Georgia Telemedicine Laws: Licensure, Prescribing, Parity

Georgia is a payment-parity state with a genuine licensure shortcut — a telemedicine-only physician license — and a medical board that regulates telehealth through its unprofessional-conduct rules rather than a statute. Treating a patient located in Georgia requires Georgia authorization, the Board's rule expects an examination that meets in-person standards before treatment, and since January 1, 2020 insurers have had to pay for telemedicine "on the same basis and at least at the rate" of in-person care. The part that trips people up is controlled substances, where the Board's position has moved by vote several times since late 2023.

Licensure: three doors, all of them Georgia doors

Care is rendered where the patient sits, and the Board's telemedicine rule opens with the requirement that "all treatment and/or consultations must be done by Georgia licensed practitioners." There are three ways to satisfy that.

The first is a full Georgia license. The second is the Interstate Medical Licensure Compact: Georgia enacted the compact through SB 16 in 2019 and has been live since September 2021; it issues licenses through the compact's expedited pathway, and can act as a physician's state of principal license when the residency or practice-location tests are met.

The third is the one that distinguishes Georgia. Under O.C.G.A. § 43-34-31.1 and Board Rule 360-2-.17, a physician who holds a full, unrestricted license in another state and has no disciplinary history in any jurisdiction can receive a telemedicine license. It is limited to telemedicine — the holder may not practice in person on a Georgia patient except in an emergency — and it requires Georgia-standard recordkeeping and immediate notice to the Board of any out-of-state restriction. It carries its own initial and renewal fees, set by the Board's published fee schedule.

One caution the Board itself posts: the DEA treats a telemedicine license as a restricted license, so a physician who needs a Georgia DEA registration should consider the full license instead. Georgia also belongs to the PT compact; Georgia is also a Nurse Licensure Compact state, a PSYPACT participating state since July 2020, and one of the nine states where Counseling Compact privileges are live.

Prescribing: the exam is the hinge, and the Board votes on the rest

Rule 360-3-.07 does not require an in-person visit as such. It requires one of four things before electronic treatment: the practitioner has personally examined the patient; a Georgia-licensed practitioner who examined the patient requested the electronic care; the care is at the request of a public health nurse, school nurse, child-protection agency, or similar body with adequate technology; or the practitioner can examine the patient "using technology or peripherals that are equal or superior to an examination done personally." That last option is what allows a first visit to happen online. The rule also requires "diligent efforts" to have the patient examined in person by a Georgia licensee at least annually.

Rule 360-3-.02(5) defines as unprofessional conduct "prescribing controlled substances … and/or dangerous drugs … based solely on a consultation via electronic means." The same rule says this does not prohibit prescribing a dangerous drug (a non-controlled prescription drug) within a valid physician-patient relationship under O.C.G.A. § 33-24-56.4, on-call prescribing of up to a 30-day supply for another licensee's patient, or prescribing in documented emergencies. The rule also allows a physician to prescribe a Schedule II stimulant for attention deficit disorder to a patient in the physical presence of a licensed nurse, provided the initial diagnosis was made and the initial prescription was issued in accordance with the federal Ryan Haight Act (21 U.S.C. § 829(e)). Rule 360-3-.07 states that it "does not authorize the prescription of controlled substances for the treatment of pain or chronic pain by electronic or other such means," and sends all pain treatment to the Board's pain management rule, Rule 360-3-.06. That rule requires a medical history, a physical examination and informed consent before a physician initially prescribes a controlled substance for pain or chronic pain, except that in a documented emergency a physician may prescribe up to 72 hours of medication without a physical examination.

The Board's departures from that default have been made by motion, not rulemaking. It announced in December 2023 that its pandemic-era flexibility would end, extended it in January 2024 to May 1, 2024, in January 2025 "agreed to accept the federal position" through 2025, and at its January 8, 2026 meeting voted "to extend telemedicine flexibilities until the end of 2026 in alignment with the DEA and HHS." The practical reading for telepsychiatry groups: Georgia currently tracks the federal window described in our DEA prescribing report, but a Board vote can change that at any meeting, and pain prescribing is excluded regardless.

Other state duties apply to telehealth exactly as they do in person:

