DEA
Controlled substances meet telemedicine.
The DEA — often alongside SAMHSA — has issued a series of rules governing how controlled substances can be prescribed via telemedicine. Here's how each rule works, and exactly what it asks of prescribers.
The Three Rules
One agency, three telemedicine rules
Each rule comes with a free CTeL fact sheet — download the one you need.
Buprenorphine Treatment via Telemedicine
FDA-approved Schedule III–V medications for opioid use disorder can be prescribed via telehealth, including audio-only. Initial prescriptions can span up to six months without an in-person evaluation, backed by mandatory PDMP reviews.
Download the fact sheet (PDF) →
Special Registrations for Telemedicine
A proposed framework for telehealth practitioners to prescribe controlled substances responsibly, with enhanced compliance requirements, recordkeeping, and reporting protocols.
Download the fact sheet (PDF) →
Continuity of Care for VA Patients
A joint DEA–SAMHSA rule authorizing VA practitioners to prescribe Schedule II–V controlled substances to VA patients via telemedicine without a prior in-person evaluation, under specific conditions.
Download the fact sheet (PDF) →Inside the Final Rule
How the DEA final rule works
Telemedicine Flexibilities
Schedule III–V controlled substances can be prescribed via telemedicine — including initial prescriptions without an in-person visit, and audio-only where appropriate. Specific pathways exist for Schedule II and high-risk medications.
Controlled-Substance Limits
Restrictions on the types, quantities, and durations of medications prescribed via telemedicine, with prescribing patterns monitored to prevent misuse and diversion.
Patient Safeguards
Enhanced identity verification, strict documentation to establish medical necessity, and pharmacist confirmation of patient identity before dispensing.
Prescriber Responsibilities
DEA registration, compliance with state law, recordkeeping for audit purposes, and mandatory state PDMP checks.
VA Continuity of Care
Prescribing for veterans
The DEA and SAMHSA jointly authorized VA practitioners to prescribe controlled substances to VA patients via telemedicine — provided another VA practitioner has previously conducted an in-person evaluation at any time, and the prescriber reviews the records first.
- Mandatory record review — the VA EHR, including the internal prescription database, and the state PDMP where the patient is located.
- Contingency supply — if the EHR or PDMP is unavailable, prescribing is limited to a 7-day supply until records can be reviewed.
- States without a PDMP — the VA EHR must be reviewed before prescribing more than a 7-day supply.
- Exclusions — the rule doesn't cover Community Care Network practitioners outside a VA facility, or disability compensation evaluations.
50-State Survey
The state-by-state picture
Beyond the federal rules, prescribing controlled substances via telehealth is shaped by each state's own law. Explore CTeL's state-by-state comparison of prescribing rules below — the full 50-State Survey is available to members and in the CTeL store.
What the full report answers
- Exam & relationship prerequisites
- Legal definition of the relationship
- Adequacy of electronic exams
- Questionnaire-only restrictions
- Board policy statements
- Statutory & regulatory silence
- MAT clinic restrictions
- State vs. federal drug classifications
Access and safety, in balance.
Stay current on the DEA rules.
CTeL members get fact-sheet primers, the 50-state survey, and timely DEA rule alerts.