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DE · STATE RULES

Telehealth rules in Delaware

Delaware writes its telehealth law as a checklist rather than a standard. One chapter of the professions title names the seven parts a provider-patient relationship has to contain, the last being a written summary handed to the patient, and then offers four alternative routes to a first diagnosis. Controlled prescribing sits in a separate regulation, where the database query is owed not at the first opioid prescription but at the first one that runs past the opening week.

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Async with conditions
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Rules checked September 2026 · 14 sources cited

ONLY IN DELAWARE

What is different about Delaware

Each rule here is true of Delaware and of none of the states that border it. Beside each one: what the neighbours do instead.

  1. 01 · Practice

    Every patient leaves with a summary

    Section 6003 assembles the provider-patient relationship out of seven named parts, and the last of them is a written visit summary provided to the patient. The other six are verification and authentication of the patient's location and, so far as possible, identity; disclosure and validation of the provider's own credentials; consent taken after the delivery model and its limits have been explained; a diagnosis reached through acceptable practice; a discussion of that diagnosis and the evidence behind it; and named coverage for anything that follows.

    Source: 24 Del. C. 6003

    Across the border

    • Maryland

      Maryland stops at the clinical evaluation and the onward referral, asking a practitioner to point the patient toward in-person care when that is clinically warranted rather than to produce a closing document.

      Source: Md. Health Occ. 1-1003

    • Pennsylvania

      Pennsylvania spends its telemedicine chapter on what counts as telemedicine and on measuring it against the in-person standard, leaving the closing record to the ordinary charting duties of the medical board.

      Source: 40 Pa.C.S. 4802, 4805

    • New Jersey

      New Jersey front-loads its documentation instead, pinning down the patient by name, date of birth, telephone number and address before any care is delivered.

      Source: N.J.S.A. 45:1-63

  2. 02 · First visit

    Four ways to reach a first diagnosis

    Before diagnosis and treatment, section 6004 requires a provider to satisfy at least one of four alternatives: an appropriate examination carried out in person, another state-licensed provider present with the patient at the originating site, a diagnosis made through audio or visual communication, or the standard of service set by the guidelines of the applicable professional societies. Visits with an established patient are not held to that list.

    Source: 24 Del. C. 6004

    Across the border

    • Maryland

      Maryland sets one test rather than a menu, calling for a clinical evaluation appropriate to the patient and letting the practitioner run it either synchronously or asynchronously.

      Source: Md. Health Occ. 1-1003

    • Pennsylvania

      Pennsylvania leaves the opening encounter to professional judgment and adds a firm requirement only where a controlled substance is in view, namely an initial medical history and physical examination.

      Source: 49 Pa. Code 16.92

    • New Jersey

      New Jersey hangs its condition on the paperwork, having the provider read the patient's history and any available medical records before making contact for a first encounter.

      Source: N.J.S.A. 45:1-62

  3. 03 · Prescribing

    The opioid clock starts the database check

    A first outpatient opioid prescription for acute pain is capped at a seven-day supply, and the monitoring database query is owed not at that prescription but at the first one that runs past the opening week. After that the rhythm slows rather than quickens: a patient treated for chronic pain is checked at least twice a year, more often where the clinical picture calls for it, and again whenever a benzodiazepine joins the regimen.

    Source: 24 Del. Admin. Code UCSA Reg. 9.0

    Across the border

    • Maryland

      Maryland front-loads the lookup, pulling at least four months of dispensing history before an opioid or benzodiazepine begins and repeating it every ninety days, with a three-day supply exempted.

      Source: Md. Health-Gen. 21-2A-04.2

    • Pennsylvania

      Pennsylvania divides the duty by drug class, querying its monitoring program for each opioid or benzodiazepine and otherwise only on a prescriber's first controlled substance for that patient.

      Source: 35 P.S. 872.8

    • New Jersey

      New Jersey ties the first lookup to a new patient's first Schedule II drug, opioid for pain or benzodiazepine, then repeats it each quarter for as long as that treatment runs.

      Source: N.J.S.A. 45:1-46.1

PRACTICE RULES

How telehealth works in Delaware

The telehealth chapter sits in the professions title and reaches the licensees of a dozen boards at once, so the same checklist governs whether the clinician is a physician, a nurse practitioner, a psychologist or a pharmacist.

  1. 01

    One chapter, many boards

    Section 6002 authorizes delivery by telehealth for professionals regulated by twelve named boards, which is why a brand staffing several disciplines works from a single set of practice conditions rather than from four separate board rules.

    Source: 24 Del. C. 6002

  2. 02

    Place first, then identity

    The relationship begins with thorough verification and authentication of where the patient is and, so far as is possible, who they are. The provider's own identity and credentials are then disclosed and validated to the patient.

