Alaska Telemedicine Laws: Licensure, Prescribing, Coverage

Alaska requires its own license for most telehealth with patients located in the state. Apart from consultations requested by an Alaska physician, physicians licensed elsewhere get only a narrow privilege under AS 08.02.130(b), limited to follow-up care for patients they have already seen in person and to care for life-threatening conditions. Providers licensed in Alaska may treat without a prior in-person visit, and Alaska-licensed physicians, physician assistants, and APRNs may prescribe controlled substances by telehealth. The Medical Board may not discipline no-exam prescribing that meets the statutory conditions. Medicaid pays for covered telehealth, audio-only included, as it pays in person, subject to regulatory exclusions. Commercial law mandates coverage, not payment parity. See how state telemedicine laws work.

Licensure: a license, or one of three narrow doors

AS 08.64.170 bars practicing medicine in Alaska without a license under that chapter. AS 08.02.130(a) lets a provider licensed in Alaska treat a patient in the state through telehealth, within scope, "without first conducting an in-person visit."

For physicians licensed in another state, subsection (b) creates a privilege that "extends only to" three situations:

1. ongoing treatment or follow-up care related to services the physician previously provided, only if the two have an established physician-patient relationship and the physician has previously conducted an in-person visit with the patient;
2. a visit about a suspected or diagnosed life-threatening condition, when an Alaska-licensed physician has referred the patient and documented the referral, and the visit covers diagnostic or treatment plan options or analysis of test results for that condition; or
3. ongoing treatment or follow-up care for a suspected or diagnosed life-threatening condition.

Out-of-state members of that physician's multidisciplinary care team may take part only if the service "is not reasonably available in the state." The State Medical Board disciplines privilege holders under AS 08.64.333. The privilege does not cover new patients generally: a physician licensed elsewhere who has not seen the patient in person, and who is not treating a suspected or diagnosed life-threatening condition, needs an Alaska license unless another exception, such as a consultation requested by an Alaska physician, applies.

AS 08.64.370 lists exceptions to the licensing chapter, including an out-of-state physician "asked by a physician or osteopath licensed in this state to help in the diagnosis or treatment of a case," unless that physician is practicing under AS 08.02.130(b).

Alaska has no provider telehealth registration, but under AS 44.33.381 and 12 AAC 12.025 a business that performs telemedicine services must join the Department of Commerce's telemedicine business registry before serving a recipient located in Alaska.

Alaska is a full Physical Therapy Compact member and belongs to neither the Nurse Licensure Compact nor the Counseling Compact. HB 110, chapter 28, SLA 2026, which became law without the governor's signature, enacted the Interstate Medical Licensure Compact (AS 08.64.253), the PA Licensure Compact (AS 08.64.254), and PSYPACT (AS 08.86.225), and enacted the Social Work Licensure Compact (AS 08.95.200) effective January 1, 2027. The IMLC Commission lists Alaska as "IMLC Passed; Implementation Delayed", and PSYPACT does not yet list Alaska as participating. See our cross-state licensing tracker.

Prescribing without an exam: a safe harbor from discipline

AS 08.64.364 covers physicians and physician assistants who treat or prescribe without a physical examination. The board may not discipline them for prescribing a non-controlled drug if the prescriber or another licensed provider in the practice is available for follow-up care, and the prescriber (when not the primary care provider) asks the patient's consent to send the encounter records to that provider and sends them if the patient consents. For controlled substances, the same protection applies only if those conditions and the opioid limits in AS 08.64.363 are met. Two outright bars follow: no prescription "in response to an Internet questionnaire or electronic mail message" to a person without a prior physician-patient relationship, and no abortion-inducing drug unless the physician complies with AS 18.16.010. Among its conditions, that statute requires an abortion to be performed by a physician licensed by the State Medical Board, in a hospital or other facility approved by the Department of Health or a federal hospital; a knowing violation is punishable by a fine, imprisonment for up to five years, or both. A 2024 superior court ruling struck the physician-only requirement, and the state's appeal was argued in the Alaska Supreme Court in October 2025. In June 2026 Planned Parenthood Great Northwest, Hawaiʻi, Alaska, Indiana, Kentucky sued in superior court to lift the approved-facility requirement, which it says bars direct-to-patient telehealth abortion. Check the status of both cases before relying on either. AS 08.68.710 applies parallel conditions to advanced practice registered nurses.

12 AAC 40.943 adopts the FSMB's April 2014 Model Policy for the Appropriate Use of Telemedicine Technologies as the standard of practice for care without an in-person physical examination. It calls for documented informed consent, an emergency plan with a written protocol when a patient needs acute or emergency care, and continuity of care.

Under AS 08.02.130, physicians, podiatrists, osteopaths, and physician assistants licensed under AS 08.64, and APRNs licensed under AS 08.68, may prescribe controlled substances through telehealth if they comply with state and federal law; subsection (g) bars other Title 8 licensees. A physician practicing under the subsection (b) privilege is not licensed under AS 08.64 and so is not covered by subsection (e). Under AS 08.64.333(a)(3), prescribing, dispensing, or administering any controlled substance by telehealth to a patient located in Alaska is by itself a ground for sanction. The sanctions include a permanent or fixed-term ban on practicing in the state, a civil fine, a cease-and-desist order, and notice to every state where the physician is licensed.

