Wyoming Telemedicine Laws: Licensure, Prescribing, Coverage

Wyoming has no telehealth act. The Medical Practice Act defines telemedicine as the practice of medicine, so a physician treating a Wyoming patient needs a Wyoming license unless a narrow Board of Medicine exemption applies, and a controlled-substance prescriber also needs a Wyoming controlled substance registration. The insurance code requires coverage, cost-sharing and payment parity for mental health and substance use services delivered by remote audio or video but has no telehealth rule for other services, and Medicaid pays live video at in-person rates.

Licensure: a license-first state with three narrow exemptions

W.S. 33-26-102(a)(xxix) defines telemedicine as "the practice of medicine by electronic communication or other means from a physician in a location to a patient in another location, with or without an intervening health care provider." Under W.S. 33-26-301(a), no person may practice medicine in Wyoming "without a license granted by the board, or as otherwise provided by law." Practicing medicine without a Board license, or aiding and abetting it, is a misdemeanor under W.S. 33-26-410(a), punishable by up to one year in county jail, a fine, or both.

Board of Medicine Rules Chapter 1, Section 7 sets out the exemptions most relevant to remote care:

• Consultation. W.S. 33-26-103(a)(iv) exempts an individual "residing in and licensed in good standing" in another state or country who is brought into Wyoming for consultation by a Wyoming-licensed physician, provided the Wyoming physician notifies the Board. The rule defines "brought into this state" as establishing a physician-patient relationship in person or through telemedicine, and caps the exemption at 12 days in any 52-week period; longer or more frequent consults need written advance approval of a majority of the Board officers. The Wyoming physician must notify the Board in writing at least one business day ahead, or within three business days after the first day in an emergency.
• Continuation of care. A physician or physician assistant who established a provider-patient relationship in another state with a patient who is a Wyoming resident may continue care by telehealth while the patient is in Wyoming, without a Wyoming license, only if the relationship began in an in-person encounter in a state where the clinician is licensed and the care is a logical and expected continuation of that in-person care. A patient presenting with new conditions, or conditions for which the standard of care calls for an in-person encounter, must return to the licensing state or be referred to a Wyoming-licensed provider. Telehealth may continue for up to six months after the relationship was established; an in-person encounter in a jurisdiction where the clinician is licensed must then take place before telehealth resumes for another six months.
• Declared emergencies. Physicians and physician assistants residing in, and holding full and unrestricted licenses in, another state or country who provide care during an emergency or pandemic declared by Order of the Governor or under a State Emergency Plan may practice without a Wyoming license while the declaration remains in effect, if they meet the Board's verification requirements. The rule speaks of clinicians who "come into this state," so confirm its reach to telemedicine with the Board. Separately, during a public health emergency declared by the Governor, Rule 1-7(d)(i) lets physicians and physician assistants not licensed in Wyoming practice as consultants to the state health officer, who submits their information to the Board; that authority ends 45 days after the Governor declares the emergency over, or earlier if the state health officer notifies the Board that the consultation has ended.

Other boards set their own rules; the Board of Physical Therapy's Chapter 7, Section 9 requires a current Wyoming license for telehealth to Wyoming patients.

Compacts: full Interstate Medical Licensure Compact member, effective July 1, 2015, under HB 107 (2015 Wyo. Sess. Laws ch. 62); Nurse Licensure Compact multistate licenses since January 19, 2018; full PSYPACT member, effective February 15, 2023, under SF 26 (2023 ch. 21); not a Physical Therapy Compact member; and a full Counseling Compact member. See our cross-state licensing tracker.

Prescribing: registration, PDMP, opioid limits and e-prescribing

No Wyoming statute or Board of Medicine rule we reviewed requires an in-person exam before a licensee prescribes by telemedicine or bars a drug schedule. The duties:

