Arkansas Telemedicine Laws: Licensure, Prescribing, Parity

Arkansas's Telemedicine Act, A.C.A. §§ 17-80-401 through 17-80-407, turns on one question: whether a professional relationship exists. An Arkansas license is required, controlled substances are restricted by Medical Board rule, and the insurance code requires commercial plans and Medicaid to pay for telemedicine on the same basis as in-person care. See how state telemedicine laws work for the national picture.

Licensure: an Arkansas license, with narrow exceptions

A.C.A. § 17-80-404(d)(1) requires a healthcare professional "who is treating patients in Arkansas through telemedicine" to be fully licensed or certified to practice in Arkansas and subject to the appropriate board's rules. Subsection (d)(2) carves out one group: a professional "located in another jurisdiction who provides only episodic consultation services." For Medical Board licensees, 17 CAR § 140-3201 (Rule 38) repeats the point: every provider caring for a patient located in Arkansas by telemedicine must hold an Arkansas license to practice medicine.

The Medical Practices Act adds a physician-specific list. A.C.A. § 17-95-206 treats an out-of-state physician who performs any part of a patient care service initiated in Arkansas, including reading an X-ray or pathology material, as practicing medicine in Arkansas. It lists six exclusions: episodic consultation by a medical specialist, consultation to a medical school, insurance or HMO coverage decisions, a service not available in the state, seeing a patient in person in another jurisdiction, and other acts the Board exempts by rule. These exclusions limit § 17-95-206 only; they do not override § 17-80-404(d), which requires an Arkansas license for telemedicine and excepts only episodic consultation. Section 17-95-207 gives an applicant under § 17-95-206 a temporary license while the application is pending. Arkansas has no telehealth registration.

Under § 17-80-403, a distant-site professional may not use telemedicine with a patient in Arkansas unless a professional relationship exists, except in emergencies where the patient's life or health is in danger or imminent danger, or when giving generic information. A relationship cannot be formed only by an internet questionnaire, email, patient-generated medical history, text messaging, fax, or any combination of them. Where a board allows the relationship to be established by telemedicine, that is permitted only "for situations in which the standard of care does not require an in-person encounter." Section 17-80-404(a)(3) bars any other licensing board from permitting telemedicine in a manner less restrictive than the Medical Board allows.

Section 17-80-404 also bars telemedicine group therapy for a child 18 or younger, and requires a professional treating a Medicaid-enrolled minor in a school setting to be, cover for, or have authorization from the child's designated primary care provider, if the child has one.

Arkansas enacted the Interstate Medical Licensure Compact in SB 119 (Act 269 of 2025), with a statutory effective date of March 12, 2025, but it is not yet live. Arkansas has issued multistate nursing licenses since January 19, 2018, is a full PSYPACT member effective November 18, 2021 under HB 1760, and is a full member of the Physical Therapy Compact and the Counseling Compact. See our cross-state licensing tracker.

Prescribing: a relationship test, then a controlled-substance bar

Section 17-80-404(c) holds telemedicine care, "including without limitation a prescription through telemedicine," to the in-person standard of care. The Medical Board adds rules for its licensees, including these five:

1. Relationship before treatment. Rule 2.8, 17 CAR § 140-202(b)(8), makes it gross negligence to treat or prescribe legend drugs without a proper relationship. Its listed routes include an in-person history and physical, access to the patient's personal health record with use of any appropriate technology including the telephone to prescribe a noncontrolled drug, or an ongoing personal or professional relationship; a relationship is also deemed to exist when treatment is given in consultation with, or on referral by, a provider who has an ongoing relationship with the patient and has agreed to supervise treatment, or in on-call or cross-coverage situations arranged by the patient's treating provider.
2. Controlled substances. Rule 38, as printed in the Board's compilation (¶2.E), bars a provider using telemedicine from prescribing any Schedule II through V drug "unless the Provider has seen the patient for an in-person exam or unless a relationship exists through consultation or referral; on-call or cross-coverage situations; or through an ongoing personal or professional relationship."
3. PDMP checks. A.C.A. § 20-7-604(d)(2) and Medical Board Rule 41 require a prescriber to check the Prescription Drug Monitoring Program every time an opioid from Schedule II or III is prescribed, and the first time a benzodiazepine is prescribed, with exemptions that include administering a controlled substance in surgical, healthcare-facility and emergency settings, prescribing or administering to hospice, palliative care and nursing home patients, and system outages. Physicians and physician assistants must document the check.
4. Opioid limits. Rule 2 treats an initial acute-pain prescription over seven days as excessive without documented justification, and chronic-pain prescribing at 50 MME per day or more as excessive unless listed conditions are documented, including in-person examination every three months.
5. Medical marijuana. A physician may not issue a written certification based on a telemedicine assessment, though an established relationship may be used for recertification by telehealth.

