Update: DEA Prescribing via Telehealth and Direct Supervision Rules

10/06/2023 Update: DEA is extending its rule to allow providers to prescribe controlled substances via telemedicine through the end of 2024 and plans to issue new standards by fall 2024.

Recently, the Drug Enforcement Administration (DEA) issued a temporary rule (PDF) related to the prescribing of controlled substances via telemedicine. This temporary rule extends the full set of telemedicine flexibilities adopted during the COVID-19 public health emergency (PHE) for six months, or through November 11, 2023. For any physician-patient telemedicine relationships established up to this date, the telemedicine flexibilities on prescription of controlled medications established during the COVID-19 PHE will be extended an additional year beyond November 2023.

Among the flexibilities enacted during the PHE was a temporary modification to the regulatory definition of “direct supervision” as it pertains to supervision of diagnostic tests, physicians’ services, and some hospital outpatient services, to allow the supervising professional to be immediately available through virtual presence using real-time audio/ video technology, instead of requiring their physical presence. With the expiration of the PHE flexibilities, CMS will allow payment for virtual supervision of residents by teaching physicians only when the patient and resident are in a rural area.