• Internet prescribing. W.S. 33-26-402(a)(xxxiii) makes it a ground for discipline to initially prescribe any controlled substance in Schedules II through V "through the Internet, the World Wide Web or a similar proprietary or common carrier electronic system absent a documented physician-patient relationship." W.S. 33-26-508(a) applies the same grounds to physician assistants.
• State registration. W.S. 35-7-1024(a) requires a Board of Pharmacy registration to dispense controlled substances within Wyoming, and W.S. 35-7-1002(a)(vii) defines "dispense" to include prescribing. The Board's registration page says a Wyoming registration "is required for all practitioners who prescribe controlled substances in Wyoming," that a practitioner "must have a valid Wyoming license and prescriptive authority from their own Board," and that the state registration comes before a federal DEA registration. We found no separate policy for out-of-state telemedicine prescribers, and the page makes no exception for clinicians practicing under a Board of Medicine licensure exemption; confirm with the Board of Pharmacy before prescribing a controlled substance to a Wyoming patient without a Wyoming license. Under Controlled Substances Rule 10-3(a), only a registered or exempt practitioner may issue a controlled substance prescription, and Rule 8-4(a) requires practitioners authorized to dispense Schedule II–V substances to register with the state PDMP.
• Pharmacy rules. Under Board of Pharmacy Rule Chapter 2, Section 8(f), it is unprofessional conduct for a resident or nonresident pharmacy or pharmacist to dispense or sell prescription drugs on the basis of a prescription generated solely through an internet practitioner consultation questionnaire, or to link to a site that prescribes on that basis. W.S. 33-24-101(b)(iv)(G) requires a pharmacist to make reasonable inquiry before filling when there are reasonable grounds to doubt that a practitioner-patient relationship exists, and Rule 2-6(c) treats prescriptions from out-of-state practitioners as valid only to the extent a Wyoming-licensed practitioner may prescribe that medication in Wyoming.
• PDMP. Under W.S. 35-7-1060(b), a practitioner other than a veterinarian, or a delegate, must search the prescription tracking program before first issuing a Schedule II–V prescription and as needed afterward under current best-practice guidelines; for opioids, the search must be repeated every three months while opioids remain part of treatment. Schedule V triggers the duty only for opioids. The Board may grant time extensions and adopt exemptions by rule.
• Opioid limit. W.S. 35-7-1030(e) bars prescribing an opioid for acute pain to an opioid-naive patient (no active opioid prescription in the preceding 45 days) for more than a seven-day supply in a seven-day period. Rule 9-2 lists five exceptions, for prescriptions bearing an indication for chronic pain that cannot be managed without opioids, cancer-related pain, palliative care, medication-assisted treatment for opioid addiction, or patients admitted for at least 12 hours to an ambulatory outpatient surgery center or hospital inpatient facility who received an opioid during the stay and whose recovery pain is expected to require opioids for more than seven days.
• E-prescribing. Since January 1, 2021, W.S. 35-7-1030(f) bars dispensing a controlled substance in any schedule without an electronic prescription, except when a practitioner other than a pharmacy dispenses directly to the ultimate user. Rule 10-5 sets the exemptions, including verbal prescriptions in defined emergencies and security-paper or faxed prescriptions in eight listed circumstances, among them terminally ill patients, pharmacies outside Wyoming, and a non-functioning e-prescribing system (capped at a 30-day supply). 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: Medicaid and profession-specific rules

The Medical Practice Act and the Board of Medicine rules we reviewed contain no telehealth consent requirement for physicians. Wyoming Medicaid lists consent among its billing standards: "Telehealth consent must be obtained if the originating site is the Member's home." The program no longer requires its consent form; consent may be obtained verbally, by email or by text message, and must be documented and kept on file. Some boards impose their own duty: the physical therapy rule requires informed consent covering technology-failure risks and, where applicable, recording and electronic storage, given verbally or in writing, including by email.

Medicaid: live video at in-person rates

The CMS-1500 Provider Manual (version 19.0, July 1, 2026) defines telehealth as an examination through "a real time interactive audio and video telecommunications system," so the member must be able to see and interact with the practitioner. Reimbursable services must be medically necessary, follow generally accepted standards of care and be covered by Medicaid; the same procedure codes and rates apply as in person, with the GT or 95 modifier. Eligible distant-site providers include physicians, psychiatric advanced practice nurses, physician assistants, psychologists and licensed mental health professionals, and enrolled out-of-state Medicaid providers may bill. The manual adds that a provider using telehealth must be licensed by, or otherwise under the jurisdiction of, the appropriate Wyoming licensing board.

The manual excludes telephone conversations, email, fax and store-and-forward from telehealth. Audio-only coverage sits elsewhere: Section 24.19.14 lists telephone evaluation and management codes 99441–99443, "limited to physician use only," for established patients, where the call does not follow a related service in the previous seven days or lead to one within 24 hours or the soonest available appointment. The AMA deleted CPT codes 99441–99443 effective January 1, 2025, so confirm with Wyoming Medicaid which audio-only codes it currently pays before billing.

Private insurance: parity for mental health and substance use care

W.S. 26-20-701(b), added by 2021 Wyo. Sess. Laws ch. 83 and applying to policies delivered, issued, renewed, modified, amended or extended on or after December 1, 2021, bars a policy or contract providing mental health or substance use coverage under Wyoming's parity law from denying coverage for mental health or substance use services delivered by remote audio or audio-visual delivery systems to a person not physically present with the provider, if the same services would be covered in person; from charging a higher copayment, deductible or coinsurance for those services than in person; and from paying the provider less than for the same services in person. The rule reaches audio-only delivery. It applies to insured individual and group policies, service and indemnity contracts and HMO contracts; self-funded employer plans are generally governed by federal law instead. Title 26 has no telehealth coverage or payment rule for other services, so plan terms and contracts set those; see our reimbursement guide.

What to watch

HB0241, the 2025 Telehealth Freedom Act, would have let providers licensed and in good standing elsewhere treat patients physically present in Wyoming by telehealth from outside the state, with notice to the licensing board unless the patient had an established relationship; the House did not consider it for introduction. A working draft of the 2026 rural health transformation bill carried similar language, but the enacted version, HB0122 (2026 ch. 61), contains no such provision. Watch the 2027 General Session for another attempt, and verify federal DEA and Medicare rules before building workflows. Compare Wyoming with its neighbors in how state telemedicine laws work.