    Source: 24 Del. C. 6003

  3. 03

    Consent comes after a disclosure

    Appropriate consent is received from the patient after the delivery model has been explained, along with the treatment method and its limitations. Consent taken before that explanation does not match what the section describes.

    Source: 24 Del. C. 6003

  4. 04

    Someone has to be reachable

    The checklist requires the availability of a distant site provider or other coverage, so a brand cannot design an encounter that ends with no named route back to a clinician.

    Source: 24 Del. C. 6003

  5. 05

    Four encounters sit outside

    The relationship requirement is waived for an informal consultation given without payment, emergency or disaster assistance, an episodic specialist consultation requested by the treating provider, and circumstances that make an in-person consultation impractical.

    Source: 24 Del. C. 6005

FIRST VISIT

Can a first visit happen without a live call in Delaware?

Yes, with conditions

Yes, provided the encounter takes one of the four statutory routes to a diagnosis, and one of those routes is a diagnosis reached through audio or visual communication. What the statute forbids is a prescription issued solely in response to an internet questionnaire, an internet consult or a telephone consult with someone the provider has no relationship with.

The relationship has to exist before treatment, and the chapter is explicit that it may be formed at a distance. The constraint falls on the method used to reach the diagnosis, not on where either party happens to be sitting.

  1. 01

    The relationship can start remotely

    Nothing in the chapter demands a prior face-to-face meeting to open the relationship. The in-person examination is one of four ways to meet the pre-diagnosis requirement, and it sits alongside three others rather than above them.

    Source: 24 Del. C. 6004

  2. 02

    A form alone is not enough

    Treatment is held to the standards of a traditional in-person encounter, and a prescription issued solely on an internet questionnaire, an internet consult or a telephone consult falls outside those standards where no relationship exists.

    Source: 24 Del. C. 6003

  3. 03

    Follow-up visits are freer

    Once the relationship is established, subsequent encounters with that patient are not held to the four-part pre-diagnosis requirement, which is what makes an asynchronous refill pathway workable after the first visit.

    Source: 24 Del. C. 6004

  4. 04

    Audio can carry a visit

    Real time two-way audio counts as telemedicine here, and audio-only contact is treated as acceptable where the patient lacks the connection needed for video, which matters for coverage in the rural parts of the state.

    Source: Center for Connected Health Policy: Delaware

PRESCRIBING

Prescriptions and controlled drugs in Delaware

Prescribing rules live outside the telehealth chapter, in the controlled substances regulations administered by the Division of Professional Regulation. Opioid treatment for pain is the part written in the most detail.

  1. 01

    Seven days to start

    A first outpatient opioid prescription for acute pain is limited to a seven-day supply for adults and for minors alike, and a longer first supply has to be medically necessary and documented as such.

    Source: 24 Del. Admin. Code UCSA Reg. 9.0

  2. 02

    The query attaches to the refill

    The monitoring database is consulted for the first prescription that carries treatment past that opening week, which means a brand's compliance trigger is the second prescription rather than the first.

    Source: 24 Del. Admin. Code UCSA Reg. 9.0

  3. 03

    Chronic pain adds a signed agreement

    A patient in long-term opioid treatment signs a treatment agreement setting out the medication rules, the reasons therapy might be changed and the consequences of breaking it, and a drug screen is run at least twice a year.

    Source: 24 Del. Admin. Code UCSA Reg. 9.0

  4. 04

    Three routes to the pharmacy

    A remote prescription may be written by the distant provider directly, or recommended to a clinician with the patient who writes it, or referred back to the patient's own provider, and a hard copy for a controlled drug may travel by mail.

    Source: Center for Connected Health Policy: Delaware

Federal rules apply on top of every state's. Prescribing controlled substances by telehealth without an in-person visit runs on DEA flexibilities currently extended through December 31, 2026, with a permanent rule still pending.

LICENSES

Who can treat patients in Delaware

Licensing runs through the Division of Professional Regulation and the boards it serves. Compact membership is broad here, covering medicine, nursing, advanced practice nursing, physician assistants, physical and occupational therapy, counseling and speech language pathology.

  1. 01

    Compacts carry most professions

    A clinician whose profession has a compact and whose home state belongs to it practices here on that basis, which covers the majority of the roles a consumer health brand staffs.

    Source: Center for Connected Health Policy: Delaware

  2. 02

    A registration for the rest

    Where no compact reaches a profession, section 6002 opens an interstate telehealth registration issued by the Division of Professional Regulation. The applicant holds an active license elsewhere and stands in good standing in every state that licenses them.

