Tessic Health

MT · STATE RULES

Telehealth rules in Montana

Montana puts its telehealth rules in a board rule rather than a statute, and the rule is unusually explicit. It fixes the place of practice at the patient's location, names the only three ways a relationship may begin, and then says plainly that Schedule II drugs may be prescribed by telemedicine where federal requirements are met. A separate consumer privacy act, which none of the neighbouring states has, governs what a brand does with the data around all of it.

Book a DemoAll states
First visit
Async with conditions
Physician license
IMLC member; own license
Controlled drugs
Schedule II allowed by rule
Nurse practitioners
Full practice

Rules checked September 2026 · 17 sources cited

ONLY IN MONTANA

What is different about Montana

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

  1. 01 · First visit

    Three ways in, and no fourth

    The Board of Medical Examiners rule lists the routes to a provider and patient relationship exhaustively: an in-person medical interview and physical examination, a consultation with another licensee who already has a documented relationship, or telemedicine where the standard of care does not require an in-person encounter.

    Source: Montana Admin. Rule 24.156.813

    Across the border

    • North Dakota

      North Dakota frames the same question as a disqualification: an examination consisting only of a static online questionnaire, or only of an audio conversation, does not meet the standard of care for a first diagnosis.

      Source: N.D. Cent. Code 43-17-44

    • South Dakota

      South Dakota narrows the definition instead of the routes, counting only HIPAA-compliant interactive audio and video as telehealth and leaving audio-only, email and fax outside it entirely.

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

    • Wyoming

      Wyoming's board rules approach it from the other side, letting a physician licensed elsewhere carry on treating a patient remotely where the relationship began at an in-person visit in that other state.

      Source: Wyoming Board of Medicine

    • Idaho

      Idaho names no routes at all and sets a single test: virtual care may begin the relationship whenever the applicable community standard of care is satisfied, under Idaho Code 54-5705.

      Source: Idaho Code 54-5705

  2. 02 · Prescribing

    Schedule II is expressly on the table

    The same board rule states that a licensee may prescribe Schedule II drugs through telemedicine in compliance with the federal requirements, which makes this an affirmative state permission rather than silence or a prohibition. The prescriber still needs a medical history sufficient for diagnosis.

    Source: Montana Admin. Rule 24.156.813

    Across the border

    • North Dakota

      North Dakota goes the opposite way on opioids: they may be prescribed through telemedicine only as a federally approved medication-assisted treatment for opioid use disorder, and for no other purpose.

      Source: N.D. Admin. Code 50-02-15-02

    • South Dakota

      South Dakota gives no such permission and reaches the question through its definition, since an encounter that is not interactive audio and video is not a telehealth service there to begin with.

      Source: S.D. Codified Laws 34-52

    • Wyoming

      Wyoming treats it as misconduct rather than permission: initially prescribing any controlled substance over the internet without a documented physician and patient relationship is listed as unprofessional conduct.

      Source: Wyoming Statutes

    • Idaho

      Idaho neither permits nor forbids it in its own right, providing in Idaho Code 54-5707 that a controlled substance may be ordered through virtual care only in compliance with federal law.

      Source: Idaho Code 54-5707

  3. 03 · Advertising

    A privacy act the neighbours never passed

    Montana's consumer data privacy act applies at a far lower threshold than most states, reaching controllers that process the data of fifty thousand consumers, and it treats information about a health condition as sensitive data requiring opt-in consent before processing.

    Source: Center for Connected Health Policy: Montana

    Across the border

    • North Dakota

      North Dakota has no consumer privacy statute, so health information there is governed by the record-keeping duties the medical board imposes and by the federal privacy floor.

      Source: N.D. Cent. Code 43-17

    • South Dakota

      South Dakota has enacted no omnibus privacy law either, leaving a marketing claim about health data to the deceptive practices provisions of its consumer protection chapter.

      Source: S.D. Codified Laws 37-24

    • Wyoming

      Wyoming provides no statutory opt-out rights over personal data, so what a brand may do with a visitor's information turns on its own published notice and the general consumer protection act.

      Source: Wyoming Statutes

    • Idaho

      Idaho has passed no comprehensive data statute, and enforcement of a misleading data practice sits with the attorney general under Idaho Code 48-603 rather than with the consumer.

