Can I Treat a Patient in Another State by Telehealth? PT, OT and SLP Rules in Every State

Yes, but almost always only with a license or a compact privilege in the state where the patient is at the time of the session. Where you sit doesn't decide it; where the patient sits does. States differ in how plainly they say it, whether they offer a telehealth-only registration instead of a full license, and whether they let you consult with a local clinician or follow an existing patient who is only visiting.

This article goes through every state for PTs and PTAs, OTs and OTAs, and SLPs: whether the state requires its own license, any registration or exception, which licensure compacts are open there, and the exact words of the rule, linked to the official source. I'm an occupational therapist, so for PT and speech I've stuck to what the rules say.

This isn't legal advice. I checked every rule on November 9, 2026, on the state's own legislature, code or board site. Your board's current rule is the one that counts.

The Short Answer

• The patient's location decides. In 46 of the 51 jurisdictions, a statute, rule or board statement says so for at least one of the three professions. Twenty-six say it in law for all three. New York and Pennsylvania say it in board guidance for all three.
• By profession: for PTs, 32 jurisdictions say it in a statute or rule, 6 in a board statement, and 13 have no specific rule. For OTs it's 32, 4 and 15. For SLPs it's 36, 7 and 8.
• No specific rule isn't permission. Hawaii, Maine, Michigan, Nebraska and Utah have nothing on telehealth licensure for any of the three. Their license requirements still apply, and none of them has an exemption written for telehealth.
• Eight offer a telehealth-only route for at least one profession: Arizona, Colorado, Florida and Vermont (registration), Kansas (a waiver for PTs and OTs), Delaware (OTs only), and Louisiana and West Virginia (SLPs only).
• Seven let you follow an existing patient who is visiting, each with conditions: DC, Idaho, Kentucky, New Hampshire, North Dakota, Washington and Virginia (OTs only).
• About 20 exempt consultation with a clinician licensed there. Most cover advising that clinician, not treating the patient yourself.
• Compacts: the PT Compact is issuing privileges in 38 jurisdictions, the OT Compact in 10 and the speech compact in 4. A privilege covers telehealth into that state.
• Medicare is a separate question. In home health a video session is never a visit. Under Part B, therapists can bill telehealth through December 31, 2027.

Every State at a Glance

How to read the table. Yes (law) means a statute or administrative rule says you need that state's license (or a compact privilege, or its registration) when the patient is there. Yes (board) means the board or licensing agency says so in a statement, FAQ or guidance document. No specific rule means the act, rules and board statements say nothing on telehealth licensure, and the cell quotes the license requirement that governs. Visiting exemptions marked doesn't mention telehealth were written for in-person visits; don't assume they cover a video session.

The compact column uses this site's compact data, checked October 10, 2026: open means the compact is issuing privileges in that state, signed means the state passed the compact but privileges aren't issued yet, bill means a bill is pending, and none means no compact law. Our licensure compact tool has the details for the PT Compact, the OT Compact and the speech compact.

States With a Telehealth Registration or Waiver

Eight states give out-of-state clinicians a telehealth-only route that is lighter than a full license, for at least one of the three professions. None of them allows in-person care.

