Public tracker · Updated 2026-09-10

GLP-1 telehealth rules, state by state.

Whether starting GLP-1 treatment online requires a live video visit is state law — and it changes. This tracker records the current requirement for every U.S. jurisdiction, sourced from state medical boards and the operational routing of our clinical network, with every change dated below.

Fully asynchronous

43 of 50

States where care can begin without a live visit

Video visit required

7 + DC

AR · MS · NM · ND · RI · SD · DC · WV

NP authority verified

44 of 51

Verified against state nurse practice acts; filled weekly

Jurisdictions tracked

51

All 50 states and Washington, D.C.

Download CSVDownload JSONRSS feed

Free under CC BY 4.0 — cite “Pallas Health — GLP-1 Telehealth Rules Tracker” with a link. Citable archive: DOI 10.5281/zenodo.21892535.

JurisdictionRequirementMedical boardMedicaid GLP-1NP prescribingUpdated
AlabamaALAsyncAlabama Board of Medical ExaminersLimitedRestrictedPrescriptive authority exists only under a written collaborative practice agreement with an Alabama physician; the collaborating physician must remain available for consultation and must be on site for at least 10 percent of scheduled hours for a nurse practitioner with under two years (4,000 hours) of collaborative practice experience2026-08-31
AlaskaAKAsyncAlaska State Medical BoardLimitedFull practiceIndependent practice in the certified role, with prescriptive authority granted by the Board of Nursing; no physician collaboration required2026-08-17
ArizonaAZAsyncArizona Medical BoardLimitedFull practicePrescribing and dispensing authority granted by the Board of Nursing; no physician supervision or collaborative agreement required2026-08-10
ArkansasARVideo visitArkansas State Medical BoardLimitedReducedPrescriptive authority requires a current collaborative practice agreement with a physician on file with the Arkansas State Board of Nursing; full independent practice is available only by separate board certificate after 6,240 qualifying practice hours2026-08-17
CaliforniaCAAsyncMedical Board of CaliforniaLimitedRestrictedStandardized procedures (furnishing); independent practice available via AB 890 certification2026-08-24
ColoradoCOAsyncColorado Medical BoardLimitedFull practiceIndependent practice; prescriptive authority is granted provisionally by the Board of Nursing and becomes full after 750 documented hours of a structured prescribing mentorship, with no ongoing physician agreement required afterward2026-08-17
ConnecticutCTAsyncConnecticut Medical Examining BoardLimitedFull practiceIndependent practice after a transition period of not less than 3 years and 2,000 hours in collaboration with a physician2026-07-27
DelawareDEAsyncDelaware Board of Medical Licensure and DisciplineLimitedFull practiceFull practice authority under exclusive Board of Nursing licensure; no collaborative agreement required2026-09-07
FloridaFLAsyncFlorida Board of MedicineLimitedRestrictedWritten supervisory protocol; autonomous registration available for primary care2026-08-03
GeorgiaGAAsyncGeorgia Composite Medical BoardLimitedRestrictedNurse protocol agreement with a delegating physician, filed with the Composite Medical Board2026-08-31
HawaiiHIAsyncHawaii Medical BoardLimitedFull practiceIndependent prescriptive authority granted by the Board of Nursing2026-08-03
IdahoIDAsyncIdaho State Board of MedicineLimitedFull practiceIndependent practice and prescribing under exclusive Board of Nursing licensure; no collaborative agreement, protocol, or physician supervision required2026-09-07
IllinoisILAsyncIllinois Department of Financial and Professional RegulationLimitedReducedWritten collaborative agreement; independent via Full Practice Authority license (4,000 hours)2026-08-03
IndianaINAsyncMedical Licensing Board of IndianaLimitedReducedWritten collaborative practice agreement with a licensed practitioner, plus Board of Nursing prescriptive authority renewed biennially2026-08-10
IowaIAAsyncIowa Board of MedicineLimitedFull practiceLicensure as an ARNP by the Iowa Board of Nursing carries independent prescriptive authority; no physician collaborative agreement, supervision, or transition-to-practice period is required2026-08-31
KansasKSAsyncKansas State Board of Healing ArtsLimitedFull practiceAn advanced practice registered nurse prescribes without a written protocol or supervising physician, after 2022 amendments to Kansas's nurse practice act eliminated its supervision and collaboration requirements2026-08-24
KentuckyKYAsyncKentucky Board of Medical LicensureLimitedIn verification rotation2026-07-27
LouisianaLAAsyncLouisiana State Board of Medical ExaminersLimitedReducedCollaborative practice agreement plus LSBN prescriptive-authority approval2026-08-10
MaineMEAsyncMaine Board of Licensure in MedicineLimitedIn verification rotation2026-09-07
MarylandMDAsyncMaryland Board of PhysiciansNoFull practiceIndependent practice with independent prescriptive authority; an applicant for initial nurse practitioner certification who is not already certified by a board of nursing must name a mentor to consult and collaborate for 18 months2026-09-08
MassachusettsMAAsyncMassachusetts Board of Registration in MedicineCoversFull practiceIndependent prescriptive authority after two years of supervised practice; mutually developed guidelines with a supervising provider before that2026-08-18
MichiganMIAsyncMichigan Board of MedicineLimitedRestrictedIndependent for non-controlled drugs; physician delegation needed only for controlled substances2026-08-03
MinnesotaMNAsyncMinnesota Board of Medical PracticeLimitedIn verification rotation2026-07-27
MississippiMSVideo visitMississippi State Board of Medical LicensureLimitedReducedPrescriptive authority is exercised only under a formal collaborative agreement with a compatible Mississippi-licensed physician, filed with the Board of Nursing before practice begins and maintained for the duration of practice2026-09-07