      Source: Idaho Code 48-603

PRACTICE RULES

How telehealth works in Montana

The Board of Medical Examiners rule on telemedicine is short and load-bearing. It settles where practice happens, how a relationship starts, what standard applies, and what a prescriber needs before writing anything.

  1. 01

    Practice happens at the patient

    Treatment of a patient physically located in this state occurs where the patient is, which is what makes a license here necessary for a clinician sitting anywhere else. The rule states it directly rather than leaving it to inference.

    Source: Montana Admin. Rule 24.156.813

  2. 02

    One standard of care

    A licensee delivering telemedicine adheres to the same standards of care required in an in-person setting. The rule offers no reduced expectation for a remote encounter and no separate telemedicine standard to fall back on.

    Source: Montana Admin. Rule 24.156.813

  3. 03

    History before a prescription

    A practitioner obtains a medical history sufficient for diagnosis before issuing any prescription, and establishes the relationship beforehand by one of the three named routes. The sequence is part of the rule, not a matter of style.

    Source: Montana Admin. Rule 24.156.813

  4. 04

    Consent under the board rules

    Informed consent for telemedicine is required through the board's rules, with the content left to professional judgement rather than a statutory checklist. Documenting what was explained is what makes the consent provable.

    Source: Montana Admin. Rule 24.156.1701

FIRST VISIT

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

Yes, with conditions

Yes, by the third of the rule's routes: telemedicine may establish the relationship where the standard of care does not require an in-person encounter. That is a clinical judgement the licensee has to be able to defend for the presentation in front of them.

Because the rule lists the routes, a brand's intake has to map onto one of them. Most direct-to-patient models rely on the third, which puts the weight on whether an in-person examination was clinically necessary.

  1. 01

    The in-person route

    A medical interview and physical examination in person establishes the relationship and then supports remote follow-up without further argument. For brands with any physical footprint, this is the cleanest path onto the other two.

    Source: Montana Admin. Rule 24.156.813

  2. 02

    The consultation route

    A consultation with another licensee who holds a documented relationship with the patient also counts, which is what makes referral-led models workable. The documentation sits with the referring clinician and has to be obtainable.

    Source: Montana Admin. Rule 24.156.813

  3. 03

    The telemedicine route

    Telemedicine alone establishes the relationship where the standard of care does not require hands-on examination. The rule gives no list of qualifying conditions, so the protocol and the record have to carry that judgement.

    Source: Center for Connected Health Policy: Montana

PRESCRIBING

Prescriptions and controlled drugs in Montana

Prescribing here follows the board rule and federal law, with no separate state layer of consent forms or review intervals. The state's own controls are in the license and in the monitoring program.

  1. 01

    Federal compliance is the condition

    The permission to prescribe Schedule II drugs by telemedicine is expressly conditioned on compliance with the federal requirements, so the operative constraints are the Drug Enforcement Administration's rather than a state carve-out.

    Source: Montana Admin. Rule 24.156.813

  2. 02

    The monitoring program

    The prescription drug registry is administered through the Board of Pharmacy, with dispensers reporting into it and prescribers able to query a patient's history. It supports the diagnosis the board rule already requires.

    Source: Montana Code Annotated

  3. 03

    Certification work is narrower

    A physician certifying a debilitating medical condition cannot rely on audio-only communication unless the relationship was previously established through an in-person encounter, which is a tighter rule than ordinary treatment carries.

    Source: Center for Connected Health Policy: Montana

  4. 04

    Dispensing into the state

    A pharmacy outside the state that ships to a patient here registers with the Montana Board of Pharmacy and is held to its dispensing and compounding standards on those shipments.

    Source: Montana Board of Medical Examiners

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 Montana

The Board of Medical Examiners licenses physicians, and the state belongs to the Interstate Medical Licensure Compact. There is no telehealth registration, so the license is the only door for most professions.

  1. 01

    A license, however it is obtained

    Out-of-state providers must be licensed here to deliver telehealth to a patient in the state. The compact shortens the application through a letter of qualification but still ends in a license issued by this board.