• Florida, all three. A PT, OT or SLP licensed elsewhere registers with the Florida board instead of getting a Florida license, but "A health care professional registered under this subsection may not open an office in this state and may not provide in-person health care services to patients located in this state." (Fla. Stat. § 456.47(4)(f) (opens in a new tab))
• Arizona, all three, with a small-volume threshold. Arizona requires registration from out-of-state providers, but not if "The health care provider provides fewer than ten telehealth encounters in a calendar year" (A.R.S. § 36-3606(E) (opens in a new tab)). SLPs register with the health department, which adds that the applicant must "Hold a current and valid license to practice in another state that is substantially similar to a license issued in Arizona for a minimum of one year" (A.A.C. R9-16-1006 (opens in a new tab)).
• Colorado, since January 1, 2026. The statute calls the registration "an alternative to licensure, certification, or registration that the applicable regulator requires" (C.R.S. § 12-30-124(10) (opens in a new tab)). The Division's FAQ lists "Occupational Therapists and Assistants" and "Physical Therapists and Assistants" among the eligible professions but not speech-language pathologists (DPO telehealth FAQ (opens in a new tab)), even though the SLP application page offers "Initial certification by Examination, Endorsement or Telehealth Method" (DPO SLP applications (opens in a new tab)). An SLP should confirm with the Division first.
• Vermont, all three, with caps. A professional licensed elsewhere who treats "a patient or client located in Vermont using telehealth shall obtain a telehealth license or telehealth registration from the Office or the Board in accordance with this chapter" (26 V.S.A. § 3053 (opens in a new tab)). The statute caps the registration "to a total of not more than 10 unique patients or clients over the 120-day period that the registration is in effect," and the telehealth license at "not more than 20 unique patients or clients located in Vermont during the two-year license term" (26 V.S.A. § 3054 (opens in a new tab)). Until the permanent rules are in place, the Office of Professional Regulation issues an interim registration: "A healthcare professional who does not hold an active, conventional Vermont license and who is providing healthcare in Vermont via telehealth must register for an Interim Telehealth Registration." (OPR, Telehealth Registrations and Licensing (opens in a new tab))
• Kansas, PTs and OTs. The Board of Healing Arts, which licenses PTs and OTs, says: "Kansas now has a permanent telemedicine license waiver option for all healthcare professions regulated by the KSBHA. A telemedicine waiver issued by the Board authorizes practice in Kansas limited solely to telemedicine services." (KSBHA Policy 21-02 (opens in a new tab)) "The initial application fee for a telemedicine waiver is $100" (KSBHA Policy 21-05 (opens in a new tab)). Kansas SLPs are licensed by a different agency, which has no waiver.
• Delaware, OTs only. Delaware's interstate telehealth registration reaches only the boards its telehealth chapter lists, and the OT board is the only one of the three on it: "A health-care provider licensed in a state that has not adopted an interstate compact applicable to the health-care provider may only provide telehealth under this chapter if the health-care provider obtains an interstate telehealth registration from the Division of Professional Regulation." (24 Del. C. § 6002(c) (opens in a new tab))
• Louisiana, SLPs only. State law tells every board to write rules for out-of-state telehealth providers, but only the speech board has a registration: "Telehealth, regardless of where the service is rendered or delivered, constitutes the practice of audiology or speech-language pathology and shall require Louisiana licensure for in-state practitioners and telehealth registration for out-of-state licensed practitioners." (LAC 46:LXXV.135 (opens in a new tab))
• West Virginia, SLPs only. The statute tells every health board to write a rule saying "The practice of the health care service occurs where the patient is located at the time the telehealth services are provided" and that the practitioner be "Registered as an interstate telehealth practitioner with the appropriate board in West Virginia" (W. Va. Code § 30-1-26(b) (opens in a new tab)). Only the speech board offers the registration. An SLP must "Pass the jurisprudence examination developed by the Board" and, to renew, "Complete 20 hours of Board approved continuing education activities specific to telepractice clinical skills" (29 CSR 1 § 16 (opens in a new tab), an emergency rule in effect since June 2, 2026). The PT and OT rules accept only a West Virginia license or a compact privilege.

Three more states have a temporary route that isn't telehealth-specific:

• Utah issues a temporary license while your endorsement application is pending, for telemedicine where "at the time the telemedicine service is performed, the patient is located in Utah" (Utah Code § 58-1-302.1 (opens in a new tab)).
• Wisconsin gives a PT, PTA, OT, OTA or SLP licensed elsewhere a temporary credential if they apply "within 30 days of beginning to provide health care services for a health care employer," and it covers "services through telehealth to a patient located in this state" (Wis. Stat. § 440.094 (opens in a new tab)).
• Montana's 2025 registration lets anyone licensed elsewhere practice for a short period after filing "verification of licensure in another state and any applicable disciplinary data bank" (MCA 37-1-144(5) (opens in a new tab)). The shared PT, OT and speech board lists it as an exception for clients in Montana (board FAQ (opens in a new tab)).

Indiana used to have an out-of-state telehealth certification and ended it on July 1, 2024. The licensing agency said the certificates "will be terminated, permanently" and that "all practitioners must still be properly licensed in the state of Indiana in order to practice in the state of Indiana, even to provide telehealth services under the requirements of Indiana Code § 25-1-9.5." (IPLA release, June 7, 2024 (opens in a new tab))

Existing Patients Who Travel

This is the situation home health clinicians ask about most: a patient on your caseload goes to a daughter's house in another state, or winters somewhere warm. Seven jurisdictions have a rule for it.

