseases, or long-standing relationships with out-of-state specialists. It also poses legal risks for providers who attempt to offer care without proper licensure.
Legal Challenges and Proposed Fixes
Legal experts and health care advocates are pushing for reform. Some have filed lawsuits arguing that restrictive state licensure laws violate the Dormant Commerce Clause, which prohibits states from unduly burdening interstate commerce. Others support federal legislation like the Uniform Telehealth Act, which would allow licensed physicians to practice across state lines. Although passed by the Uniform Law Commission in 2022, only two states have adopted it so far.
Another proposal is to expand the Sports Medicine Licensure Clarity Act, which currently allows sports medicine professionals to treat athletes across state lines. Advocates suggest applying similar protections to telehealth providers treating high-risk or pediatric patients.
The Bottom Line
Until federal reform is enacted, physicians must hold a valid license in the state where their patient is located during a telemedicine session. Practicing without one is not just risky—it’s illegal. Telemedicine may be borderless in theory, but in practice, it’s still bound by state lines.
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Sources
What You Need to Know About the State of Telemedicine – Johns Hopkins University
https://washingtondc.jhu.edu/news/what-you-need-to-know-about-the-state-of-telemedicine/
2024-09-25
Health Care Professionals Practicing Via Telehealth – Federal Register
https://www.federalregister.gov/documents/2025/10/02/2025-19324/health-care-professionals-practicing-via-telehealth
2025-10-02