MissouriMOAsyncMissouri State Board of Registration for the Healing ArtsLimitedRestrictedPrescriptive authority is delegated by a physician through a written collaborative practice arrangement and may not be exercised outside it; a collaborating physician may hold arrangements with no more than six full-time equivalent advanced practice nurses, physician assistants, or assistant physicians2026-08-31
MontanaMTAsyncMontana Board of Medical ExaminersLimitedFull practicePrescriptive authority granted on application by the Board of Nursing; no collaborative agreement, protocol, or physician supervision required2026-09-07
NebraskaNEAsyncNebraska Board of Medicine and SurgeryLimitedFull practiceIndependent practice and prescribing under Board of Nursing licensure after 2,000 practice hours completed under a transition-to-practice agreement; no ongoing integrated practice agreement with a physician is required2026-09-07
NevadaNVAsyncNevada State Board of Medical ExaminersLimitedFull practiceIndependent prescriptive authority under Board of Nursing licensure with Board of Pharmacy registration; no collaborative agreement or physician supervision required for non-controlled drugs2026-09-07
New HampshireNHAsyncNew Hampshire Board of MedicineLimitedFull practicePlenary authority to prescribe, administer, and dispense under exclusive Board of Nursing licensure; no collaborative agreement or physician supervision required2026-09-07
New JerseyNJAsyncNew Jersey State Board of Medical ExaminersLimitedFull practiceIndependent after more than 5,000 hours of licensed active advanced nursing practice; joint protocol with a collaborating physician required before that2026-08-10
New MexicoNMVideo visitNew Mexico Medical BoardLimitedFull practiceIndependent practice and prescriptive authority under Board of Nursing licensure; no collaborative agreement or physician supervision required at any stage of practice2026-09-07
New YorkNYAsyncNew York State Board for MedicineCoversFull practiceIndependent after 3,600 practice hours; written collaborative agreement before that2026-08-27
North CarolinaNCAsyncNorth Carolina Medical BoardLimitedRestrictedCollaborative practice agreement; approval granted jointly by the Board of Nursing and Medical Board2026-08-03
North DakotaNDVideo visitNorth Dakota Board of MedicineLimitedFull practicePrescriptive authority added to the APRN license by the Board of Nursing; no collaborative agreement or physician supervision required2026-08-03
OhioOHAsyncState Medical Board of OhioLimitedReducedStandard Care Arrangement with a collaborating physician2026-08-31
OklahomaOKAsyncOklahoma State Board of Medical Licensure and SupervisionLimitedIn verification rotation2026-07-27
OregonORAsyncOregon Medical BoardLimitedIn verification rotation2026-07-27
PennsylvaniaPAAsyncPennsylvania State Board of MedicineLimitedReducedPrescriptive Authority Collaborative Agreement filed with the State Board of Nursing2026-08-24
Rhode IslandRIVideo visitRhode Island Board of Medical Licensure and DisciplineLimitedFull practiceIndependent prescriptive authority under sole Board of Nursing authority; no collaborative agreement or physician supervision2026-08-24
South CarolinaSCAsyncSouth Carolina Board of Medical ExaminersLimitedReducedPrescriptive authority is exercised under a written practice agreement with a physician that must be maintained for the duration of practice; prescribing is limited to the drugs and devices named in that agreement and to the nurse practitioner's specialty field2026-08-17
South DakotaSDVideo visitSouth Dakota Board of Medical and Osteopathic ExaminersLimitedFull practiceIndependent after 1,040 licensed CNP practice hours; written collaborative agreement with a physician, CNP, or CNM required until then2026-08-03
TennesseeTNAsyncTennessee Board of Medical ExaminersLimitedRestrictedCertificate of fitness from the Board of Nursing plus a collaborating physician named on every prescription2026-08-10
TexasTXAsyncTexas Medical BoardNoRestrictedPrescriptive Authority Agreement with a delegating Texas physician2026-07-27
UtahUTAsyncUtah Physicians Licensing BoardLimitedFull practiceIndependent practice with independent prescriptive authority and no transition-to-practice period or physician consultation-and-referral plan, following the 2023 removal of those requirements2026-08-25
VermontVTAsyncVermont Board of Medical PracticeLimitedFull practiceIndependent practice after transition to practice; collaborating provider agreement required until 24 months and 2,400 hours of active practice2026-08-17
VirginiaVAAsyncVirginia Board of MedicineLimitedRestrictedWritten practice agreement with a patient care team physician; autonomous practice available after three years of full-time clinical experience2026-08-10
WashingtonWAAsyncWashington Medical CommissionCoversFull practicePrescriptive authority granted by the Nursing Care Quality Assurance Commission; no physician collaborative agreement or supervision required2026-08-17
Washington, DCDCVideo visitDistrict of Columbia Board of MedicineLimitedFull practiceIndependent practice and prescribing under exclusive Board of Nursing licensure; no collaborative agreement or physician supervision required2026-08-03
West VirginiaWVVideo visitWest Virginia Board of MedicineLimitedReducedPrescriptive authority requires a written collaborative agreement with a West Virginia-licensed physician verified with the Board of Nursing; the agreement may be dropped only on separate board approval after three years of documented collaborative practice with granted prescriptive authority2026-09-07
WisconsinWIAsyncWisconsin Medical Examining BoardLimitedIn verification rotation2026-07-27
WyomingWYAsyncWyoming Board of MedicineLimitedIn verification rotation2026-07-27