• PDMP. A prescriber of a controlled substance listed in paragraph (1) or (2) of O.C.G.A. § 16-13-26 (the Schedule II opiates and cocaine derivatives) or of a benzodiazepine must seek and review the patient's information in the Georgia PDMP the first time the prescriber issues that prescription to the patient, and at least once every 90 days after that. Exceptions cover a supply of no more than three days and 26 pills; patients in a hospital or health care facility where the medication is administered on site; outpatient surgery prescriptions of no more than ten days and 40 pills; terminally ill or outpatient hospice patients; and patients receiving cancer treatment. The prescriber must document the check and who ran it (O.C.G.A. § 16-13-63; Rule 360-38-.04). The Department of Public Health states that all prescribers with an active Georgia professional license and an active DEA number must register with the PDMP.
• Registration. O.C.G.A. § 16-13-35 requires anyone who dispenses controlled substances in Georgia to hold an annual State Board of Pharmacy registration, and it makes separate provision for physicians, dentists, and veterinarians licensed in Georgia to prescribe and dispense drugs; we found no separate registration application for Georgia-licensed physicians, so the DEA registration for Georgia is the operative step. APRNs and PAs should confirm their status with the Georgia Drugs and Narcotics Agency. Georgia Medicaid requires a Georgia DEA registration of out-of-state telehealth providers who prescribe controlled substances to members in the state.
• Opioid limits. We found no Georgia statute or Board rule capping the day supply of an opioid prescription. Rule 360-3-.06 instead requires a written treatment agreement, periodic bodily-fluid monitoring and a clinical visit at least every three months (annually with documented hardship or at a morphine-equivalent daily dose of 30 mg or less) when a Schedule II or III drug is prescribed for chronic pain for 90 consecutive days or more, outside terminal, nursing home and hospice care.
• E-prescribing. We found no Georgia statute requiring electronic prescribing of 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. The Board rules above still apply on top of that federal rule.

Consent: Medicaid requires it in writing; the Board rule does not

Georgia has no general telehealth consent statute, and Rule 360-3-.07 imposes disclosure duties rather than a consent form. Georgia Medicaid is stricter. The DCH Telehealth Guidance requires written consent before the initial telehealth service, stating that the member agrees to participate and describing the risks, benefits, and consequences of telehealth, filed in the medical record. A parent or guardian must present a minor and sign, unless state or federal law exempts the service from parental consent, and members must be told they can refuse telehealth at any time without losing access to care. Licensed counselors, social workers, and marriage and family therapists also answer to their own board's telemental-health rule.

Medicaid: video-first, credential-heavy, narrow on audio

Georgia Medicaid covers live interactive audio-video visits when medically necessary, billed with the GT modifier and place-of-service 02 (outside the home) or 10 (patient's home). The POS 10 instruction is the clearest signal that the home is a recognized originating site, even though the facility-fee list (HCPCS Q3014) is institutional. Store-and-forward is defined and used for specific services such as dental, billed with the GQ modifier. Remote patient monitoring is not a covered Medicaid benefit per CCHP's current summary.

Audio-only is the constraint. The handbook lists "telephone conversations" among non-covered modalities while providing modifier 93 for audio-only services "as appropriate" — in practice a narrow set, largely behavioral health, and any audio-only encounter must run on HIPAA-compliant technology. Confirm the specific code with DCH or the member's care management organization.

Out-of-state providers face additional enrollment conditions: credentialing through DCH's centralized verification organization, an arrangement with a local physician holding admitting privileges or a local hospitalist, and a Georgia DEA registration if prescribing controlled substances to members located in the state.

Private insurance: coverage parity and payment parity, with an audio-only exception

O.C.G.A. § 33-24-56.4, the Georgia Telehealth Act, as amended effective January 1, 2020, requires insurers to cover services appropriately provided through telehealth and to reimburse telemedicine "on the same basis and at least at the rate" paid for the same in-person service — true payment parity, not merely coverage parity. The originating site may be the patient's home, workplace, or school. Insurers may not require an in-person visit before telemedicine, may not impose telehealth-specific deductibles or dollar maximums, may not impose any type of utilization review on telemedicine that they do not impose on the same service in person, may not limit coverage to a particular vendor or platform, and may not restrict telemedicine prescribing beyond what state and federal law already require (as amended by HB 307, Act 188 of 2021). The Telehealth Act does not address out-of-network providers. For network plans other than HMOs, a 2023 network adequacy law adds that an insurer may not require prior authorization for a telehealth service that would not need it in person, require a provider to join a telehealth network, or require a patient to use telehealth instead of a nonparticipating provider available in person (O.C.G.A. § 33-20E-24(e), effective January 1, 2024).

Nothing in the parity subsection requires an insurer to pay for an audio-only visit "for any service other than mental or behavioral health services," and the statute's definition of telemedicine admits audio-only telephone only when real-time audio-visual communication is unavailable to the patient. For how Georgia's parity interacts with Medicare and commercial billing, see our reimbursement guide.

What to watch

Georgia's statutes have been stable since 2020, and the Board has no pending notice of intent on Rule 360-3-.07. Three things move. First, the Board's controlled-substance position, which is a standing vote tied to the federal DEA flexibilities and can be revisited at any monthly meeting. Second, the DCH Telehealth Guidance handbook, which the state revises periodically and which governs the audio-only and modifier details. Third, the scope of payment parity, which has no sunset but has not been extended to audio-only beyond behavioral health. Verify current requirements with the Composite Medical Board and DCH before acting — and compare Georgia's approach with the rest of the region in the national overview.