• District of Columbia. Without a DC license you "may not provide a telehealth service to a client or patient physically located in the District unless the practitioner and the client or patient have an existing practitioner-client or practitioner-patient relationship and: (1) The client or patient is temporarily present in the District; or (2) The client or patient is a District resident and the telehealth services provided do not exceed 120 days or a longer period of time as determined by the Mayor through rulemaking." (D.C. Code § 3-1201.05(e) (opens in a new tab))
• Idaho. No Idaho license is needed when the provider "Has established a patient-provider relationship with a person and provides temporary or short-term follow-up health care services to such person to ensure continuity of care" (Idaho Code § 54-5713(1)(b) (opens in a new tab)). A provider using an exception "consents to the applicable Idaho laws, rules, and regulations governing the provider’s profession".
• Kentucky. State law says no board may "Prohibit the delivery of telehealth services to a person who is not a permanent resident of Kentucky who is temporarily located in Kentucky by a provider who is credentialed by a professional licensure board in the person's state of permanent residence" (KRS 211.336(2)(j) (opens in a new tab)). The PT rule fits that, since it asks for a license where the patient "is physically present or domiciled" (201 KAR 22:160 (opens in a new tab)). The OT and SLP rules speak only of where the client is physically located, so an OT or SLP should check with the board.
• New Hampshire. PTs, OTs and SLPs are among the "allied health professionals, governed by RSA 328-F" who "shall be authorized to provide consultation services or follow-up care via telehealth to a patient who previously received services from the provider in the state where the provider is licensed" (RSA 310:7, VI (opens in a new tab)). The law doesn't say how long follow-up care may continue.
• North Dakota. Serving a patient in North Dakota is practice there "regardless of the means by which the services are provided or the physical location of the person providing those services," but you need no license where the services "are provided through a remote means and are a continuation of an existing relationship between the foreign practitioner and the individual receiving the services which was formed in the state or jurisdiction in which the foreign practitioner is currently licensed" (N.D.C.C. §§ 43-51-02, -03 (opens in a new tab)). This covers every profession licensed under Title 43, including PT, OT and speech.
• Washington. The Uniform Telehealth Act allows follow-up "by a primary care practitioner, mental health practitioner, or recognized clinical specialist to maintain continuity of care with an established patient who is temporarily located in this state and received treatment in the state where the practitioner is located and licensed" (RCW 18.134.050 (opens in a new tab)). The act doesn't define recognized clinical specialist, so don't assume it covers a therapist.
• Virginia, OTs only. An OT licensed elsewhere may treat a Virginia patient by telemedicine "for the purpose of providing continuity of care" when "the patient is a current patient of the practitioner with whom the practitioner has previously established a practitioner-patient relationship and the practitioner has performed an in-person examination of the patient within the previous 12 months" (Va. Code § 54.1-2901(A)(35) (opens in a new tab)). PTs, SLPs and OTAs aren't on that list.

Everywhere else, when your patient crosses a state line the new state's rules apply from the first session there. If you see it coming, a compact privilege in that state (where the compact is open) is the cleanest fix.

Consultation

About 20 states exempt some kind of consultation by a clinician licensed elsewhere. Read them closely: most cover advising a local clinician, not treating the patient yourself.

