Maine Telemedicine Laws: Registration, Prescribing, Parity

Maine requires physicians, physician assistants and nurses treating a patient located in the state by telehealth to hold a Maine license or, for LPNs and RNs, a compact multistate license. Its out-of-state pathways are narrow: a physician registration limited to consultative services requested by a Maine clinician and, since July 29, 2026, a licensure exemption for out-of-state physicians ordering up to 90 days of home health care after an in-person examination. A joint rule of three boards sets practice standards, opioid statutes shape prescribing, and the insurance code requires coverage and cost-sharing parity without setting a payment rate.

Licensure: a Maine license, or a consult-only registration

The joint telehealth rule, 02-373 C.M.R. ch. 11 (shared with the osteopathic and nursing boards; formerly Chapter 6, amended July 24, 2022), sets the baseline. Physicians, physician assistants and advanced practice registered nurses who use telehealth "in the examination, diagnosis, consultation or treatment of a patient located in Maine" must hold an active Maine license or an active registration to provide interstate consultative telemedicine services. LPNs and RNs need a Maine license or a multistate license from a compact state.

The registration sits in 32 M.R.S. § 3300-D, a Board of Licensure in Medicine section; the osteopathic chapter has no parallel. The board may register a physician only if all of these hold: the physician is fully licensed without restriction in the state from which telehealth is provided; has not had a license to practice medicine revoked or restricted in any state or jurisdiction; does not open an office in Maine, meet patients in Maine, or receive calls in Maine from patients; and agrees to provide only consultative services requested by a Maine-licensed physician, APRN or physician associate, who "retains ultimate authority over the diagnosis, care and treatment of the patient." Registration is renewed every two years, with a fee. Registrants must report new license restrictions immediately and submit to Maine law, courts and board rules.

Public Law 2025, chapter 567, enacted 22 M.R.S. § 2145-A, effective July 29, 2026. A home health agency licensed in Maine and certified by CMS may provide up to 90 days of home health care to a Maine resident on the order of a physician licensed in another state, and the physician is exempt from Maine licensure solely for ordering those services, if all of these hold: the physician's license is in good standing, and the agency verifies it and keeps the verification on file; the order follows an in-person physical examination performed in the state where the physician is licensed, and the services are limited to the medical purpose and clinical scope of that examination; the physician orders services only while the patient is receiving home health care and provides telehealth only to that patient; and the physician and agency comply with DHHS rules and the federal home health conditions of participation, 42 CFR Part 484. Subsection 4 bars the physician from any other telehealth or in-person care in Maine, and under subsection 3 the department, consulting the medical or osteopathic board, may end the exemption for a physician found in violation.

Maine is a full Interstate Medical Licensure Compact member, statutory effective date November 1, 2017, under LD 1359 (PL 2017, ch. 253); has issued multistate nursing licenses since January 19, 2018; and is a full PSYPACT member, effective October 18, 2021, under HB 631. The Physical Therapy Compact is enacted but not yet issuing privileges; the Counseling Compact is enacted but pending. See the cross-state licensing tracker.

Prescribing: the joint rule, then the opioid statutes

Chapter 11 starts from an in-person default: physicians, physician assistants and advanced practice registered nurses generally perform an in-person clinical interview and physical examination, and may do both through telehealth only if the technology is sufficient to establish an informed diagnosis as though they had been performed in person. Before treatment "including issuing prescriptions," a licensee must interview the patient for the relevant medical history and perform a pertinent physical examination as the standard of care defines it for the visit, when clinically necessary, sufficient for diagnosis and treatment. A static internet questionnaire is not an acceptable interview and examination, and prescribing based solely on an internet request or a static internet questionnaire is prohibited. Absent a valid licensee-patient relationship, prescribing based solely on a telephonic evaluation is also prohibited, except when taking call for a licensee with an established relationship. A licensee who prescribes by telehealth must document the clinical evaluation, indication, appropriateness and safety considerations for the prescription to the applicable standard of care, and telehealth prescriptions carry the same accountability as in-person ones.

The rule's operating duties include verifying patient identity for synchronous care and letting the patient verify the clinicians' identity and credentials; obtaining emergency contact information and referring to an acute care facility or emergency department when needed for safety; knowing local follow-up resources; coordinating with, and sending records to, in-person clinicians when medically appropriate; giving a visit summary on request; disclosing 12 listed items, including fees, credentials and limits on the drugs available by telehealth; and a ban on directing prescriptions to a pharmacy in exchange for any consideration, unless under a collaborative practice agreement.

