West Virginia Telemedicine Laws: Registration, Rx, Parity

West Virginia regulates telehealth through three connected layers: a registration statute that lets out-of-state practitioners treat West Virginia patients without a full license, physician telemedicine statutes that limit Schedule II prescribing to patients seen only remotely, and an insurance statute that requires same-rate payment for established patients and acute-care consults and a negotiated rate for 'virtual telehealth,' defined as new or follow-up acute-care visits that do not require chronic management or scheduled medications. Consent is a statutory duty for physicians. Medicaid's core telehealth policy covers real-time audio-video services.

Licensure: registration instead of a license

Under W. Va. Code § 30-3-13a(b), the practice of medicine "occurs where the patient is located," and a physician or podiatrist who practices telemedicine must be licensed under the Medical Practice Act or registered under Chapter 30, Article 1. Section 30-14-12d says the same for osteopathic physicians. Section 30-1-26 created the registration route: a practitioner must be licensed in good standing in all states where licensed, not under investigation or subject to an administrative complaint, and registered with the appropriate West Virginia board.

The Board of Medicine's rule, 11 CSR 15 (effective June 1, 2022), issues registrations to physicians, podiatric physicians and physician assistants. Eligibility must be "continuously met," and registration expires March 31 unless renewed. It does not authorize practice from a location within West Virginia or from an international location. Registrants are subject to West Virginia law and board discipline and must immediately report any restriction on a license elsewhere. Osteopathic physicians and their physician assistants register with the Board of Osteopathic Medicine under 24 CSR 10.

The physician statutes exempt two situations from their telemedicine section: an informal consultation or second opinion at the request of a West Virginia-licensed physician who "retains authority and responsibility for the patient's care," and emergency or disaster assistance "if no charge is made."

West Virginia is a full Interstate Medical Licensure Compact member, with a statutory effective date of June 10, 2015 (HB 2496). It is a full Nurse Licensure Compact member, effective January 19, 2018; a full PSYPACT member, effective November 18, 2021 (SB 668); and a full Physical Therapy Compact member. Its Counseling Compact status is pending: enacted, but not yet issuing privileges. See our cross-state licensing tracker.

Prescribing: a Schedule II bar with named exceptions

Section 30-3-13a(g), mirrored in § 30-14-12d, sets the limits. A physician or podiatrist treating a patient "solely through the utilization of telemedicine technologies" may not prescribe any Schedule II controlled substance, but the limit does not apply to a physician or a member of the same group practice with an established patient, defined in § 30-1-26 as one seen face-to-face within the past three years by the physician or a same-specialty, same-subspecialty colleague in the group. It also does not apply to treating minors, or adults enrolled in a primary or secondary education program, diagnosed with intellectual or developmental disabilities, neurological disease, attention deficit disorder, autism or traumatic brain injury (with supporting records); or to orders for immediate administration to a hospital patient, excluding the emergency department. A separate limit bars prescribing Schedule II pain medication for chronic nonmalignant pain "solely based upon a telemedicine encounter," with the same established-patient exception. Physicians may not prescribe any drug with the intent of causing an abortion. Section 30-1-26 also directs board rules to prohibit prescribing or dispensing an abortifacient, and prescribing or dispensing gender altering medication to anyone under 18.

A patient relationship may be established by real-time video or real-time audio-only calls, but not by email, internet questionnaires or text messaging. Under 11 CSR 15, a telehealth provider prescribing any Schedule II through V drug to a West Virginia patient must maintain access to the Controlled Substances Monitoring Program, meet the preconditions in § 60A-9-5a and 11 CSR 10, record the drug and its basis, follow the Opioid Reduction Act, and comply with all other state and federal controlled-substance laws. The rule also makes completing a controlled substance prescribing course, before prescribing controlled substances to West Virginia patients, the standard of care; registrants may use a board-approved course or the course their licensing state requires.

Section 60A-9-5a requires a monitoring-program search when first prescribing any Schedule II drug, opioid or benzodiazepine to a patient without a terminal illness, and at least annually while treatment continues. The Opioid Reduction Act's limits in § 16-54-4 include a seven-day cap on initial Schedule II opioid prescriptions for practitioners other than dentists and optometrists, a three-day cap on initial prescriptions to minors (with a required discussion of risks with the parent or guardian), and a 30-day cap on any Schedule II opioid prescription, with two further 30-day prescriptions allowed after a monitoring-program check. Before an initial Schedule II opioid prescription, the practitioner must take and document a thorough history, conduct a physical examination as appropriate, develop a treatment plan and check the monitoring program; the patient must sign a narcotics contract with the third prescription; and the practitioner must conduct and document a physical examination every 90 days during continued Schedule II opioid treatment. A proviso in subsection (g) states that 'the limitations in this section' do not apply to cancer patients, patients receiving hospice care from a licensed hospice provider, patients receiving palliative care, long-term care facility residents, or patients receiving medications prescribed to treat substance abuse or opioid dependence. We did not find a West Virginia statute mandating electronic prescribing of controlled substances; 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.

