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DEA Telemedicine & Controlled Substances: Don’t Get Caught in the Transition

DEA Telemedicine & Controlled Substances: Don’t Get Caught in the Transition

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The pandemic-era flexibilities that allowed clinicians to prescribe controlled substances via telemedicine without an initial in-person visit are on borrowed time. The DEA has proposed permanent rules, but the clock is ticking and practices need a plan.

Key DEA Telemedicine Rule Changes for Controlled Substances

Six-Month Rule for Tele-Initiated Care

Under the proposal, clinicians could start certain treatments (like buprenorphine for opioid use disorder) via telemedicine, including audio-only, but must complete an in-person evaluation within six months.

Prescription Drug monitoring Program (PDMP) Checks Required

Prescribers must review PDMP data before issuing controlled substance prescriptions.

Temporary Extensions Continue-for Now

The DEA signaled a fourth extension beyond December 31, 2025, but final text and timeliness remain uncertain. If rules aren’t finalized quickly, practices could face abrupt compliance changes.

Preparing Your Practice for DEA Telemedicine Compliance

Build a Contingency Plan

  • Identify patients currently receiving controlled substances via telemedicine.
  • Schedule in-person visits within six months of tele-initiation.

Harden Compliance

  • Require PDMP checks for all controlled substance prescriptions.
  • Document telemedicine modality and compliance steps in the EHR.

Train Staff & Communicate

  • Prepare scripts for explaining new requirements to patients.
  • Update scheduling workflows to flag at-risk patients.

Monitor DEA updates

  • Subscribe to DEA alerts and professional association guidance for final rule timing.

Stay Compliant

As final guidance takes shape, FD will continue sharing timely insights to help practices anticipate changes, adjust workflows and stay compliant—without disruption to patient care.

Have questions about how these changes may impact your practice? Our team can help you assess risk and prepare for the transition.

Talk to a specialist

Contributors

Heather Gibson, Senior Consultant, Frazier & Deeter Advisory, LLC

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