Frequently Asked Questions

Telehealth is defined as the use of synchronous (real-time information sharing) or asynchronous (relay of information with lag time) telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, the assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. Telehealth does not include e-mail messages or fax transmissions.

Telemedicine was a term defined by the Boards of Medicine and Osteopathic Medicine in Rules 64B8-9.0141 and 64B15-14.0081, F.A.C., before the term “telehealth” was defined in section 456.47, F.S. – Use of telehealth to provide services. Both rules have been repealed now that the telehealth law is in effect. The definition of “telehealth” includes the practice of telemedicine.

Telehealth provider is defined as an individual who provides a health care service using telehealth and who is licensed under s. 393.17; part III of chapter 401; chapter 457; chapter 458; chapter 459; chapter 460; chapter 461; chapter 463; chapter 464; chapter 465; chapter 466; chapter 467; part I, part III, part IV, part V, part X, part XIII, or part XIV of chapter 468; chapter 478; chapter 480; part I, part II, or part III of chapter 483; chapter 484; chapter 486; chapter 490; or chapter 491; who is licensed under a multi-state health care licensure compact of which Florida is a member state; or who is registered under and complies with s. 456.47(4), Florida Statutes.

Professions that may practice as telehealth providers include, but are not limited to: a behavior analyst, emergency medical technician, paramedic, acupuncturist, physician, osteopathic physician, chiropractor, podiatrist, optometrist, certified nursing assistant, licensed practical nurse, registered nurse, advanced practiced registered nurse, pharmacist, dentist, midwife, speech language pathologist, audiologist, occupational therapist, radiologic technologist, respiratory therapist, dietitian, athletic trainer, orthotist, prosthetist, pedorthist, electrologist, massage therapist, medical physicist, clinical lab personnel, genetic counselor, hearing aid specialist, physical therapist, optician, psychologist, clinical social worker, mental health counselor, psychotherapist, marriage and family therapist.

A provisional license cannot be used to register as an out-of-state telehealth provider. You must have an active, unencumbered license issued by another state, the District of Columbia, or a possession or territory of the U.S. A provisional license is not “unencumbered” since it has a provision or an obligation that must be complied with, i.e., supervision.

Telehealth providers must practice in a manner consistent with his or her scope of practice and the prevailing professional standard of practice for a health care professional who provides in-person health care services to patients in Florida.

If you have any questions related to scope or standard of practice for your specific profession, please contact the appropriate board office. A list of Florida boards, councils, and department-regulated professions can be found by visiting www.flhealthsource.gov and clicking on the blue link labeled “Florida Boards.”

A telehealth provider may use telehealth to perform patient evaluations. If a telehealth provider conducts a patient evaluation sufficient to diagnose and treat the patient, the telehealth provider is not required to research a patient’s medical history or conduct a physical examination before using telehealth to provide health care services.

A telehealth provider may not use telehealth to prescribe a controlled substance listed in Schedule II of section 893.03, Florida Statutes, unless the controlled substance is prescribed for the following:

  • the treatment of a psychiatric disorder;
  • inpatient treatment at a hospital licensed under Ch. 395, Florida Statutes;
  • the treatment of a patient receiving hospice services as defined in s. 400.601, Florida Statutes; or
  • the treatment of a nursing home resident as defined in s. 400.021, Florida Statutes.

 

Telehealth providers must use the same standard of maintaining patient medical records as used for in-person services. They must also keep medical records confidential, as required in ss. 395.3025(4), F.S.

Health care practitioners with an out-of-state license or certification that falls under section 456.47(1)(b), F.S, qualify for an out-of-state telehealth provider registration number when they meet the following requirements:

  • Submit the completed Application for Out-of-State Telehealth Provider Registration;
  • Maintain an active, unencumbered license from another state, the District of Columbia, or a possession or territory of the United States (license verification is required upon registration);
  • Not have a pending investigation, discipline, or revocation on your license within the last five years;
  • Designate a duly appointed registered agent for service of process in Florida (the agent’s name must be on the Registered Agent Name List maintained by the Division of Corporations)
  • Maintain liability coverage or financial responsibility for telehealth services provided to patients in Florida in an amount equal to or greater than Florida health care practitioner requirements
  • Not open a Florida office or provide in-person health care services to Florida patients
  • Only use a Florida-licensed pharmacy, registered nonresident pharmacy, or outsourcing facility to dispense medicinal drugs to patients in Florida (pharmacists only)

 

Once you are approved as an out-of-state telehealth provider, you will receive an approval letter with your telehealth provider registration number. This approval letter will serve as your proof of registration. Your telehealth provider information, including your registration number, will also be posted on www.flhealthsource.gov/telehealth. A separate license will not be printed for your registration.

