Michigan Telemedicine Laws: Licensure, Prescribing, Parity

Michigan is a full-license state with a short telehealth statute and a long prescribing statute. The rules that actually shape a Michigan telehealth practice sit outside the telehealth sections — in the controlled-substances article, which demands a bona fide prescriber-patient relationship and a MAPS check, and in the Medicaid statute, which mandates payment parity while the private-insurance statute stops at coverage. The 2026 story is the Interstate Medical Licensure Compact, which Michigan nearly lost and then re-enacted without a sunset.

Licensure: Michigan license, compact restored, no registration

Michigan has no out-of-state telehealth registration and no telehealth-only license. The operative sentence appears in the Insurance Code rather than the Public Health Code: under MCL 500.3476, telemedicine services "must be provided by a health care professional who is licensed, registered, or otherwise authorized" to practice "in the state where the patient is located." Michigan Medicaid's provider manual repeats that language. For a Michigan patient, that means a Michigan license.

The Public Health Code's licensure exemptions in MCL 333.16171 are narrow: students in training, military and federal service, disaster and emergency care, an out-of-state professional "called in for consultation or treatment" by a Michigan professional "in an exceptional circumstance," and a practitioner living adjacent to Michigan's land border whose practice extends across it without a Michigan office. None describes a virtual practice built on Michigan patients.

The compact route almost disappeared. Michigan's 2018 compact statute carried a sunset that the Legislature extended once and then let lapse on March 28, 2025, starting a one-year withdrawal clock. HB 5455 re-enacted the compact as a new MCL 333.16189 with no repeal date; the Senate passed it 31–0 on March 24, 2026, and it became Public Act 6 of 2026 two days later, before the withdrawal took effect. Our cross-state licensing tracker lists Michigan as a full IMLC member and the Physical Therapy Compact as enacted but not yet issuing privileges; Michigan is a PSYPACT participating state, effective March 2023, but belongs to neither the Nurse Licensure Compact nor the Counseling Compact.

Prescribing: the telehealth statute is short; the controlled-substance statute is not

MCL 333.16285 lets a health professional providing a telehealth service prescribe a drug if the professional is a prescriber acting within scope and, for a controlled substance, meets the Public Health Code's requirements for prescribing one. It adds two duties: a referral to geographically accessible services, including emergency care, when medically necessary, and availability for follow-up or a referral for it. The telehealth sections themselves bar no drug schedule and require no prior in-person exam.

The weight sits in the controlled-substances article and the pharmacy article of the Public Health Code. The duties:

• Bona fide relationship. Under MCL 333.7303a(2), a licensed prescriber may not prescribe a Schedule 2 through 5 controlled substance without a "bona fide prescriber-patient relationship," which MCL 333.7104 defines as a records review and an assessment of history and current condition, "including a relevant medical evaluation of the patient conducted in person or through telehealth," with records kept to accepted standards. Telehealth can establish the relationship; skipping the evaluation cannot. The prescriber must provide follow-up care to monitor the drug's efficacy or, if unable to, refer the patient to the patient's primary care provider or to another geographically accessible prescriber. Hospice patients are excepted from the relationship requirement, as are cases covered by rules under MCL 333.16204e. Before prescribing any controlled substance, the prescriber must also ask about other controlled substances the patient may be using and record the answer (MCL 333.7303a(3)).
• PDMP. Every licensed prescriber must register with MAPS, Michigan's prescription monitoring system, before prescribing or dispensing any controlled substance (MCL 333.7303a(5)). Before prescribing or dispensing more than a 3-day supply, the prescriber must obtain and review the patient's MAPS report (MCL 333.7303a(4)). The report duty does not apply to a controlled substance dispensed and administered in a licensed hospital or freestanding surgical outpatient facility, to a hospice patient whose report was reviewed at hospice admission, or to veterinary cases.
• State registration. MCL 333.7303(1) requires anyone who prescribes a controlled substance in Michigan to hold a controlled substances license issued by the Michigan Board of Pharmacy through LARA. The license is renewed together with the professional license. The statute's exemptions cover agents, employees, carriers and patients, not out-of-state prescribers, and it does not say how the requirement applies to a prescriber located outside Michigan who treats a Michigan patient by telehealth; because the statute reaches anyone who prescribes a controlled substance "in this state," the conservative reading is that a prescriber treating Michigan patients needs the license, so confirm with LARA before prescribing.
• Opioid limits. A prescriber treating a patient for acute pain may not prescribe more than a 7-day supply of an opioid within a 7-day period (MCL 333.7333b). The section lists no exceptions. Before issuing a minor the first prescription in a course of treatment for an opioid-containing controlled substance, the prescriber must discuss with the minor, and with a parent, guardian, or another adult the parent or guardian has authorized in writing to consent to the minor's treatment, the risks of addiction and overdose, the added risk for patients with both mental and substance use disorders, the danger of combining opioids with benzodiazepines, alcohol or other central nervous system depressants, and any other information in the patient counseling section of the drug's FDA-approved label, and must obtain a signed "start talking" consent form, separate from any other consent document, for the record (MCL 333.7303b). The exceptions cover a medical emergency, surgery, cases where, in the prescriber's judgment, meeting the requirements would be detrimental to the minor's health or safety, hospice or hospital oncology care and discharge from those settings, and treatment for which parental consent is not legally required. If the form is signed by an authorized adult other than a parent or guardian, the prescription is limited to a single 72-hour supply.
• E-prescribing. MCL 333.17754a(1) requires a prescriber to transmit every prescription, including a controlled-substance prescription, electronically to a pharmacy of the patient's choice; LARA's Bureau of Professional Licensing set January 1, 2023 as the start of enforcement. Subsection (5) lists 14 exceptions, including a temporary technological or electrical failure, a LARA waiver (valid for up to two years and renewable), a documented belief that electronic transmission would delay the drug in a way that harms the patient, a prescription to be dispensed outside Michigan, and a prescription issued by a prescriber located outside Michigan to be dispensed by a Michigan pharmacy. A prescriber without a waiver who relies on an exception must document it and provide the documentation to LARA on request. 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.