“Async” means a state-licensed clinician may establish care and prescribe non-controlled medications from an asynchronous review. “NP prescribing” is the state’s nurse practitioner practice classification with the instrument an NP needs to prescribe non-controlled drugs like GLP-1s; states marked “in verification rotation” are verified state by state in our weekly source-check cycle. “Updated” is the later of the entry’s last content revision or last source re-verification. Click any jurisdiction for its statute citations, board links, and FAQs.

What changed, and when

Every confirmed change to the rules above, newest first. Entries are never edited or backdated — corrections get their own entry.

  1. 2026-07-27

    California, South Carolina, and Pennsylvania Medicaid programs eliminated coverage of GLP-1s for weight-loss indications effective January 1, 2026 (Medi-Cal removed Wegovy®, Zepbound®, and Saxenda® for members 21 and older; type 2 diabetes coverage continues in all three, and Medi-Cal keeps narrow exceptions such as Wegovy® for cardiovascular risk reduction). With New Hampshire, logged July 25, all four eliminations reported by KFF are now reflected in the tracker.

    Medi-Cal Rx provider bulletins (October and December 2025) and KFF Medicaid GLP-1 coverage research; surfaced by our automated source check (PR #45).

  2. 2026-07-27

    Rhode Island's FY2027 budget, signed June 12, 2026, ends Medicaid coverage of GLP-1s for weight-loss indications effective October 1, 2026; type 2 diabetes coverage is unaffected. Our note previously described the change as proposed.

    Rhode Island Current reporting on the enacted FY27 budget (June 12, 2026); surfaced by our automated source check (PR #45).

  3. 2026-07-27

    Correction — statute and rule citations updated on four state pages: Vermont now cites 18 V.S.A. § 9361(b) (previously a nonexistent § 3053a), Ohio cites Ohio Rev. Code § 4743.09 and OAC 4731-37-01 (previously the controlled-substances chapter 4731-11), Colorado cites C.R.S. § 12-240-107 (previously § 12-240-138, the professional-entities section), and Alabama cites Ala. Code §§ 34-24-701 through 34-24-707 (previously the repealed Admin. Code ch. 540-X-15). Regulatory substance is unchanged in all four.

    State statute and administrative-code databases; surfaced by our automated source check (PR #45).

  4. 2026-07-25

    New Hampshire Medicaid eliminated coverage of GLP-1 medications prescribed solely for weight loss, effective January 1, 2026; coverage continues for type 2 diabetes and certain other chronic conditions with prior authorization. New Hampshire's tracker entry has been updated accordingly.

    NH Healthy Families member notice (October 2025) and KFF Medicaid GLP-1 coverage research; surfaced by our automated source check (PR #38).

