DEA Extend Telehealth Flexibilities Through 2026

This extension means clinicians can continue prescribing Schedule II–V controlled substances via telehealth without an initial in-person evaluation for the entire year of 2026. It also allows audio-only telehealth for opioid use disorder treatment

Pre-Pandemic Era (Before 2020)

• Under the Ryan Haight Act, an in-person medical evaluation was required before prescribing controlled substances via telehealth.
• Audio-video telehealth was allowed only after the first in-person visit; audio-only was prohibited.
• Buprenorphine prescribing followed the same restrictions.

Pandemic Era (2020 – Dec 31, 2025)

• Emergency flexibilities allowed clinicians to prescribe Schedule II–V controlled substances via audio-video telehealth without an initial in-person visit.
• Audio-only telehealth was permitted for buprenorphine treatment for opioid use disorder.

• Schedule II–V Controlled Substances: Prescribing via interactive audio-video telehealth for new or existing patients without prior in-person evaluation.
• Audio-only Telehealth: Permitted for Schedule III–V narcotic medications approved for opioid use disorder treatment, also without an in-person requirement.
• Purpose: Provides DEA and HHS additional time to finalize permanent regulations.

Interaction with Buprenorphine Final Rule

• The buprenorphine final rule (effective Dec 31, 2025) remains in place.
• Practitioners may use the broader flexibilities under this extension unless they choose to follow the more specific requirements of the buprenorphine rule.

• Telehealth flexibilities for controlled substances prescribing extended through 2026. 
• No in-person evaluation required for Schedule II–V prescribing via audio-video telehealth. 
• Audio-only telehealth remains permitted for opioid use disorder treatment. 
• Permanent DEA telehealth rules anticipated before end of 2026.