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 under SEA 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), and section 8(c) adds that a telehealth controlled-substance prescription "must be prescribed and dispensed in accordance with IC 25-1-9.3 and IC 25-26-24." The duties:

• Telehealth conditions. Under section 8(b), the prescriber must maintain 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, issue the prescription for a legitimate medical purpose in the usual course of professional practice, comply with INSPECT under IC 25-26-24, follow all other applicable federal and state laws, and conduct the encounter "using an audiovisual, real time, two-way interactive communication system." Audio-only cannot carry a controlled-substance prescription in Indiana.
• State registration. IC 35-48-3-3(b) requires every person who dispenses or proposes to dispense a controlled substance within Indiana to hold a registration issued by the Indiana Board of Pharmacy, and IC 35-48-1.1-11 defines "dispense" to include prescribing. A practitioner's registration expires when the practitioner's license expires and is renewed with it. The opioid chapter, IC 25-1-9.7-1, likewise defines a prescriber as a practitioner who holds both an Indiana controlled substance registration and a federal DEA registration.
• INSPECT. Under IC 25-26-24-19(k), all practitioners have been required since January 1, 2021 to obtain a patient's information from the INSPECT database, directly or through the patient's integrated health record, before prescribing an opioid or benzodiazepine, in addition to any requirements under the Medical Licensing Board's controlled substance rules (IC 25-22.5-13). A patient under a pain management contract need not be checked more than once every ninety days. Subsections (q) and (r) excuse the check when the practitioner has a Board of Pharmacy waiver for lack of Internet access at the place of business; when the patient is recovering, or completing a prescription written by another practitioner, while still an inpatient or in observation status; when the database is suspended or not operational and the practitioner documents the date and time of the attempt in the patient's medical record; and when the patient is enrolled in a hospice program. IC 25-26-24-20 requires every practitioner permitted to prescribe controlled substances to be certified to receive INSPECT information.
• E-prescribing. IC 25-1-9.3-7 requires a prescriber, after December 31, 2021, to issue a prescription for a controlled substance in an electronic format and by electronic transmission to a pharmacy, under Board of Pharmacy rules. Section 8 allows a written, faxed or oral prescription instead when the prescriber cannot transmit electronically because of a temporary technological or electrical failure, a lack of the needed technology, or a pharmacy that cannot receive it; when the prescription will be dispensed by a pharmacy outside Indiana; when the prescriber and the pharmacist are the same entity; for prescriptions with elements the NCPDP SCRIPT standard or FDA requirements cannot support, non-patient-specific prescriptions such as standing orders, and prescriptions under a research protocol; when the prescriber holds a Board of Pharmacy waiver, or the board has determined by rule that electronic transmission would be impractical and cause a delay harmful to the patient; and when the prescriber reasonably determines that it would be impractical for the patient to obtain an electronic prescription in a timely manner and the delay would adversely affect the patient's medical condition. 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.
• Opioid limit. Under IC 25-1-9.7-2(a), a prescriber's initial opioid prescription for an adult being prescribed an opioid by that prescriber for the first time, and any opioid prescription for a patient under eighteen, may not exceed a seven-day supply. Subsection (b) lifts the limit for the treatment of cancer, palliative care, medication-assisted treatment for a substance use disorder, or a condition the Medical Licensing Board exempts by rule, and when, in the prescriber's professional judgment, the patient requires more. A prescriber who exceeds the limit under the palliative-care or professional-judgment exemption after determining that a non-opioid drug is not appropriate must document that indication and the exemption used in the patient's medical record. Opioids for an intrathecal or epidural pain pump are capped at a 180-day supply instead. The medication-assisted treatment exemption reaches the one opioid use section 8 permits by telehealth, treatment of opioid dependence.

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.

For telepsychiatry, most psychiatric controlled substances are prescribable by video under Indiana law, and the carve-out for opioid dependence treatment is what keeps buprenorphine workable.

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 of accident and sickness insurance to cover telehealth services "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; any annual or lifetime dollar limit on telehealth must be the same aggregate limit that applies to everything the policy covers. Insurers may not require a separate telehealth consent, and a policy that covers videoconferencing, store-and-forward, or remote patient monitoring services may not require a specific information technology application for them. IC 27-13-7-22 carries the same rules for HMO contracts, with copayment in place of deductible. 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 may apply to telehealth in the same manner as to the same services delivered in person. The chapter sets no in-network or contracted-provider rule. It also neither names nor excludes audio-only telephone calls: "telehealth services" are services delivered by the technology IC 25-1-9.5-6 allows, which lists secure videoconferencing, store-and-forward, and remote patient monitoring, and excludes email, instant messaging, fax, and internet questionnaires or consultations unless the practitioner has an established relationship with the patient. These rules reach insured policies and HMO contracts; self-funded employer plans are generally governed by federal law instead. 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.