• Missouri allows "Episodic consultation by a health care provider licensed and located in another state who provides such consultation services on request to a physician in this state" (RSMo § 191.1145.4 (opens in a new tab)).
• New Jersey's PT rule says a provider in another state "who consults with a licensed physical therapist or licensed physical therapist assistant in New Jersey through the use of information and communications technologies, but does not direct patient care, will not be considered as providing health care services to a patient in New Jersey" (N.J.A.C. 13:39A-10.1(d) (opens in a new tab), an archived copy of the board's own file, which is no longer on its site).
• Arkansas's telemedicine license rule "does not apply to the acts of a healthcare professional located in another jurisdiction who provides only episodic consultation services" (Ark. Code § 17-80-404(d)(2) (opens in a new tab)).
• Vermont exempts consultation only when it "is based on a review of records without in-person or remote contact between the consulting health care professional and the patient or client" (26 V.S.A. § 3059 (opens in a new tab)).
• PT-to-PT advice has its own exemption in several PT acts: Pennsylvania where "there is no fee paid for the consultation" (PT Practice Act § 4 (opens in a new tab)), Oregon "for a period not to exceed 60 days in each calendar year" (ORS 688.030(4) (opens in a new tab)), Utah for "providing consultation by telecommunication to a physical therapist" (Utah Code § 58-24b-304 (opens in a new tab)), and Georgia, where an out-of-state PT "may provide a consultation via telehealth to a physical therapist in the state of Georgia" (Ga. Comp. R. & Regs. r. 490-9-.06 (opens in a new tab)).

Where the Professions Differ

In 18 states the answer isn't the same for all three professions. The most useful differences to know:

• North Carolina's speech rule counts both states. "Telepractice constitutes the practice of Speech and Language Pathology and Audiology in both the patient site and provider site. Providers must hold a license in the state of the provider site and shall be in compliance with the statutory and regulatory requirements of the patient site." (21 NCAC 64 .0219(d) (opens in a new tab)) The OT statute, by contrast, says plainly that anyone elsewhere who "by use of electronic or other medium, performs any of the acts described as the practice of occupational therapy pursuant to this Article, but is not licensed pursuant to this Article, shall be regarded as practicing occupational therapy without a North Carolina license" (N.C.G.S. § 90-270.78(b) (opens in a new tab)). The PT act and rules say nothing.
• Minnesota's OT exemption reads unusually broadly. As amended in 2025, the OT license requirement "does not apply to" "(3) a person who is credentialed under the law of another state that has credentialing requirements at least as stringent as the requirements of sections 148.6401 to 148.645" (Minn. Stat. § 148.6403, subd. 5 (opens in a new tab)). It doesn't mention telehealth, and the old 30-day limit is gone, so an out-of-state OT should confirm with the Minnesota board before relying on it. For SLPs the Health Department is explicit: "The provision of speech-pathology or audiology services in Minnesota through telepractice, electronic, or other means, regardless of the location of the speech-language pathologist or audiologist, shall constitute the practice of speech-language pathology or audiology and shall require Minnesota licensure." (MDH telepractice statement (opens in a new tab))
• Montana's board answers it for all three, though only the speech act does. "If, regardless of where you are located, your clients are located in Montana at the time of service, you do need a Montana license (or compact privilege)" (board FAQ (opens in a new tab)) For SLPs the statute says a nonresident SLP "who is not licensed under this chapter may not provide services to patients in Montana through telehealth without first obtaining a license from the board in accordance with this part or pursuant to the Audiology and Speech-Language Pathology Interstate Compact" (MCA 37-15-314 (opens in a new tab)).
• Massachusetts has a speech board policy and nothing for PT or OT. The policy also binds its own licensees: "Massachusetts-licensed Speech-Language Pathologists and Audiologists must comply with statutes, regulations and policies of the state or country where the client is located" (Board Policy No. 2019-001 (opens in a new tab)).
• Mississippi ties PT telehealth to a Mississippi license and lets evaluations happen by video: the licensee must "Perform all evaluations, including initial evaluations, re-evaluations and scheduled discharges with use of a secure electronic mode of communication using video/voice or in person" (30 Miss. Admin. Code Pt. 3103, R. 3.2 (opens in a new tab)). The OT and SLP rules don't say where the patient must be.
• Georgia's speech rule reaches anyone "physically located in another state or foreign country" who "performs an act that is part of a patient care service located in this state" (Ga. Comp. R. & Regs. r. 609-13-.01 (opens in a new tab)). The OT rules mention telehealth only for supervising assistants.
• California has an OT regulation, while PT and SLP rest on the license statutes plus board statements. The PT board's newsletter makes the point both ways: "If a patient relocates outside of California, even temporarily, the patient then is under the jurisdiction of the area in which the patient is located." (PTBC Progress Notes, Fall/Winter 2025 (opens in a new tab))

States With No Specific Rule

Five states have nothing on telehealth licensure for any of the three professions: Hawaii, Maine, Michigan, Nebraska and Utah. Fifteen more have no specific rule for one or two of them (see the table). In all of them the license requirement still applies to a patient in the state.

