Mississippi Telemedicine Laws: Licensure, Exams, Coverage

Mississippi requires a Mississippi license for a physician treating a patient located in the state, with one narrow consultation exception in statute. It has no telehealth registration. Board of Medical Licensure rules set the exam and prescribing standards. Medicaid's telehealth visit benefit covers only live video outside a declared emergency, and health insurance and employee benefit plans, including the State and School Employees Health Insurance Plan, must cover telemedicine like in-person care under a statute set to repeal on July 1, 2028. The Legislature enacted no change to these telemedicine statutes in 2026.

Licensure: a full-license state with one consultation exception

Miss. Code Ann. § 73-25-34 defines telemedicine as an out-of-state physician rendering an opinion or treatment for a Mississippi patient from transmitted patient data. Subsection (2) bars anyone from practicing medicine across state lines in Mississippi without first obtaining a license from the State Board of Medical Licensure.

The one statutory exception, subsection (3), has two conditions, and both must be met. The out-of-state physician's evaluation, treatment or opinion must be requested by a physician licensed in Mississippi, and that requesting physician must already have established a doctor/patient relationship with the patient.

Board Rule 5.2 (Title 30, Part 2635) deems medicine practiced where the patient is, so only providers with a valid Mississippi license may practice any form of telemedicine in the state. For Chapter 5, "provider" means a physician or physician assistant with an unrestricted Mississippi license. The rule carves out interpretation of clinical laboratory, pathology and histopathology studies by physicians without Mississippi licensure, but only while a Mississippi-licensed provider is responsible for accepting, rejecting or modifying the interpretation and keeps exclusive control over any later therapy or diagnostics.

Mississippi is a full member of the Interstate Medical Licensure Compact, with a statutory effective date of May 16, 2016 under HB 41, and has issued Nurse Licensure Compact multistate licenses since January 19, 2018. It is a full Physical Therapy Compact member. PSYPACT is pending: SB 2157 was enacted April 8, 2024, and PSYPACT lists the effective date as to be determined. The Counseling Compact is also pending, enacted but not yet live. The cross-state licensing tracker follows each one.

Prescribing: exam first, then Part 2640's drug rules

The board's telemedicine rules require a valid physician-patient relationship before any form of telemedicine. Rule 5.4 lists six elements: verifying identity, an appropriate history and physical exam meeting the standard of care, a diagnosis through accepted medical practices, discussing diagnosis and treatment risks and benefits to obtain informed consent, ensuring follow-up care, and a complete medical record.

Rule 5.5 requires an appropriate examination before diagnosis and treatment of a patient in Mississippi. It need not be in person if the technology gives the physician the same information as a face-to-face exam. Other exams may be appropriate when a licensed health care provider on site with the patient supplies the physical findings. Store-and-forward may enhance, but never replace, real-time provider-patient interaction, which "may be audio-visual or audio only where medically appropriate." A simple questionnaire without an appropriate exam violates the rule and may lead to discipline. Rule 7.1 adds that prescribing to people the physician has never met, based solely on answers to a set of questions, fails an acceptable standard of care and could be unprofessional conduct.

Part 2640, Chapter 1 governs the drugs themselves, and several of its duties apply whatever the modality, including:

• Relationship and exam. Rule 1.11.A bars prescriptions outside a valid licensee-patient relationship, and Rule 1.4 requires a good-faith prior examination and medical indication. Both allow the history and exam through appropriate telemedicine under Rule 5.5.
• Prescription Monitoring Program. Under Rule 1.3, every licensee must review the MPMP at each encounter in which an opioid is prescribed for acute or chronic non-cancer, non-terminal pain. Licensees outside pain management practices must check it at first contact with a new patient and at least every three months for patients receiving other controlled substances, with listed drug exceptions and an exception for inpatient treatment that ends at discharge, when a patient leaving with a controlled-substance prescription must be checked. Licensees in a pain management practice must review it at every encounter in which any controlled substance is prescribed. Rule 1.10.H requires a check with each benzodiazepine prescription.
• Opioid limits. Rule 1.7 bars long-acting opioids for acute non-cancer, non-terminal pain, discourages more than a three-day supply and forbids more than a ten-day supply, with additional ten-day supplies only under documented conditions. For chronic pain, licensees must strive to stay at or below 50 morphine milligram equivalents a day, avoid 90 or more without significant justification, and refer patients needing more than 100 to a pain specialist.
• Benzodiazepines. Rule 1.10.H limits them to a one-month supply with no more than two refills, or a 90-day supply with no refills.
• Weight loss. Rule 1.5 requires the licensee to be present at the facility when prescribing or dispensing controlled substances for weight reduction, and restates the statutory ban on Schedule II drugs for the exclusive treatment of obesity, weight control or weight loss. It also generally caps controlled-substance prescriptions for weight loss at a 30-day supply and requires an in-person re-evaluation every 30 days for a patient continued on one, or every 90 days for certain licensees.
• Electronic prescriptions. Rule 1.11.D permits electronic controlled-substance prescriptions when the practitioner meets DEA requirements and uses a certified system.

