Tessic Health

ND · STATE RULES

Telehealth rules in North Dakota

North Dakota wrote the sharpest opioid rule in its region. A prescriber may reach for an opioid through a telemedicine encounter only where it is a federally approved medication-assisted treatment for opioid use disorder, and for no other purpose at all. The same chapter disqualifies a first examination built on a static questionnaire or on an audio conversation, and opens a one-year window for a physician licensed in another state, or a Canadian province, to continue care that started there.

Book a DemoAll states
First visit
Async with conditions
Physician license
IMLC; one-year continuation
Controlled drugs
Opioids only for use disorder
Nurse practitioners
Full practice

Rules checked September 2026 · 13 sources cited

ONLY IN NORTH DAKOTA

What is different about North Dakota

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

  1. 01 · Prescribing

    Opioids only for opioid use disorder

    The telemedicine rule states that opioids may be prescribed through telemedicine only where the prescription is a federally approved medication-assisted treatment for opioid use disorder, and may not be prescribed through a telemedicine encounter for any other purpose. Pain management by telemedicine is therefore closed rather than conditioned.

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

    Across the border

    • Minnesota

      Minnesota imposes no such ban. Its distinctive prescribing rule is a transmission mandate covering every prescription, controlled or not, rather than a subject-matter limit on opioids.

      Source: Minn. Stat. 147.033

    • South Dakota

      South Dakota never reaches the question in these terms, because its telehealth definition covers only HIPAA-compliant interactive audio and video and excludes audio-only, email and fax outright.

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

    • Montana

      Montana runs the opposite way, with a board rule that expressly permits a licensee to prescribe Schedule II drugs by telemedicine where the federal requirements are satisfied.

      Source: Montana Admin. Rule 24.156.813

  2. 02 · First visit

    Neither a form nor a phone call is an exam

    N.D. Cent. Code 43-17-44 requires an examination or evaluation before a first diagnosis or treatment, and disqualifies two things by name: an examination consisting only of a static online questionnaire, and one consisting only of an audio conversation. Once an acceptable examination establishes the relationship, follow-up may be as the licensee thinks appropriate.

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

    Across the border

    • Minnesota

      Minnesota treats audio-only as telehealth in its own right, with statute keeping that recognition open until the first of July, twenty twenty-seven, rather than ruling a call out of a first evaluation.

      Source: Minn. Stat. 62A.673

    • South Dakota

      South Dakota reaches a similar place by definition rather than by disqualification, since a phone call was never inside its interactive audio and video definition to begin with.

      Source: S.D. Codified Laws 34-52

    • Montana

      Montana names three permitted routes to a relationship instead of two forbidden examinations, and lets telemedicine carry the first encounter wherever the standard of care does not demand hands-on work.

      Source: Montana Admin. Rule 24.156.813

  3. 03 · Licenses

    A year to continue care, Canada included

    Administrative rules let a physician licensed in another state or territory, the District of Columbia, or a Canadian province practice by telehealth here in named situations, including continued care of an established relationship for up to one year before an in-person encounter is required in the licensing state.

    Source: N.D. Admin. Code 50-02-15-03

    Across the border

    • Minnesota

      Minnesota provides no continuation clock and no recognition of a Canadian license, routing out-of-state physicians through the compact toward a license issued by its own board.

      Source: Center for Connected Health Policy: Minnesota

    • South Dakota

      South Dakota asks that a professional be fully licensed there or employed by a licensed health care facility, and offers reciprocity to qualified physicians rather than a window measured in months.

      Source: S.D. Codified Laws 34-52

    • Montana

      Montana holds the line at full licensure for medicine, with its only carve-out covering dietitians delivering medical nutrition therapy alongside a locally licensed practitioner.

      Source: Center for Connected Health Policy: Montana

PRACTICE RULES

How telehealth works in North Dakota

The state defines telemedicine broadly, taking in direct interactive encounters, asynchronous store-and-forward technology and remote monitoring, and then constrains what a licensee may do inside that definition.