  5. 2026-07-25

    Correction — Mississippi Medicaid lists Wegovy® and Saxenda® as preferred anti-obesity agents for weight management (manual prior authorization required); our note previously understated weight-management coverage.

    Mississippi Division of Medicaid Universal PDL (January 2026) and anti-obesity agent PA criteria; surfaced by our automated source check (PR #38).

  6. 2026-07-25

    Correction — Idaho renamed its telehealth statute; Idaho Code §54-5701 and following is now the Idaho Virtual Care Access Act (formerly the Telehealth Access Act). Section numbers and substance are unchanged.

    Idaho Legislature, Title 54, Chapter 57; surfaced by our automated source check (PR #38).

  7. 2026-07-24

    Arkansas, Washington D.C., North Dakota, and South Dakota moved to video-visit-required; Kansas moved to async-eligible. The video-required list now stands at 8 jurisdictions (7 states plus Washington, D.C.).

    Confirmed with our clinical network's licensing and routing team, 2026-07-24.

  8. 2026-05-29

    Baseline video-visit-required list at tracker inception: New Mexico, Mississippi, Kansas, West Virginia, and Rhode Island (5 jurisdictions). All other states and D.C. permitted asynchronous establishment of care for non-controlled prescriptions.

    Confirmed with our clinical network's licensing and routing team.

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How this tracker is maintained

  • Each jurisdiction’s page cites its state medical board and the telehealth statute or regulation the entry rests on.
  • Requirements are confirmed against the operational routing rules of our clinical network — the system that actually assigns patients to state-licensed clinicians — which is how changes often surface here before they are widely reported.
  • Entries are cross-referenced against public policy databases, including the Center for Connected Health Policy’s state telehealth policy finder and KFF’s Medicaid GLP-1 coverage research.
  • Nurse practitioner prescriptive authority is verified against each state’s nurse practice act and Board of Nursing rules (the statute citation ships in the dataset), cross-referenced with AANP’s State Practice Environment classifications and NCSBN data. States are verified in a weekly rotation; unverified states are labeled rather than guessed.
  • This page renders directly from the same data that routes real patients — there is no separately maintained marketing copy to drift out of date.
  • Changes are broadcast the day the record updates: the JSON download carries the full dated changelog, and the same entries feed the RSS feed and email alerts.

Informational only — not legal or medical advice. Rules change; confirm current requirements with the relevant state medical board before relying on them.

Common questions

Which states require a video visit to get GLP-1 medication through telehealth?

As of 2026-09-10: Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, Washington, D.C., and West Virginia — 7 states plus the District of Columbia. In the other 43 states, a licensed clinician can establish care and prescribe non-controlled medications like GLP-1s from an asynchronous (message-based) visit.

What does an asynchronous visit mean?

You complete a structured medical intake online, and a clinician licensed in your state reviews your full health history before any prescription is considered — no appointment or live call. Video-visit states add one scheduled live video appointment to that same process.

Can nurse practitioners prescribe GLP-1s through telehealth?

In every state we have verified so far, yes — GLP-1s are not controlled substances, so they fall under each state's standard NP prescriptive-authority rules. What differs is the arrangement required: in full-practice states NPs prescribe independently, while reduced- and restricted-practice states require a written agreement with a physician (the exact instrument is named in the NP prescribing column). NP authority has been verified for 44 of 51 jurisdictions so far; the rest are in the weekly verification rotation.

What do full, reduced, and restricted practice mean?

They are the standard classifications of nurse practitioner practice authority. Full practice means NPs evaluate, diagnose, and prescribe under the exclusive authority of the state board of nursing, with no physician agreement. Reduced practice requires a collaborative agreement with a physician for some elements of care, typically including prescribing. Restricted practice requires career-long supervision or delegation by a physician. Several states also have conditional pathways — experienced NPs can earn independence — which the mechanism note captures.

Where does this data come from?

Each jurisdiction's entry cites its state medical board and telehealth statute (on the linked state page), cross-referenced against public policy databases, and confirmed against the operational routing rules of our clinical network — which is how changes often surface here before they are widely reported. Every change is dated in the changelog below.

Can I reuse this data?

Yes — the dataset is free to download (CSV and JSON, with the full dated changelog included in the JSON) under CC BY 4.0. Cite 'Pallas Health — GLP-1 Telehealth Rules Tracker' with a link to this page. Changes are also published as an RSS feed and email alerts.

Checking your own state?

Every jurisdiction above links to an in-depth guide — licensing, Medicaid, and what starting care actually looks like there.

Browse state guides