The Florida Department of Health is required to maintain a public list of all registered out-of-state telehealth providers, which includes the following information:

  • Name
  • Health care occupation
  • Completed health care training and education, including completion dates and any certificates or degrees obtained
  • Out-of-state health care license, including license number
  • Florida telehealth provider registration number
  • Specialty
  • Board certification
  • Five-year disciplinary history, including sanctions and board actions
  • Medical malpractice insurance provider and policy limits
  • Name and address of the registered agent designated for service of process in this state

There are two exemptions that allow an out-of-state licensee to perform telehealth for Florida patients without registering:

  1. In response to an emergency medical condition, which is defined as:
    1. A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
      1. Serious jeopardy to patient health, including a pregnant woman or fetus.
      2. Serious impairment to bodily functions.
      3. Serious dysfunction of any bodily organ or part.
    2. With respect to a pregnant woman:
      1. That there is inadequate time to effect safe transfer to another hospital prior to delivery;
      2. That a transfer may pose a threat to the health and safety of the patient or fetus; or
      3. That there is evidence of the onset and persistence of uterine contractions or rupture of the membranes.
  2. In consultation with a health care professional licensed in this state who has ultimate authority over the diagnosis and care of the patient

No, if you are a Registered Nurse or a Licensed Practical Nurse you are not required to register as an out-of-state telehealth provider. Since Florida is part of the enhanced Nurse Licensure Compact (eNLC), nurses with a MSL in participating states are already eligible to provide telehealth services to Florida patients. Please be aware that Advanced Practice Registered Nurses are not part of the Nurse Licensure Compact.

Florida licensees can already provide telehealth services to patients in Florida that they can treat in person. No additional registration or certification is required. The out-of-state telehealth provider registration only applies to health care practitioners who are not licensed in Florida and are licensed in another state, the District of Columbia, or a possession or territory of the United States. If a Florida licensee would like to provide telehealth services to a patient outside of Florida, they must review the laws and rules in the location of the patient.

A telehealth provider and a patient may be in separate locations when telehealth is used to provide health care services to a patient. For example, if a Florida licensee travels outside of Florida then they may still perform telehealth services to patients in Florida.

To ensure you stay compliant as a registered out-of-state telehealth provider, you must do the following:

  • The out-of-state license used to register as a telehealth provider must remain active and unencumbered (the department will audit these licenses to ensure they are renewed)
  • If you have a website, a hyperlink to the department’s website, https://www.flhealthsource.gov/telehealth/, must be prominently displayed
  • You must maintain liability coverage or financial responsibility for telehealth services provided to patients in Florida in an amount equal to or greater than Florida health care practitioner requirements
  • You cannot open an office in Florida or provide in-person health care services to patients in Florida
  • You must notify the department of restrictions placed on any health care license you hold in any state or jurisdiction within five business days after the restriction is placed
  • You must notify the department of any disciplinary action taken or pending against any health care license you hold in any state or jurisdiction within five business days after the disciplinary action is initiated or placed

Florida does not have laws or rules specific to the practice of telehealth services outside of Florida. If a Florida licensee would like to provide telehealth services to a patient outside of Florida, he or she must contact the state where the patient is located to find out about the state’s laws and rules related to telehealth.

A registered agent is an individual or entity which is designated to receive service of process notices or other correspondence from the Florida Department of Health. Florida law provides that every out-of-state telehealth provider must have a designated registered agent, who must have an address in Florida. Please note that a registered agent is not related to your health care profession and their sole purpose is to ensure the department has established contact when needed. For example, if the department finds that you are not compliant with your licensure requirements and needs to contact you, you will be notified through your mailing address and through the registered agent you have designated to help ensure you receive the documentation.

The department cannot recommend a registered agent for you to designate. You should research, contact, and designate a registered agent that you feel comfortable using (many use a search engine, such as Google, to locate a registered agent in Florida), but you must ensure the one you choose is listed under the Florida Department of State, Division of Corporations’ database. Please note that the purpose of this database is not to choose a registered agent, but to verify one you have already found. The database can be found at https://dos.myflorida.com/sunbiz/, by clicking on “Search Records” and choosing “Registered Agent Name.” After choosing a registered agent, visit this webpage and type in the name of the registered agent to verify that their name and address match the information you add to the application for out-of-state telehealth provider registration.

Once you contact a registered agent, they will walk you through the process of how to designate them. Please note that because you are requesting a service, registered agents may require a fee. The department is not responsible for any costs associated with registered agents.