  1. 01

    A bona fide relationship first

    N.D. Cent. Code 43-17-44 requires the licensee to establish a bona fide relationship with the patient before diagnosing or treating, which is what the examination requirement exists to produce.

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

  2. 02

    Verify who is on each end

    The licensee verifies the identity of the patient seeking care and discloses the identity and licensure status of any licensee providing medical services in the encounter. Both halves are the licensee's duty, not the platform's.

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

  3. 03

    Some professions are tighter

    Optometry requires the initial relationship to be established through an eye examination by an optometrist with a physical location in the state, and veterinary medicine bars a relationship formed solely through telemedicine.

    Source: Center for Connected Health Policy: North Dakota

  4. 04

    Consent content by profession

    Optometric consent must cover the provider's technology and how a technical disconnection would be resolved, and physical therapy requires written or verbal consent documented before a consultation. The general chapter leaves the rest to professional judgement.

    Source: Center for Connected Health Policy: North Dakota

FIRST VISIT

Can a first visit happen without a live call in North Dakota?

Yes, with conditions

Yes, if the encounter is a real evaluation. A static online questionnaire will not do it, and neither will an audio-only conversation, so a first visit here runs on video or on an asynchronous review substantial enough to count as an examination.

Once the first evaluation is done properly, the chapter relaxes: subsequent follow-up care may be provided as the licensee deems appropriate, which is where audio-only and asynchronous contact become workable.

  1. 01

    What the first exam must be

    The requirement is an examination or evaluation before initially diagnosing or treating for a specific illness or condition. Two shortcuts are named and excluded, which leaves interactive video or a thorough documented review.

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

  2. 02

    Follow-up is looser

    After an acceptable examination establishes the relationship, subsequent follow-up care may be provided as deemed appropriate, so a refill check or a progress review does not have to repeat the first encounter's format.

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

  3. 03

    Prescribing follows the exam

    A licensee who has performed a telemedicine examination or evaluation meeting the chapter's requirements may prescribe according to professional discretion and judgement, subject to the opioid limit that sits above it.

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

PRESCRIBING

Prescriptions and controlled drugs in North Dakota

Two rules do the work: the opioid restriction, and a requirement that a telemedicine prescriber take part in the state monitoring program rather than simply be permitted to query it.

  1. 01

    Participation, not just access

    The rule requires a telemedicine prescriber to comply with state and federal controlled-substance law and to participate in the state prescription drug monitoring program, which is phrased as an obligation rather than a permission.

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

  2. 02

    The opioid carve-out is narrow

    The only opioid prescription a telemedicine encounter supports is a federally approved medication-assisted treatment for opioid use disorder. A short course after an injury, or a chronic pain regimen, does not fit inside it.

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

  3. 03

    The federal valid-prescription test

    The state adopts the federal definition of a valid prescription issued for a legitimate medical purpose in the usual course of professional practice, which means the federal online pharmacy rules bite directly here.

    Source: Center for Connected Health Policy: North Dakota

  4. 04

    Non-opioid prescribing is ordinary

    Outside opioids, a licensee who has performed a qualifying examination prescribes on professional judgement, so weight, skin, hair and sexual health programs are not caught by the opioid restriction.

    Source: North Dakota Board of Medicine

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 North Dakota

The Board of Medicine licenses physicians and the state belongs to a long list of compacts. The distinctive feature is the set of named situations in which a clinician licensed elsewhere may practice here without one.

  1. 01

    The named situations

    Besides continued care of an established relationship, the rule covers temporary care for someone visiting the state, preparation for a scheduled in-person visit, consultation with a locally licensed physician, and gratuitous emergency services.

    Source: N.D. Admin. Code 50-02-15-03

  2. 02

    The compact for everything else

    For a continuing practice the compact is the route, giving a physician an expedited application through a letter of qualification from their state of principal licensure and ending in a license issued here.