Because Michigan bans no drug schedule by telehealth, federal rules decide which controlled substances can be prescribed without an in-person visit, and our DEA prescribing report follows them. Telepsychiatry practices should treat §§ 7303, 7303a, 7303b, 7333b and 17754a together as the checklist.

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: statutory, minimal, mirrored by Medicaid

MCL 333.16284 says a health professional "shall not provide a telehealth service without directly or indirectly obtaining consent for treatment." The only exception is care for an inmate housed in a Department of Corrections facility. It prescribes no form or signature; "directly or indirectly" leaves room for verbal consent captured at intake. MCL 333.16287 directs the licensing department, in consultation with the boards, to write implementing rules. Michigan Medicaid restates the requirement: consent must be obtained before the service and documented in the beneficiary's record. MCL 333.16286 lets a disciplinary subcommittee restrict a professional's telehealth practice for violating the consent or prescribing sections.

Medicaid: parity by statute, audio-only by database

Michigan wrote its Medicaid telehealth policy into law. MCL 400.105h requires the Medicaid and Healthy Michigan programs to cover telemedicine when the originating site is the home, a school, any site allowed in the Provider Manual, or "any established site considered appropriate by the provider"; to cover medical, dental, behavioral, and substance use disorder services; and to cover both audio-video and audio-only synchronous interactions. The programs may not impose tighter quantity limits than in-person care, may not require telemedicine in place of in-person contact, and may not reimburse distant providers "at a lower rate than comparable services rendered in person, except when reimbursing a provider who exclusively provides telemedicine services."

MDHHS bulletin MMP 23-10, effective May 12, 2023, turns the statute into billing rules. Audio-video services carry modifier 95 and audio-only services modifier 93, each with the place-of-service code that would apply in person; Prepaid Inpatient Health Plan and Community Mental Health Services Program providers instead report place of service 02 or 10. Audio-only is limited to codes on a rolling MDHHS audio-only database and is allowed only when the beneficiary cannot use video and prefers audio — "not the provider's convenience"; anything requiring visualization must be on video. Bulletin MMP 25-06 notes that the audio-only telephone codes 99441–99443 were deleted at the end of 2024; for services on and after January 1, 2025, providers report the evaluation and management code that best represents the service, with modifier 93 for audio-only. Apart from the out-of-state rules below, fee-for-service imposes no telehealth-specific prior authorization unless the in-person service needs one; managed care plans set their own. Asynchronous services — store-and-forward, e-consults, and remote patient monitoring — are covered under bulletin MSA 21-24, with RPM limited to FDA-defined medical devices and the device cost generally bundled into the service. MMP 23-10 also says telemedicine "cannot be continued indefinitely" without periodic in-person reassessment.

Bulletin MMP 24-06, effective April 1, 2024, sets which providers may bill for telemedicine and adds rules for telehealth-only businesses. Telemedicine providers must be enrolled in Michigan Medicaid and able to refer the beneficiary to a provider of the same type or specialty for in-person care when necessary. Virtual-only providers, meaning Michigan-licensed providers with no physical treatment location, may serve Medicaid beneficiaries but must report place of service 02 or 10 with the appropriate modifier. Virtual-only providers not associated with a Michigan billing provider in CHAMPS, the Medicaid billing system, are subject to the out-of-state prior authorization requirement, and unless policy says otherwise, telemedicine providers associated with a billing provider located outside Michigan must obtain prior authorization. Psychologists holding a PSYPACT Authority to Practice Interjurisdictional Telepsychology may be reimbursed, must report place of service 02 or 10, and face only the prior authorization that would apply to an in-state provider. Otherwise, a provider licensed in another state is reimbursed only when the beneficiary is located in the state where the provider is licensed.

Private insurance: coverage parity, not payment parity

MCL 500.3476 bars a state-regulated insurer from requiring face-to-face contact "for services appropriately provided through telemedicine, as determined by the insurer," and requires "at least the same coverage" for a service delivered by telemedicine as for the same service in person. Telemedicine remains subject to the policy's copayments, coinsurance, deductibles, and approved amounts. The definition covers HIPAA-compliant interactive audio or video, or both, and store-and-forward messaging, so audio-only sits inside it; the statute sets no separate conditions for audio-only care. It does not limit coverage to in-network or contracted providers and does not mention utilization review or prior authorization, so those follow the policy's terms, and the insurer decides which services are appropriately provided through telemedicine. What is missing is any rate language. Public Act 51 of 2024 (HB 4579, effective April 2, 2025) added the coverage sentence; neither the bill as introduced nor the substitute that became law set a reimbursement rate. Public Act 52 of 2024, effective the same day, also amended § 3476 and applies it to policies issued outside Michigan that cover Michigan residents. Michigan has coverage parity and no payment parity for commercial plans, while Medicaid has both. Model commercial revenue from contracts, as our reimbursement guide explains.

What to watch

Three items. First, SB 772 of 2026, introduced January 28, 2026 and parked in a Senate committee, would amend § 3476 on telehealth reimbursement rates; it has not moved. Second, LARA's implementation of the re-enacted compact and any rules under § 16287. Third, the federal side — DEA telemedicine prescribing and Medicare telehealth flexibilities — determines what Michigan's lack of an in-person prerequisite is worth; verify current status. Verify current requirements with the Board of Medicine, LARA, and MDHHS before acting, and compare Michigan with its neighbors in the national overview.