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: board guidance, Medicaid paperwork

No Mississippi statute imposes a general telemedicine consent requirement. Board Rule 5.3 says a provider using telemedicine "should" obtain informed consent before providing care, and the patient should learn the risks and benefits of treatment over a telemedicine network, including how to get follow-up care after an adverse reaction or an equipment failure. Rule 5.4 lists informed consent among the relationship elements that "must be established." The rule prescribes no form.

Medicaid is stricter. Part 225, Rule 1.6 requires the record at both the originating and distant sites to include signed consent for treatment using telehealth. For store-and-forward care, § 83-9-353(3) requires that the patient be told of the right to an interactive communication with the distant specialist, and receive one on request.

Medicaid: live video only, established patients only

Title 23, Part 225, last revised effective August 1, 2026, defines telehealth as delivery by an enrolled Mississippi Medicaid provider through an interaction that is live, interactive and audiovisual. It covers medically necessary telehealth as a substitute for in-person consultations, office visits and outpatient visits at 11 originating sites, including the beneficiary's home, by 14 listed distant-site provider types. A telepresenter is required unless the originating site is the home or the Division decides otherwise. Distant-site providers are paid the applicable fee-for-service rate or encounter; eligible originating sites receive a facility fee.

Rule 1.4 excludes EPSDT well-child visits, services not covered in person, and physician or practitioner visits by telehealth for non-established beneficiaries. It says telephone conversations, email, fax, internet evaluations and social media are not telehealth services. Under Part 225, audio-only telehealth is allowed only under Rule 1.7, during a state of emergency declared by the Governor or the President, when authorized by the State of Mississippi. Remote patient monitoring, teleradiology and continuous glucose monitoring have separate chapters of Part 225.

Private insurance: coverage parity with a sunset

Section 83-9-351, as extended by SB 2415 effective June 30, 2025, requires all health insurance and employee benefit plans to cover telemedicine "to the same extent that the services would be covered if they were provided through in-person consultation." Its definition of health insurance plan includes the State and School Employees Health Insurance Plan and excludes specified-disease and limited-benefit coverage. Cost-sharing may not exceed in-person levels, out-of-network telemedicine is reimbursed under the plan's ordinary out-of-network policies, and plans may not limit coverage to provider-to-provider consultations. Plans may still limit coverage to medically necessary services, subject to the terms and conditions of the policy. Live telemedicine must be real-time audio-visual capable; the Commissioner of Insurance may adopt rules on when audio-only is allowed. Nothing sets rates equal to in-person care, and the section stands repealed from and after July 1, 2028.

Section 83-9-353 separately requires coverage and reimbursement of store-and-forward and remote patient monitoring services based on the criteria the section sets out, including patient-eligibility criteria for remote patient monitoring. Store-and-forward "shall be reimbursed to the same extent that the services would be covered if they were provided through in-person consultation." To qualify for reimbursement under the section, store-and-forward providers must be licensed Mississippi providers affiliated with an established Mississippi health care facility; if a service is not available in Mississippi, a plan may choose to reimburse a non-Mississippi-based provider licensed to practice in Mississippi. The section's minimum remote patient monitoring rates apply only to Mississippi-based telehealth programs affiliated with a Mississippi health care facility. Plans may limit coverage under this section to a plan-approved telemedicine network. Our reimbursement guide covers contract modeling.

What to watch

First, the July 1, 2028 repeal of § 83-9-351. Second, the consultation exception: Senate-passed bills in 2024 (SB 2240), 2025 (SB 2075) and 2026 (SB 2454) would each have struck § 73-25-34(3), and each died in a House committee. Third, obesity prescribing: 2026's HB 1136 and SB 2554 would have allowed physicians to prescribe obesity drugs by telemedicine, and both died, as did HB 107 on Medicaid telehealth rates for FQHCs, rural health clinics and community mental health centers. Fourth, PSYPACT and Counseling Compact activation. Compare Mississippi with other states in how state telemedicine laws work.