Use of Telemedicine While Providing MAT - May 15, 2018

Use of Telemedicine While Providing Medication 

Assisted Treatment (MAT) 

Under the Ryan Haight Act of 2008, where controlled 

substances are prescribed by means of the Internet, the 

general requirement is that the prescribing Practitioner must 

have conducted at least one in-person medical evaluation of 

the patient. U.S.C. § 829(e). However, the Act provides an 

exception to this requirement. 21 U.S.C. § 829 

(e)(3)(A). Specifically, a DEA-registered Practitioner acting 

within the United States and its territories is exempt from 

the requirement of an in-person medical evaluation as a 

prerequisite to prescribing or otherwise dispensing controlled 

substances by means of the Internet if the Practitioner is engaged in the practice of telemedicine 

and is acting in accordance with the requirements of 21 U.S.C. § 802(54).

Under 21 U.S.C. § 802(54)(A),(B), for most (DEA-registered) Practitioners in the United States, 

including Qualifying Practitioners and Qualifying Other Practitioners (“Medication Assisted 

Treatment Providers”) who are using FDA approved Schedule III-V controlled substances to treat 

opioid addiction, the term “practice of telemedicine” means the practice of medicine in accordance 

with applicable Federal and State laws, by a practitioner (other than a pharmacist) who is at a 

location remote from the patient, and is communicating with the patient, or health care professional 

who is treating the patient using a telecommunications system referred to in (42 C.F.R. § 

410.78(a)(3)) which practice is being conducted:

A. while the patient is being treated by, and physically located in, a DEA-registered 

hospital or clinic registered under 21 U.S.C. § 823(f) of this title; and by a practitioner

-who is acting in the usual course of professional practice; 

-who is acting in accordance with applicable State law; and

-is registered under 21 U.S.C. § 823(f) with the DEA in the State in which the patient is located.

OR

B. while the patient is being treated by, and in the physical presence of, a DEAregistered practitioner

-who is acting in the usual course of professional practice; 

-who is acting in accordance with applicable State law; and

-is registered under 21 U.S.C. § 823(f) with the DEA in the State in which the patient is located. 

Please be advised that the remote Practitioner engaged in the practice of telemedicine must be 

registered with the DEA in the state where they are physically located and in every state where 

their patient(s) is (are) physically located. 21 U.S.C. § 822(e)(1); 21 C.F.R.§ 1301.12(a); Notice 

69478 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006.

Also be advised that all records for the prescribing of an FDA approved narcotic for the treatment of 

opioid addiction need to be kept in accordance with 21 C.F.R. § 1304.03(c), 21 C.F.R. § 1304.21(b), 

and with all other requirements of 21 C.F.R. Part 1300 to End.

Please note that while this document reflects DEA’s interpretation of the relevant provisions of the 

Controlled Substances Act (CSA) and DEA regulations, to the extent it goes beyond merely 

reiterating the text of law or regulations, it does not have the force of law and is not legally binding 

on registrants. Because this document is not a regulation that has the force of law, it may be 

rescinded or modified at DEA’s discretion.