Expanding telehealth coverage and flexibility remains a priority for states, report says

Telehealth has become a critical service for residents in need of accessible health care and services across the U.S. States have continuously adopted policies that aim to increase telehealth’s adoption and use, particularly as federal support for such services begins to wane, one expert says. 

Over the last year, states have leveraged policy to expand health care provider flexibility and transparency, a trend that has continued since the COVID-19 pandemic, which caused a “sharp pivot toward more use of telehealth,” said Mei Wa Kwong, executive director of the Center for Connected Health Policy. 

States have increasingly focused on setting telehealth policies that create more permanent, structured frameworks now that the global public health emergency has subsided, prioritizing telehealth’s affordability and accessibility, according to a new report from the CCHP. 

The report findings are based on research on state law, administrative codes and Medicaid provider manuals conducted from May to September 2025, which may have changed since the report’s publication, researchers wrote. 

Broader telehealth policies “can definitely help health access, and in the long run, improve patient outcomes,” Kwong said. With fewer barriers to accessing or offering telehealth services, people can identify and manage health conditions before they get worse, she explained. 

Eighteen states offer some form of licensure or registration exception for providers to practice telehealth, according to the report. Such exceptions commonly enable providers to care for patients in a different state, such as students who go to an out-of-state school. 

The report points to Minnesota as an example, as it allows licensed out-of-state physicians to offer telehealth services to in-state residents given their license has not been previously revoked or restricted in any jurisdiction, they do not open an office or meet patients in-person in Minnesota and annually register with the state medical board. 

Minnesota’s registration model “emphasizes oversight while minimizing barriers for providers offering limited telehealth services,” according to the report. Kwong added that more expansive licensure policies can help mitigate service and provider gaps in communities and improve patients’ continuity of care by reducing geographic distance as a barrier to seeking treatment. 

Other efforts to improve telehealth flexibility include Missouri’s push to loosen restrictions on how providers deliver telehealth services. Under SB79, for example, providers are not confined to use certain electronic platforms to offer telehealth services to patients, according to the report. 

Another trend the report highlighted was states efforts to broaden eligibility for providers who can offer telehealth services, Kwong said.

Colorado recently allowed practitioners, such as nurse practitioners and physician assistants, to participate in telehealth if they are involved with a patient’s care. Similarly, the Medicaid programs in Connecticut and Massachusetts over the last year have allowed doulas to be reimbursable for their support during perinatal visits and labor and delivery work in person or via telehealth, according to the report. 

Policymakers are also addressing where people are allowed to receive telehealth care, like in schools, according to the report. Forty-one states allow telehealth care to be delivered in school-based settings, clarifying rules on billing, modifiers and place-of-service codes. Oregon, for example, has revised its administrative code to explicitly address telehealth in school settings. The revision requires patient consent and establishes provisions to support the continued use of telehealth during a state or national emergency, the report stated. 

“States continue to make incremental refinements, frequently focused on clarifying existing policies — such as specifying covered services, eligible provider types or detailed billing instructions. These nuanced updates reflect a continued effort to standardize implementation rather than overhaul existing frameworks,” the report stated.  

Looking to the future, states could soon start to consider how or if policy is needed to ensure responsible use of AI in telehealth systems and processes, Kwong said. 

“There is a lot of policy in general all around AI in the states. They haven’t really touched on telehealth … so that’s definitely a trend to keep an eye on,” she explained. 

Another policy area where states could take action in coming years is “carving out exceptions on licensure” rules, particularly as state governments prepare for the impacts of federal cuts to the Medicaid program, Kwong said. With stricter eligibility and funding rules, for example, some states may see providers leave the area or patients seek care or prescriptions out of state that they can’t otherwise access. 

More inclusive licensure exceptions, for example, could help maintain patients’ access to certain providers and services through telehealth, Kwong said. Expanding telehealth restrictions could help “make up for the shortfall in Medicaid funding, because [states] can think [they] can stretch more dollars by using telehealth,” she added. 

But a critical part of expanding telehealth is helping providers adopt the service, Kwong said. 

According to the report, nearly half of all states require payment parity for in-person and virtual services as of 2025. Payment parity ensures that health plans reimburse providers at the same rate for either option because, otherwise, providers may reduce their telehealth offerings. 

When considering how to leverage policy to improve telehealth care in a state, “you also have to keep in mind the people it impacts [and] the people who have to implement it, and make sure the policy gives them the tools for them to do that,” Kwong said.