A.C.A. § 5-64-308(c), as amended by Act 447 of 2019, requires prescriptions for Schedule II through VI controlled substances to be transmitted electronically to a pharmacy, subject to the exceptions in subsection (d), including technological failure, out-of-state pharmacies and waivers. The mandate takes effect on the later of January 1, 2021 or the Attorney General's certification that HHS requires mandatory electronic prescribing; the Department of Health told prescribers to be ready by January 1, 2022, but the code still labels the section contingent, so confirm enforcement with the Board of Pharmacy.

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: general informed-consent law, not a telehealth form

Arkansas has no telemedicine-specific consent statute. Section 17-80-404(e) directs professionals to follow applicable state and federal law on four subjects: informed consent, privacy of individually identifiable health information, medical recordkeeping and confidentiality, and fraud and abuse. In Rule 38, consent appears once: unless the patient declines to consent, the provider must forward a record of the encounter to the patient's regular treating provider when that provider is someone else. Rule 38 also requires advance disclosure of the provider's identity, licensure, board certifications and the patient's financial responsibilities, and it requires the provider to obtain a detailed explanation of the patient's complaint, provide or arrange any indicated follow-up care, arrange an in-person visit or direct the patient to an appropriate provider when the provider recommends one (and document that recommendation), and establish protocols for referring patients to emergency services (17 CAR § 140-3201(b)(2), (4), (9), (10)).

Medicaid: same basis, audio-only by condition

The insurance-code telemedicine subchapter applies to Arkansas Medicaid by its terms, under A.C.A. § 23-79-1602(a)(2), and its definition of health benefit plan includes the Arkansas Health and Opportunity for Me program. Section 105.190 of the Medicaid provider manual's Section I, effective January 1, 2022, pays for telemedicine when the service is comparable to the in-person service, reimburses it "on the same basis as for services provided in person," and allows a facility fee only to an originating site operated by a professional or entity authorized to bill Medicaid directly. There is no distant-site facility fee. Under Section III, § 305.000, the originating site bills HCPCS Q3014 and the distant site bills the professional code with place of service 02.

Audio-only is covered only when it qualifies. The manual excludes audio-only communication "unless the audio-only communication is in real-time, is interactive, and substantially meets the requirements for a health care service that would otherwise be covered." The record must document the problem, the content of the conversation, medical decision-making and the plan of care, and it is subject to the same audits as in-person documentation. Section I lists no specific audio-only services; check the provider-type manual.

Private insurance: coverage and payment parity

A.C.A. § 23-79-1602(c)(1) requires a health benefit plan to cover and reimburse telemedicine "on the same basis" as in-person care, and subsection (d)(2) supplies the payment rule: the combined amount allowed to the distant and originating sites "shall not be less than the total amount allowed for healthcare services provided in person." Two limits apply. A plan need not reimburse a telemedicine service "that is not comparable to the same service provided in person," and it need not pay more than it would have in person. Under subsection (f), a plan may also limit telemedicine coverage to medically necessary services on the same terms that apply in person, and may conduct utilization review, including prior authorization, if it decides appropriateness the same way it does for in-person care.

Subsection (e) bars dollar maximums, deductibles, copayments, coinsurance and benefit limits not equally imposed on all covered services; prior authorization stricter than for in-person care; any requirement that a covered person use a commercial telemedicine vendor or a telemedicine-only network rather than their regular provider; and cost-sharing on commercial telemedicine providers that is not equally imposed on network providers. Audio-only counts as telemedicine only if it meets the test in § 23-79-1601(7)(C), the same test Medicaid uses. A plan may voluntarily pay for excluded modalities, and under subsection (h) it may not bar a provider from billing the patient for audio-only services the plan does not reimburse. The statute has no sunset. It reaches insured plans, HMOs, and self-insured governmental and church plans, but does not list private self-funded employer plans. See our reimbursement guide.

What to watch

No 2025 or 2026 act amended the Telemedicine Act or the insurance telemedicine subchapter, and the next regular session convenes in 2027. Three items to track. First, when Arkansas begins issuing licenses through the Interstate Medical Licensure Compact under Act 269 of 2025. Second, the federal rule's December 31, 2026 end date; Rule 38's controlled-substance limit binds Medical Board licensees whatever the federal rule allows. Third, the Medicaid manual itself: Section I's telemedicine text still cites a real-time audio-video examination route under Rule 2.8 that the current Rule 2.8 text does not contain, so confirm relationship requirements with the Medical Board before relying on the Medicaid description.