The Florida Department of State, Division of Corporations’ database is set up in a way where the registered agent is listed under a LLC they are designated for but please note that we are not concerned with the LLC and do not require you to create a LLC. When verifying your Registered Agent, we match the name and address listed on your application in the database under the section titled “Registered Agent Name & Address” – we do not review the LLC they listed under. Please note that this database was created by the Department of State for certain purposes, therefore the Department of Health does not have the ability to change the setup. If you have questions about how to use the website listed above, please use the Division of Corporations’ guide at https://dos.myflorida.com/sunbiz/search/guides/corporation-records/ or contact the Division of Corporations.

If you would like to review registered agents that have been designated by other out-of-state telehealth providers, visit MQA’s license verification database at https://mqa-internet.doh.state.fl.us/MQASearchServices/HealthCareProviders/. Choose “OUT-OF-STATE TELEHEALTH PROVIDERS” from the Board/Council drop-down menu or choose a profession with “Out-of-State Telehealth Provider” at the end of the name from the Profession drop-down menu (Example: Medical Doctor Out-of-State Telehealth Provider). Click the “Search” button and a list of other out-of-state telehealth providers will appear. You may click on each provider to review the registered agent they have designated.

To verify a license, visit MQA’s license verification database at https://mqa-internet.doh.state.fl.us/MQASearchServices/HealthCareProviders/. Choose “OUT-OF-STATE TELEHEALTH PROVIDERS” from the Board/Council drop-down menu or choose a profession with “Out-of-State Telehealth Provider” at the end of the name from the Profession drop-down menu (Example: Medical Doctor Out-of-State Telehealth Provider). Fill in the rest of the identifying fields based on the information you are seeking and click the Search button. For assistance with using the database, please visit http://www.floridahealth.gov/licensing-and-regulation/license-help/index.html.

There is no fee to apply or to become registered.

Submit a written request to the department stating that you no longer wish to have your out-of-state telehealth provider registration and would like the status changed to null and void. The request may be emailed to MQA.Telehealth@flhealth.gov or mailed to Telehealth, 4052 Bald Cypress Way, Bin C-11, Tallahassee, FL 32399-1708.

Medical malpractice insurance is only required for medical doctors and osteopathic physicians; however, all out-of-state telehealth provider registrants are required to maintain either professional liability coverage or financial responsibility that includes coverage or financial responsibility for telehealth services provided to patients not located in the provider’s home state. If you are not a medical doctor or an osteopathic physician, you are only required to choose one of the financial responsibility options in section 6 of the application for out-of-state telehealth provider registration.

Any questions about billing or insurance coverage fall outside of our agency and should be directed to the Agency for Health Care Administration (AHCA) or Office of Insurance Regulation.

Florida does not have a temporary telehealth registration. Out-of-state health care practitioners must be registered with the Florida Department of Health to perform telehealth services for patients in Florida. To complete the application for registration, visit https://www.flhealthsource.gov/telehealth/ and click the link labeled “Documents” at the bottom of the homepage. This registration does not expire but you may request to nullify it at any time.

The out-of-state telehealth provider registration does not expire, though out-of-state telehealth providers must comply with all registration requirements until they request to nullify their registration.

The DEA has the following on their website regarding practitioners who wish to prescribe controlled substances in multiple states:

“Please be aware that practitioners who wish to administer, dispense, or prescribe controlled substances in multiple states have the following options regarding a DEA registration:

  1. Practitioners will need to obtain a separate DEA registration in each state where they plan to administer, dispense, or prescribe controlled substances.
  2. If the practitioners will be working solely in a hospital/clinic setting, they may use the hospital’s DEA registration instead of registering independently with DEA if the hospital agrees and the situation warrants. 21 C.F.R. § 1301.22(c).
  3. Alternately, under 21 C.F.R. § 1301.51, practitioners may transfer their existing DEA registration from one state to another as needed by contacting DEA’s Registration and Program Support Section at 1-800-882-9539 or request the change online at www.DEAdiversion.usdoj.gov. DEA will investigate each modification of registration as if it was a new application. DEA will issue a new DEA certificate with the appropriate changes if DEA approves the modification.
  4. DEA has provided a limited exception to this requirement in that practitioners who register at one location in a state, but practice at other locations within the same state, are not required to register with DEA at any other location in that state at which they only prescribe controlled substances. 21 CFR § 1301.12(b)(3).”

For further clarification, please contact the DEA at 1-800-882-9539. You may also find links to Florida’s laws governing controlled substances below:

– Chapter 893, Florida Statutes, Drug Abuse Prevention and Control

– Section 456.0301, Florida Statutes, Requirement for instruction on controlled substance prescribing

– Section 456.44, Florida Statutes, Controlled substance prescribing