    Source: Interstate Medical Licensure Compact

  3. 03

    Nurse practitioners practice independently

    Full practice authority applies here on the American Association of Nurse Practitioners map, so a nurse practitioner diagnoses, orders tests, manages treatment and prescribes under the board of nursing alone.

    Source: AANP: full practice authority brief

  4. 04

    Other professions have their own exits

    Medical nutrition therapists and foreign veterinarians continuing an existing relationship may work by telehealth without a license here, which is narrower than it sounds and does not extend to prescribing.

    Source: Center for Connected Health Policy: North Dakota

How Tessic Health's providers are licensed in North Dakota

ADVERTISING

Marketing to patients in North Dakota

There is no comprehensive consumer privacy act, so marketing runs into the consumer fraud provisions, the board's misconduct rules, and the federal health privacy floor.

  1. 01

    Consumer fraud

    State law prohibits deceptive acts and misrepresentation in connection with the sale or advertisement of merchandise or services, with enforcement by the attorney general and civil penalties attached.

    Source: N.D. Cent. Code

  2. 02

    Careful with opioid claims

    Because opioids by telemedicine are limited to treatment for opioid use disorder, any marketing that implies remote pain management is available here describes something the rule does not permit.

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

  3. 03

    Licensure disclosure is required

    The duty to disclose the identity and licensure status of the licensee providing services is a patient-facing obligation, so the clinician's name and credential belong in the product rather than only in the record.

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

  4. 04

    Claims reach the license

    False or misleading advertising by a licensee is a discipline ground before the Board of Medicine, which means a brand's promotional language can put the treating clinician's credential at issue.

    Source: North Dakota Board of Medicine

TESSIC HEALTH IN NORTH DAKOTA

How Tessic Health's providers cover North Dakota

No opioid is prescribed to a North Dakota patient outside treatment for opioid use disorder, and every first encounter is built to survive the chapter's examination test.

  1. 01

    First visits on video

    First encounters here run on interactive video, or on an asynchronous review documented thoroughly enough to count as an evaluation, because a static questionnaire and an audio-only call are both excluded by name.

  2. 02

    Opioids are off the menu

    Prescribing protocols for patients in this state exclude opioids except as a federally approved medication-assisted treatment for opioid use disorder, and the exclusion is enforced in the formulary rather than left to the clinician.

  3. 03

    Monitoring program participation

    Prescribers treating patients here participate in the state prescription drug monitoring program as a condition of taking visits, rather than registering only when a query is needed.

  4. 04

    Identity and credential on screen

    Each encounter verifies the patient's identity and shows the treating clinician's name and licensure status to the patient, which the chapter requires of the licensee directly.

  5. 05

    Follow-up uses the looser rule

    Once a qualifying first evaluation is on file, follow-up contact can use lighter modalities, which is where asynchronous messaging and audio check-ins are used rather than at the opening of care.

COMMON QUESTIONS

Questions about telehealth in North Dakota

  • No. An examination consisting only of a static online questionnaire does not meet the standard of care for a first diagnosis or treatment, and an examination consisting only of an audio conversation is excluded by the same provision.

  • Only for opioid use disorder. The rule permits an opioid prescription through telemedicine where it is a federally approved medication-assisted treatment for that condition, and states that opioids may not be prescribed through telemedicine for any other purpose.

  • In the named situations, yes. The rules reach physicians licensed in another state or territory, the District of Columbia, or a Canadian province, including continued care of an established relationship for up to one year.

  • For follow-up, yes. The exclusion applies to the first examination, and once an acceptable evaluation has established the relationship, subsequent follow-up care may be provided as the licensee deems appropriate.

  • Yes. The telemedicine rule requires a prescriber to comply with state and federal controlled-substance law and to participate in the state prescription drug monitoring program, which is framed as an obligation.

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

SOURCES

Rules checked September 2026 · 13 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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