• Opioid supply. AS 08.64.363 caps an initial outpatient opioid prescription for an adult, and any opioid prescription for a minor, at a seven-day supply, and a prescriber must discuss the risks with a minor's parent or guardian. Exceptions cover acute conditions, chronic pain, cancer pain and palliative care; travel or logistical barriers to a refill; and substance abuse or opioid dependence treatment, each with documentation that a nonopioid alternative was not appropriate.
• PDMP. A practitioner who prescribes, administers, or directly dispenses a schedule II, III, or IV controlled substance must register with the database (AS 17.30.200(n)), and the Medical Board requires every licensee with a DEA registration to register (AS 08.64.101(a)(7)). Under regulations that AS 17.30.200(k)(4) requires, a practitioner must review the database before dispensing, prescribing, or administering a schedule II or III controlled substance, with exceptions for inpatient settings, emergency scenes and ambulances, emergency rooms, the first 48 hours after surgery or a procedure, hospices and nursing homes with in-house pharmacies, and nonrefillable prescriptions for three days or less.
• Registration. Alaska issues no separate state controlled-substance registration; PDMP registration is the state step.

We found no Alaska electronic-prescribing mandate for controlled substances. Medicare Part D separately requires at least 70 percent of Part D Schedule II–V prescriptions to be electronic under 42 CFR 423.160, subject to exceptions and waivers.

Federal law adds a separate layer for controlled substances. Under the temporary rule DEA and HHS published December 31, 2025 (90 FR 61301), which runs through December 31, 2026, a DEA-registered practitioner may prescribe Schedule II–V controlled substances after a real-time audio-video telemedicine encounter without a prior in-person evaluation, when the rule's other conditions are met; audio-only encounters qualify only for Schedule III–V narcotic medications approved by the FDA to treat opioid use disorder. See our guide to federal telehealth laws.

Consent: a Medicaid documentation rule

Alaska has no general telehealth consent statute. AS 08.64.364 asks for consent only before records go to the primary care provider, and the FSMB policy calls for informed consent. To be paid by Medicaid for a synchronous telehealth service, 7 AAC 110.630(9) requires the rendering provider, and any consulting provider, to note in the record the delivery method, the recipient's location, and "confirmation that the recipient has consented to a telehealth method of delivery." No form is prescribed.

Medicaid: parity in statute, audio-only by rule

AS 47.07.069(a) directs the Department of Health to pay for all covered services provided through telehealth "in the same manner as if the services had been provided in person." Its list includes behavioral health, rural health clinics and FQHCs, and services "by telephone." Subsection (b) bars lowering the rate based on either party's location or the communication method, or whether the service was synchronous or asynchronous.

7 AAC 110.625 covers HIPAA-compliant two-way audio-video, two-way audio-only, and store-and-forward. Under 7 AAC 110.620, a telehealth service must be one covered in person and meet the same prior authorization rules and service limits. 7 AAC 110.635 excludes services including chiropractic, dental, home health, personal care, and most home and community-based waiver services. The payment conditions in 7 AAC 110.630 include an active Alaska license or certification, or a license in the jurisdiction where the provider is located; Medicaid enrollment; telemedicine business registry registration if required; delivery within the provider's scope of licensure, with the encounter stopped and only the in-scope portion billed if it goes beyond; telehealth modifiers and place-of-service coding; the recipient's presence, except as otherwise provided; and standard record keeping. That license language is a billing condition only; it does not change who may practice in Alaska.

Private insurance: coverage, not payment

AS 21.42.422(a) requires an insurer offering a group or individual plan in Alaska to "provide coverage for benefits provided through telehealth by a health care provider licensed in this state." It may not require prior in-person contact before paying for covered services. Covered insurers include HMOs and governmental plans, except nonfederal governmental plans that opt out under federal law. The section sets no payment rate and says nothing about cost-sharing or utilization review.

What to watch

• Compact implementation. HB 110 delays some sections to January 1, 2027, but not the IMLC or PSYPACT sections (or the PA Licensure Compact), which follow the 90-day rule in AS 01.10.070. Watch for the IMLC to begin issuing Alaska licenses and for PSYPACT to list Alaska.
• Respiratory care. HB 110 adds licensed respiratory care practitioners to the AS 08.02.130 provider list effective January 1, 2027.
• Medicaid rates. Sections 9 and 10 of chapter 38, SLA 2022, would drop the "same manner" language and let telehealth rates differ from in-person rates. They take effect June 30, 2030, only if federal HHS approves the state plan amendments, or finds approval unnecessary, by then.
• SB 83. This bill on insurer telehealth reimbursement, whose title would also have repealed the effective date of that Medicaid change, went to House Rules on May 16, 2026 and did not pass.