Statutory duties that apply in person and by telehealth include four:

1. Opioid limits. 32 M.R.S. § 3300-F (physicians and physician associates), with similar provisions in § 2600-C (osteopathic) and § 2210 (nursing), caps aggregate opioid medication at 100 morphine milligram equivalents per day, a 30-day supply within 30 days for chronic pain, and a 7-day supply within 7 days for acute pain (14 days for certain FDA stock-bottle products). Exemptions apply only for active and aftercare cancer pain, palliative care for serious illness, end-of-life and hospice care, medication-assisted treatment for substance use disorder, other circumstances set by DHHS rule, and directly ordering or administering a benzodiazepine or opioid in an emergency room, inpatient hospital, long-term care or residential care setting or in connection with a surgical procedure.
2. Electronic prescribing. Prescribers with the capability must prescribe all opioid medication electronically; those without it must request a waiver from the DHHS commissioner, who may grant exceptions including prescribing outside the usual place of business and technological failures. This state mandate is limited to opioid medication. Separately, Medicare Part D 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.
3. Prescription monitoring. Under 22 M.R.S. § 7253, a prescriber must check the program on the initial prescription of a benzodiazepine or opioid and every 90 days while it is renewed. For human patients the exemptions are directly ordering or administering in an emergency room, inpatient hospital, long-term care or residential care setting or in connection with a surgical procedure, and ordering, prescribing or administering for pain associated with end-of-life or hospice care. Since PL 2025, c. 37, § 7246 defines prescriber to include clinicians who use telehealth to prescribe controlled substances to Maine patients.
4. Continuing education and entity policy. Opioid prescribers need three hours of opioid education every two years, and health care entities must keep an opioid prescribing policy.

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: required by rule, and by MaineCare

Section 3(10) of Chapter 11 requires a licensee to ensure the patient provides "appropriate informed consent," including consent to the use of telehealth for examination, consultation, diagnosis and treatment, "timely documented in the patient's telehealth record." The rule names no form and reaches only the three boards' licensees.

For MaineCare members, 22 M.R.S. § 3173-H(6) allows verbal, electronic or written consent. The benefits manual requires that consent before any telehealth service, with a copy kept in the record, plus disclosures including that telehealth is voluntary and may be refused without losing benefits. Remote consultations need documented consent each time.

Medicaid: any covered service, audio-only included

MaineCare Benefits Manual Chapter I, Section 4 (amended November 6, 2023) lets any medically necessary covered service be delivered by telehealth when the member is eligible for it and the quality is comparable to in-person delivery. Services that need direct physical contact that cannot be delegated to a provider at the member's location, and services medically inappropriate for telehealth, are excluded. Telehealth "may be either Telephonic or Interactive," and telephonic means audio-only telephone.

Providers bill the in-person claim with modifier GT (interactive) or 93 (telephonic); the underlying service's co-payment applies, with no separate telehealth co-payment. Telephone evaluation and management codes are billed without either modifier and, like virtual check-ins, are not billable when tied to an office visit within the manual's time windows. Store-and-forward is limited to established patients, and remote patient monitoring is a home health agency service. As a reimbursement condition, a provider must be licensed or registered in the state where the member is located.

Private insurance: coverage parity, cost-sharing capped

Under 24-A M.R.S. § 4316(2), a carrier offering a health plan in Maine may not deny coverage because a service is provided through telehealth if the service would be covered in person and the provider acts within scope and board telehealth rules. Cost-sharing may not exceed that for a comparable in-person service. Subsection 3 requires coverage of medically necessary telehealth that is otherwise covered and of comparable quality, with no geographic limits, no required prior in-person visit, and prior authorization only where the in-person service requires it.

The statute keeps carrier tools: utilization review is allowed if it uses the same manner and criteria as for in-person care, and carriers must require a clinical evaluation, in person or by telehealth, before a covered prescription. Carriers may not impose telehealth prescribing restrictions stricter than state and federal in-person prescribing law, credentialing or prior-approval requirements beyond those for in-person providers, or specific technology, as long as the provider's equipment meets industry interoperability standards and HIPAA. Carriers must also cover telehealth treatment of two or more enrollees at the same time, including counseling for opioid use disorder, and must cover telemonitoring when it is medically necessary and the enrollee and home can support it. Telehealth availability cannot count toward network adequacy. The section sets no reimbursement rate and has no sunset. See our reimbursement guide.

What to watch

First, 22 M.R.S. § 2145-A took effect July 29, 2026, and DHHS may adopt rules to implement it. Second, Public Law 2025, chapter 687 (LD 2082), signed April 13, 2026, bars offering therapy or psychotherapy, including through internet-based artificial intelligence, unless a licensed professional provides it. Third, Physical Therapy Compact and Counseling Compact privileges, enacted but pending. Fourth, the expiration of the temporary federal controlled-substance rule described above. The 132nd Legislature's Second Regular Session adjourned sine die on April 29, 2026. See how state telemedicine laws work.