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: a statutory duty for physicians

Section 30-3-13a(d) requires a physician or podiatrist using telemedicine to verify the patient's identity and location, disclose the physician's identity, qualifications and location, "obtain from the patient appropriate consent for the use of telemedicine technologies," evaluate the patient to in-person standards, and keep records verifying compliance. Section 30-14-12d imposes the same duty on osteopathic physicians. The Board of Medicine rule repeats it for all its telehealth providers except in pathology and radiology. Neither statute specifies a form.

West Virginia Medicaid is more specific. Policy 519.17 requires the member's consent to telehealth, which may be included in the member's initial general consent for treatment, and requires the provider with ultimate responsibility to first obtain written consent after discussing the right to withdraw at any time, the risks, benefits and consequences of telemedicine, confidentiality protections, the patient's right to documentation of transmitted medical information, and the bar on sharing patient images or information without further written consent.

Medicaid: video-based policy with rate rules in statute

BMS Provider Manual Policy 519.17, effective January 1, 2022, defines the covered telecommunication system as "an interactive audio and video system" permitting real-time communication. Originating sites include the patient's home, billed with place of service 10. Interstate practitioners must register with the appropriate West Virginia board and enroll as interstate providers. Telehealth is covered only for services identified in the relevant chapters, and Appendix A (effective January 1, 2025) lists the standard codes. The FQHC and RHC chapter, Policy 522.8 (effective July 1, 2019), states that telehealth is not a telephone conversation; the 2022 revision of Policy 519.17 deleted its own telephone exclusion. Some program chapters describe telephone contacts for care coordination, so check the chapter for the specific service.

Section 9-5-28 governs rates: for plans issued or adjusted on or after July 1, 2021, Medicaid pays virtual telehealth encounters at a negotiated rate, and pays established-patient services and acute care facility consultations "on the same basis and at the same rate" as in-person care. For the broader framework, see how state telemedicine laws work.

Private insurance: coverage parity, payment parity for some visits

Section 33-57-1 applies to insurers under Chapter 33, Articles 15, 16, 24, 25 and 25A, which cover individual and group accident and sickness policies, hospital and medical service corporations, health care corporations and HMOs. For policies issued or renewed on or after July 1, 2020, those insurers must cover services delivered through telehealth "if those same services are covered through face-to-face consultation," and may not exclude a service solely because it is delivered by telehealth.

Payment runs on two tracks under subsection (d), for plans issued, renewed, amended or adjusted on or after July 1, 2021. Virtual telehealth, defined as a new or follow-up patient for acute care that does not require chronic management or scheduled medications, is paid "at a rate negotiated between the provider and the insurance company." Services for an established patient, or consulting care to a patient in an acute care facility, are paid "on the same basis and at the same rate" as in-person care. Subsection (e) bars dollar maximums, cost-sharing and durational limits on telehealth that are not equally imposed on other covered services. Coverage extends to medically necessary remote patient monitoring, and the statute contains no sunset. It contains no utilization-review or prior-authorization clause and does not bar insurers from applying the policy's medical-necessity or prior-authorization terms. Self-funded employer plans governed by ERISA are not subject to the section. PEIA carries parallel language in § 5-16-7b.

What to watch

First, 11 CSR 15 states that it terminates August 1, 2027, so watch for a replacement rule (the Secretary of State's rules database lists a 11-15 version 'In Progress'). Section 30-1-26(b)(4) also directs board rules to require an in-person visit within 12 months of initial telemedicine for established patients, with exceptions, and the 2022 Board of Medicine rule text does not state that requirement. Second, HB 5615 (2026), which would remove in-person requirements tied to initial telemedicine services, was introduced February 16, 2026 and referred to House Health and Human Resources with no further action. SB 677 (2026), a broad revision of Board of Medicine licensing law that includes § 30-3-13a, passed the Senate March 4, 2026 and was referred to House Government Organization with no further action. Third, the federal DEA rule expires December 31, 2026.