• Maine put the same short section into each act: "A person licensed under this chapter may provide telehealth services as long as the licensee acts within the scope of practice of the licensee's license" (32 M.R.S. § 3120 (opens in a new tab)). The boards were told to write telehealth rules and haven't; the speech board's notice still says "The board will be adopting more specific rules governing telehealth services." (Board of Speech, Audiology and Hearing, telehealth information (opens in a new tab))
• Hawaii's visiting exemptions are written for visits. The speech one is the widest: a nonresident "may offer speech pathology or audiology services in this State for no more than thirty working days in any calendar year, if such services are performed in cooperation with a speech pathologist or audiologist licensed under this chapter" (HRS § 468E-4(8) (opens in a new tab)).
• Michigan's exceptions apply to every health profession and don't mention telehealth: a practitioner from another state who "in an exceptional circumstance, is called in for consultation or treatment by a health professional in this state" (MCL 333.16171(f) (opens in a new tab)).

Assistants and Supervision by Telehealth

These rules matter as much as the license question if you supervise PTAs, OTAs or SLP assistants on a home health caseload (our supervisory visit guide covers the Medicare side).

• West Virginia and Wyoming tie the PTA to a locally licensed PT. West Virginia: telehealth "must be provided by a physical therapist, or physical therapist assistant under the supervision of the physical therapist who possesses a current" West Virginia license or compact privilege (16 CSR 1 § 13.2 (opens in a new tab)). Wyoming: "Physical therapy assistants may use telehealth technology to deliver services to patients in Wyoming under the supervision of a physical therapist who possesses a current Wyoming license." (PT Board Rules ch. 7 § 9 (opens in a new tab))
• Video supervision of PTAs is allowed in some states. Delaware: the supervising PT "must see the patient, in person or by telehealth, at least once every sixth treatment day, and the Physical Therapist Assistant must receive face to face supervision, in person or by telehealth, at least once every twelfth treatment day" (24 Del. Admin. Code 2600-1.2.3 (opens in a new tab)). Alaska: "Supervision shall be conducted on site or by video or teleconference when in-person supervision is not reasonably practicable." (12 AAC 54.510 (opens in a new tab))
• Others hold the line. North Dakota: "Telehealth does not meet the requirement for direct supervision." (N.D.C.C. § 43-26.1-01 (opens in a new tab)) Florida: "the physical therapist shall be accessible at all times by telecommunication and shall be within the same geographic location as the assistant" (Fla. Admin. Code r. 64B17-6.001(5)(c)1. (opens in a new tab)).
• Wisconsin lets the PT's periodic reassessment happen by video under conditions: "The assessment and reevaluation may be conducted via telehealth if all of the following conditions are met" (Wis. Admin. Code PT 5.01(2)(h) (opens in a new tab)).
• OTAs. Oregon allows routine and general supervision by video, which "can be done through telehealth, but cannot be done when close supervision as defined in 339-010-0005 is required" (OAR 339-010-0006(9) (opens in a new tab)). Georgia's OT rules define supervision as "in person supervision with weekly verbal contact and consultation which may be done via telehealth" (Ga. Comp. R. & Regs. r. 671-2-.02 (opens in a new tab)).
• Aides are out in Texas, where telehealth "is not a means for supervision of physical therapy aides" (22 TAC § 322.5(h) (opens in a new tab)), and in Oregon: "An aide may not provide telehealth services." (OAR 848-040-0180(1) (opens in a new tab))
• SLP assistants. Alabama: "Telepractice services may not be administered by assistants." (Ala. Admin. Code r. 870-X-7-.05 (opens in a new tab)) Tennessee: "Telesupervision of Clinical Fellows, Speech Language Pathology Assistants, and Clinical Externs by the Supervising Licensee is authorized as part of direct supervision." (Tenn. Comp. R. & Regs. 1370-01-.21(12) (opens in a new tab)) Illinois counts "supervision by a speech-language pathologist by way of video conferencing technology during telehealth practice" as direct supervision (225 ILCS 110/8.8 (opens in a new tab)), and Missouri says "direct supervision may be either in-person or through appropriate remote methods" (20 CSR 2150-4.201 (opens in a new tab)).

