Indiana Telemedicine Laws: Licensure, Opioid Ban, Parity

Indiana reads as permissive until the prescribing section. The telehealth chapter, IC 25-1-9.5, lets a prescriber establish a relationship and write a prescription for a patient never examined in person, and the state runs no telehealth license. What it does run is a flat prohibition on prescribing opioids by telehealth, an absolute prohibition on telehealth abortion, and a statutory checklist for the virtual encounter. The most recent structural change was a subtraction: the telehealth certificate Indiana once required no longer exists.

Licensure: an Indiana license, and nothing substitutes for it

IC 25-1-9.5-3.5 defines "practitioner" as an individual holding "an unlimited license to practice" one of roughly two dozen professions in Indiana — physicians, nurses, psychologists, behavioral health professionals, physical therapists, dentists, and others — plus students, peers, and certain community mental health center staff under subsection (b). Only those practitioners may deliver telehealth, and Indiana offers no out-of-state registration.

Something resembling one existed until recently. A practitioner working from outside the state filed a Telehealth Certificate with the Indiana Professional Licensing Agency, and the employer or contractor a Telehealth Facility Certificate. Sections 5 and 6 of Senate Enrolled Act 132 (2024) removed those requirements; the PLA terminated every outstanding certificate permanently effective July 1, 2024 and restated that practitioners must still be licensed in Indiana, telehealth included.

What survives in IC 25-1-9.5-9 is a long-arm rule, not a credential. A practitioner physically outside Indiana who establishes a provider-patient relationship with, or determines whether to prescribe for, an individual located in Indiana is practicing in Indiana, and waives any right to a forum or body of law other than Indiana's for claims arising from that care. The waiver reaches the employer and contractor too. Our cross-state licensing tracker lists Indiana as a full Interstate Medical Licensure Compact member effective May 1, 2023 under SB 251 and as a full Physical Therapy Compact state; Indiana is also a Nurse Licensure Compact state, issuing multistate licenses since July 2020, a PSYPACT participating state since July 2022, and one of the nine states where Counseling Compact privileges are live.

Prescribing: no prior exam required, but opioids are excluded

IC 25-1-9.5-8(a) permits a prescriber to issue a prescription to a telehealth patient who has not been examined in person, provided the standard of care is satisfied, the prescription falls within the prescriber's scope, and the drug is not an opioid. The carve-out is narrow: an opioid may be prescribed only if it has been approved by the FDA for the treatment of opioid addiction and is used to treat or manage opioid dependence. Abortion-inducing drugs are separately barred, and IC 25-1-9.5-0.5 prohibits telehealth for any abortion, including writing or filling a prescription intended to produce one.

Everything else in the schedules runs through IC 25-1-9.5-8(b). The prescriber must hold a valid Indiana controlled substance registration under IC 35-48-3, meet the federal conditions in 21 U.S.C. 829 and the DEA regulations, prescribe for a legitimate medical purpose in the usual course of practice, comply with INSPECT under IC 25-26-24, and conduct the encounter "using an audiovisual, real time, two-way interactive communication system." Audio-only cannot carry a controlled-substance prescription in Indiana. INSPECT is a standing obligation: under IC 25-26-24-19(k), all practitioners have been required since January 1, 2021 to pull the database before prescribing an opioid or benzodiazepine, with a ninety-day interval for patients under a pain management contract.

For telepsychiatry, most psychiatric controlled substances are prescribable by video, and opioid agonist therapy is the exception that keeps buprenorphine workable. The federal layer governs what that is worth; our DEA prescribing report tracks it, currently extended through the end of 2026. Verify current status before building a workflow.

Consent: required, documented, and never a separate form

IC 25-1-9.5-7(b) sets out what a telehealth provider-patient relationship must include: the patient's name, contact information, and location; disclosure of the practitioner's name and licensure; informed consent; medical history sufficient to establish a diagnosis; a discussion of the diagnosis and the risks and benefits of treatment options, including when in-person care is advisable; a medical record; follow-up instructions; and a visit summary listing any prescription. Subsection (b)(6) adds a notification duty — with the patient's consent, the prescriber tells the primary care provider about prescriptions — unless the practitioner uses an EHR that provider can access or has already seen the patient twice by telehealth.

Two provisions cut the other way. IC 16-36-1-15 says a provider may not be required to obtain a separate additional written consent for telehealth, and IC 27-8-34-6(d) repeats that rule for insurers. Section 7(d) is unusual: a patient waives confidentiality of information overheard by another individual nearby during the visit. Sections 7(e) and 7(f) bar an employer from compelling a practitioner to use telehealth against clinical judgment.

Medicaid: a code list, not a blanket

IC 12-15-5-11 directs the state to reimburse federally qualified health centers, rural health clinics, community mental health centers, critical access hospitals, home health agencies, and other eligible providers for telehealth. It bars distance restrictions and, subject to federal law, any location requirement for the originating or distant site, which is why the home qualifies.

The IHCP Telehealth and Virtual Services module turns that into billing rules. Covered telehealth is limited to the medical, dental, and remote monitoring codes on the published code set; surgical, radiological, laboratory, anesthesia, DME, and transportation services may not be delivered virtually. Claims carry place of service 02 or 10 plus modifier 95 for audio-video or 93 for audio-only, and audio-only is allowed only for designated codes, never for dental. Code Q3014 covers the originating-site facility fee. Remote patient monitoring is covered but requires prior authorization with a signed plan of care and a qualifying circumstance such as recent surgery or high-risk pregnancy. The module describes fee-for-service; managed care entities set their own rules.

One caution: the module still tells out-of-state providers they need a telehealth provider certification under IC 25-1-9.5-9, a requirement the statute no longer contains. Treat Indiana licensure and IHCP enrollment as the operative conditions, and verify with the PLA and the Medicaid program.

Private insurance: coverage parity, no rate

IC 27-8-34-6 requires a policy to cover telehealth "in accordance with the same clinical criteria" as the same services delivered in person, and forbids a dollar limit, deductible, or coinsurance less favorable than the in-person equivalent. Insurers may not require a separate telehealth consent or mandate a specific information technology application. IC 27-13-7-22 carries the same rules for HMO contracts. Section 7 preserves the limits: no coverage is required for a service the policy excludes, telehealth is never mandatory when the treating provider considers it inappropriate, and utilization review applies as in person. Absent is any rate language, so commercial telehealth economics in Indiana are contractual. Model them from signed agreements, as our reimbursement guide explains.

What to watch

Three items. First, whether the Medicaid module drops the repealed certification cross-reference, which sends out-of-state providers hunting a credential the PLA no longer issues. Second, Indiana's opioid prohibition against federal telemedicine prescribing rules, since the state restriction binds regardless of what the DEA permits; verify current status. Third, payment parity, which Indiana has declined to enact. Verify current requirements with the Medical Licensing Board, the Professional Licensing Agency, and the state Medicaid program before acting, and compare Indiana with its neighbors in the national overview.