    Source: Interstate Medical Licensure Compact

  2. 02

    The nutrition therapy exception

    A registered or certified dietitian from another state may deliver medical nutrition therapy by telehealth without a license here when consulting with a locally licensed practitioner or continuing care for an established patient.

    Source: Center for Connected Health Policy: Montana

  3. 03

    Nurse practitioners practice independently

    Nurse practitioners sit in the full practice column of the American Association of Nurse Practitioners map, assessing, diagnosing, ordering tests and prescribing under the board of nursing with no physician agreement behind them.

    Source: AANP: full practice authority brief

  4. 04

    Discipline reaches the remote visit

    Because practice occurs where the patient is, a clinician treating someone here submits to the board's jurisdiction for that encounter. The board applies its rules to a video visit exactly as it would to a clinic appointment.

    Source: Montana Board of Medical Examiners

How Tessic Health's providers are licensed in Montana

ADVERTISING

Marketing to patients in Montana

Marketing here meets two bodies of law: the consumer protection chapter on the claims themselves, and the privacy act on the data behind the targeting, which is the part that separates this state from its neighbours.

  1. 01

    Opt-in for health data

    Information revealing a health condition is sensitive data, which the privacy act requires consent to process. That reaches conversion tracking and audience building as much as it reaches the clinical record.

    Source: Center for Connected Health Policy: Montana

  2. 02

    A low threshold to be caught

    Because the act applies at fifty thousand consumers rather than the hundred thousand common elsewhere, a mid-sized telehealth brand can be in scope here while remaining out of scope in several neighbouring states.

    Source: Montana Code Annotated

  3. 03

    Genetic data has its own rules

    Montana separately regulates consumer genetic information, requiring express consent for collection, use and disclosure by direct-to-consumer testing companies, which matters for any brand bundling a genetic panel into a program.

    Source: Montana Code Annotated

  4. 04

    Claims are still a license matter

    False or misleading advertising by a licensee is grounds for discipline by the Board of Medical Examiners, so the brand's promotional claims about outcomes can reach the clinician's license as well as the company.

    Source: Montana Board of Medical Examiners

TESSIC HEALTH IN MONTANA

How Tessic Health's providers cover Montana

Every Montana encounter is mapped to one of the three routes the board rule recognizes before it is booked.

  1. 01

    Licensed where the patient sits

    Clinicians treating someone located in the state hold a license from the relevant board here, obtained through the compact where that route is open to them, because the rule places the practice at the patient.

  2. 02

    The route is recorded

    Intake records which of the three routes established the relationship, and where it is the telemedicine route, the note states why an in-person examination was not clinically required.

  3. 03

    History before any prescription

    No prescription is issued before a medical history sufficient for diagnosis is gathered and documented, which is the sequence the board rule sets out rather than a matter of internal preference.

  4. 04

    Consent captured under board rules

    Informed consent for telemedicine is taken and documented at the first encounter, covering the modality, its limits and the plan for escalation to in-person care.

  5. 05

    Consent before health data is used

    Brands operating here take opt-in consent before any data revealing a health condition is processed for marketing, and prescriptions ship at 0% markup from pharmacies registered with the state board.

COMMON QUESTIONS

Questions about telehealth in Montana

  • By one of three routes in the board rule: an in-person interview and physical examination, a consultation with another licensee who already has a documented relationship, or telemedicine where the standard of care does not require an in-person encounter.

  • Yes, in compliance with federal requirements. The board rule says so expressly, which is a permission rather than silence, and the prescriber still needs a medical history sufficient for diagnosis first.

  • No. Out-of-state providers need a license from the relevant board here. The Interstate Medical Licensure Compact can shorten the application for physicians, but it still produces a license issued by this state.

  • Possibly at a smaller size than elsewhere. The act reaches controllers processing the data of fifty thousand consumers, and it classes data revealing a health condition as sensitive, which requires consent before processing.

  • Narrow cases only. A dietitian from another state may provide medical nutrition therapy by telehealth when consulting with a locally licensed practitioner or continuing care for an established patient.

  • No. This is a full practice authority state, so a nurse practitioner assesses, diagnoses, orders and interprets tests, and prescribes under the board of nursing with no collaborative agreement required.

SOURCES

Rules checked September 2026 · 17 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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