DEA, HHS Extend Telemedicine Flexibilities For Remote Controlled Prescribing

The U.S. Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) have issued a fourth temporary extension of COVID-19 telemedicine flexibilities for prescribing controlled substances, allowing clinicians to continue remote prescribing of Schedule II–V medications through December 31, 2026. Under the extension, providers may prescribe controlled medications indefinitely via telemedicine after at least one in-person medical evaluation, even if that visit occurred long ago or was for a different condition, provided prescriptions are issued for legitimate medical purposes and comply with federal and state laws.

The policy applies to a wide range of controlled substances, from high-abuse-potential drugs such as opioids and stimulants to lower-risk medications like certain cough syrups containing codeine. While telemedicine prescribing remains broadly permitted, the DEA noted that some Schedule II medications may still require an initial in-person visit. The extension also preserves audio-only telemedicine for prescribing FDA-approved Schedule III–V narcotic medications used in opioid use disorder treatment, without requiring an in-person evaluation.

Originally introduced in March 2020 during the COVID-19 public health emergency, these flexibilities were designed to maintain access to care when in-person visits were limited. The DEA said the latest extension is intended to prevent the so-called “telemedicine cliff”—a sudden loss of access to care that could occur if the flexibilities expire before permanent regulations are finalized. According to the agency, patients and providers have warned that ending telehealth prescribing abruptly could disrupt treatment nationwide, underscoring the need for a longer transition period while federal rulemaking continues.