    Source: 24 Del. C. 6002

  3. 03

    Registering means submitting

    By taking the registration, the clinician agrees to be governed by this state's law for their profession, to answer in its courts, to follow its conduct rules and standards, and to accept the jurisdiction of the relevant licensing board.

    Source: 24 Del. C. 6002

  4. 04

    Nurse practitioners practice on their own

    The nurse practitioner association classes this as a full practice authority state, so an advanced practice registered nurse evaluates, diagnoses and prescribes under the exclusive licensure authority of the nursing board.

    Source: AANP: full practice authority brief

  5. 05

    Renewal names one training topic

    Renewal asks for proof of the continuing medical education the board sets, plus evidence of training on recognizing child sexual and physical abuse, exploitation and domestic violence, and on the reporting duties that attach to them.

    Source: 24 Del. C. 1723

How Tessic Health's providers are licensed in Delaware

ADVERTISING

Marketing to patients in Delaware

No telehealth-specific advertising rule exists, so promotion answers to the consumer fraud act and to the disclosure duties the telehealth chapter already places inside the visit.

  1. 01

    Deception without a victim

    A deception, false promise, misrepresentation or concealment of a material fact in connection with the sale or advertisement of a service is unlawful whether or not anyone was actually misled, deceived or damaged by it.

    Source: 6 Del. C. 2513

  2. 02

    Credentials are part of the product

    Because the statute requires the provider's identity and credentials to be disclosed and validated inside the encounter, a brand that markets an anonymous or interchangeable clinician is describing something the chapter does not permit.

    Source: 24 Del. C. 6003

  3. 03

    Do not sell a questionnaire

    Marketing that promises a prescription from a form alone describes an encounter the chapter rules out for a new patient, so a landing page should promise a clinical review rather than an outcome.

    Source: 24 Del. C. 6003

  4. 04

    The summary is a record, not a receipt

    The written visit summary the patient receives is part of the regulated encounter. Styling it as a promotional message, or bundling an offer into it, mixes a clinical document with a marketing one.

    Source: 24 Del. C. 6003

TESSIC HEALTH IN DELAWARE

How Tessic Health's providers cover Delaware

Three things change for patients here: the visit ends with a document, the first diagnosis is routed down one of the four statutory paths, and opioid work is scheduled against the seven-day clock rather than the first prescription.

  1. 01

    The summary is generated, not requested

    Encounters with patients in this state close by producing a written summary for the patient, because the statute counts that document as one of the seven parts of the relationship rather than as an optional courtesy.

  2. 02

    The diagnosis route is recorded

    Each first encounter here records which of the four statutory alternatives was used to reach the diagnosis, so the chart shows the path taken rather than leaving it to be reconstructed later.

  3. 03

    Coverage is named before the call ends

    Patients here are given a named route back to a clinician before the encounter closes, since the availability of a distant site provider or other coverage is written into the relationship itself.

  4. 04

    Pain work is scheduled against the clock

    Where opioid treatment is in scope, the second prescription is the one that carries the database query, and long-term treatment triggers a signed agreement and a twice-yearly screen.

  5. 05

    Licensing is compact first

    Providers serving this state work through compact privileges where their profession has one, and the interstate telehealth registration is used for the disciplines no compact reaches.

COMMON QUESTIONS

Questions about telehealth in Delaware

  • Yes. A written visit summary given to the patient is one of the seven parts the statute says a provider-patient relationship must include. An encounter that ends without one is missing a required element, not simply an optional courtesy.

  • Yes, if one of the other three routes is used. Before diagnosis and treatment the provider either examines in person, has another licensed provider present with the patient, makes the diagnosis by audio or visual communication, or meets the relevant professional society standard.

  • No. Treatment is measured against the standards of a traditional in-person encounter, and issuing a prescription solely on an internet questionnaire, an internet consult or a telephone consult is outside them where no relationship exists.

  • For acute pain, at the first prescription that carries treatment past the initial seven-day supply rather than at the first prescription itself. For chronic pain the check repeats at least every six months, and whenever a benzodiazepine is added.

  • Through a compact where one covers the profession, and otherwise through an interstate telehealth registration from the Division of Professional Regulation. Taking that registration means accepting this state's law, courts, conduct rules and board authority.

  • No. This is a full practice authority state, so an advanced practice registered nurse assesses, diagnoses and prescribes under the nursing board's exclusive authority without a collaborative agreement attached to the license.

SOURCES

Rules checked September 2026 · 14 sources cited. A planning summary, not legal advice. Statutes, board rules and enforcement priorities change; a brand's own counsel should review its model and marketing before launch.

OTHER STATES

Rules in other states

Each state page is researched from that state's own statutes and board rules.

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