Telehealth rules in Iowa

1. 01 · First visit

   An interview and an examination, both named

   Before providing treatment, including issuing a prescription, the licensee interviews the patient to collect relevant medical history and performs a physical examination. The rule names both steps, and separately rules out an internet questionnaire made of a static set of questions as a medical interview.

   Source: Iowa Admin. Code 481-655.9

   Across the border

   • Minnesota

     Minnesota names no examination requirement and instead decides modality in its insurance code, where audio-only counts as telehealth until the recognition lapses on 1 July 2027.

     Source: Minn. Stat. 62A.673

   • Wisconsin

     Wisconsin builds its asynchronous rules around patients a practice already knows, recognizing a patient-initiated electronic visit conducted through a compliant portal rather than demanding an examination first.

     Source: Wis. Stat. 448

   • Illinois

     Illinois permits an asynchronous first encounter, so an intake reviewed and acted on without a live interaction can establish care there where the standard of care is met.

     Source: Center for Connected Health Policy: Illinois

   • Missouri

     Missouri asks for an interview, a review of relevant history and an examination sufficient for diagnosis and treatment, stopping short of naming a physical examination as Iowa does.

     Source: Mo. Rev. Stat. 191.1146

   • Nebraska

     Nebraska lets any credential holder open the relationship through telehealth with no examination named at all, spending its statutory detail on the written consent statement instead.

     Source: Neb. Rev. Stat. 38-1,143

   • South Dakota

     South Dakota imposes no examination requirement and settles the question by definition, counting only HIPAA-compliant interactive audio and video as telehealth in the first place.

     Source: S.D. Codified Laws 58-17-167

2. 02 · Prescribing

   No new medication in a school session

   Iowa Code chapter 280A governs school-based telehealth, and it provides that a mental health professional with prescribing authority shall not prescribe any new medication to a student during a telehealth session. Continuing an existing prescription is a different matter; starting one is closed.

   Source: Iowa Code

   Across the border

   • Minnesota

     Minnesota places no prescribing limit on a school session and instead gives the person receiving services the right to choose and to refuse the use of interactive video.

     Source: Center for Connected Health Policy: Minnesota

   • Wisconsin

     Wisconsin sets no school-specific prescribing rule, requiring instead that informed consent be obtained annually and documented as the member understanding their right to decline telehealth.

     Source: Center for Connected Health Policy: Wisconsin

   • Illinois

     Illinois regulates prescribing through a state controlled substance license and an electronic prescribing duty for schedules two through five, not through where the session takes place.

     Source: Center for Connected Health Policy: Illinois

   • Missouri

     Missouri's school provision is about permission rather than pharmacy, requiring a parent or guardian to authorize telemedicine delivered in a school, with that authorization able to cover the school year.

     Source: Mo. Rev. Stat. 191.1145

   • Nebraska

     Nebraska's child-focused rule is about staffing, expecting a trained adult familiar with the treatment plan to be immediately available in person during a minor's behavioral health visit.

     Source: Neb. Rev. Stat. 71-8509

   • South Dakota

     South Dakota has no school telehealth prescribing provision, and its telehealth chapter concerns itself with who may deliver the service and with consent borrowed from other law.

     Source: S.D. Codified Laws 34-52

3. 03 · Practice

   Name the risk of unauthorized access

   Across speech pathology, audiology, dietetics and the therapy professions, informed consent has to address the risks and limitations of the technology and, specifically, the potential for unauthorized access to protected health information. The risk is named in the rule rather than left to the clinician to think of.

   Source: Iowa Admin. Code 481-655.9

   Across the border

   • Minnesota

     Minnesota puts its data protection in the health records act instead, requiring a signed and dated consent before records are released and giving that consent a one-year life.

     Source: Minn. Stat. 144.293

   • Wisconsin

     Wisconsin requires informed consent before patient health care records are disclosed and backs it with a private action, without listing the technology risks a telehealth consent must cover.

     Source: Wis. Stat. 146.82

   • Illinois

     Illinois handles the point through general consent and record duties rather than by naming unauthorized access as a disclosure a telehealth consent form has to make.

     Source: Center for Connected Health Policy: Illinois

   • Missouri

     Missouri accepts verbal consent so long as it is documented in the medical record, and reserves written authorization for telemedicine delivered to a child in a school setting.

     Source: Mo. Rev. Stat. 191.1145

   • Nebraska

     Nebraska's four statutory statements cover refusal, confidentiality, access to information and the sharing of identifiable images, without reaching the security of the connection itself.

     Source: Neb. Rev. Stat. 71-8505

   • South Dakota

     South Dakota adds no content at all, telling the professional to follow whatever informed consent requirement already applies to them under state or federal law.

     Source: S.D. Codified Laws 34-52-7

1. 01

   Static is the disqualifying word

   What the rule excludes is a static set of questions. An intake that adapts to the patient's answers, and is followed by an interactive encounter, is a different artifact from the one the rule names.

   Source: Iowa Admin. Code 481-655.9

2. 02

   The examination is part of the sequence

   Interview, then examination, then treatment is the order the rule sets out, and prescriptions sit inside treatment. A prescription written before that sequence is complete is exposed on the rule's own terms.

   Source: Iowa Admin. Code 481-655.9

3. 03

   Consent runs alongside

   Informed consent covers both the medical services and the use of telemedicine, and for allied professions it also names the technology risks, which makes the consent screen part of the clinical record rather than of the terms page.

   Source: Iowa Admin. Code 481-655.9

1. 01

   An active license, stated in the rule

   The requirement that a physician using telemedicine for a patient located here hold an active state license is written into the telemedicine rule itself rather than left to inference from the practice act.

   Source: Iowa Admin. Code 481-655.9

2. 02

   The compact expedites it

   A letter of qualification from a physician's state of principal licensure shortens the application through the Interstate Medical Licensure Compact, and the result is a license issued by this state's board.

   Source: Interstate Medical Licensure Compact

3. 03

   Nurse practitioners practice independently

   Full practice authority applies on the American Association of Nurse Practitioners map, so an advanced registered nurse practitioner diagnoses, orders and interprets tests and prescribes under the board of nursing alone.

   Source: AANP: full practice authority brief

4. 04

   Compacts across professions

   Membership covers speech-language pathology and audiology, counselling, dentistry, dietetics, emergency medical services, nursing, occupational therapy, physician assistants, physical therapy, respiratory care and social work.

   Source: Center for Connected Health Policy: Iowa

How Tessic Health's providers are licensed in Iowa