Before a Telehealth Session Across a State Line

None of this is legal advice. It is what the rules above have in common, put as steps.

1. Confirm where the patient is today. Several states make you verify it at the start of each session, and it decides whose rules apply. A patient on your home health caseload who is staying with family out of state is, for that call, a patient in that state.
2. Check for a compact privilege first. If both states are open members of your profession's compact, a privilege covers telehealth and in-person care. Our licensure compact tool shows where each compact is issuing privileges.
3. If there's no compact, look for a registration or exception in the table above, and read its conditions. Most registrations bar in-person care and many cap patients or days.
4. Don't stretch a visiting exemption. A rule that lets you practice for 30 days in this state was written for someone who travels there. Unless it mentions telehealth, ask the board before using it for video sessions.
5. Assistants follow their own rules. Check whether the state allows a PTA, OTA or SLP assistant to treat by telehealth, and whether the supervising clinician needs that state's license too.
6. Ask the board when in doubt. Most boards answer this question in writing, and that answer is worth keeping in your file.

Medicare: a separate question

Everything above is state law: who may treat a patient in that state. Medicare decides something else, which is what it will pay for. Meeting one doesn't settle the other.

Home health

In home health, a video session can be part of the care, but it isn't a visit. The plan of care must list "Any provision of remote patient monitoring or other services furnished via telecommunications technology (as defined in § 409.46(e)) or audio-only technology. Such services must be tied to the patient-specific needs as identified in the comprehensive assessment, cannot substitute for a home visit ordered as part of the plan of care, and cannot be considered a home visit for the purposes of patient eligibility or payment." (42 CFR 409.43(a)(3)(i)(B) (opens in a new tab))

The technology the plan can include is defined in the cost rules:

Telecommunications technology, as indicated on the plan of care, can include: remote patient monitoring, defined as the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient or caregiver or both to the home health agency; teletypewriter (TTY); and 2-way audio-video telecommunications technology that allows for real-time interaction between the patient and clinician. The costs of any equipment, set-up, and service related to the technology are allowable only as administrative costs.

That is 42 CFR 409.46(e) (opens in a new tab). So a therapist's video check-in can sit on the plan of care, but it can't stand in for an ordered visit, and it doesn't count as a visit for eligibility or payment. And the state rules above still apply to it: if the patient is in another state for the call, so is the practice.

Part B outpatient therapy

Under Part B, PTs, OTs and SLPs can bill Medicare for telehealth only because Congress keeps extending a temporary rule. The current extension runs through December 31, 2027. The Consolidated Appropriations Act, 2026 (Public Law 119-75, approved February 3, 2026) did it in a subsection headed "Expanding Practitioners Eligible to Furnish Telehealth Services," which changed the end date in section 1834(m)(4)(E) of the Social Security Act from "ending on January 30, 2026" to "ending on December 31, 2027" (Pub. L. 119-75, § 6209(b) (opens in a new tab)). That section is the one under which the definition of practitioner "shall include a qualified occupational therapist (as such term is used in section 1395x(g) of this title), a qualified physical therapist (as such term is used in section 1395x(p) of this title), a qualified speech-language pathologist" (42 U.S.C. 1395m(m)(4)(E), 2024 edition (opens in a new tab), which shows the end date in force at the time).

CMS's own FAQ, updated October 8, 2026, says the same:

Through December 31, 2027, an extended range of practitioners may bill for Medicare telehealth services. Starting January 1, 2028, physical therapists, occupational therapists, speech-language pathologists, and audiologists can no longer furnish Medicare Telehealth services.

That is from the CMS Telehealth FAQ (opens in a new tab), which also says that "Through December 31, 2027, beneficiaries can receive Medicare telehealth services anywhere in the United States and territories," including at home. Congress has moved this date several times since 2020, so check it again before 2028.

Key Takeaways

• Telehealth licensure follows the patient: you need a license or compact privilege in the state where the patient is during the session, unless that state gives you another route.
• 46 of the 51 jurisdictions say so for at least one profession. The five that don't (Hawaii, Maine, Michigan, Nebraska, Utah) still require their own license to practice.
• Arizona, Colorado, Florida and Vermont have telehealth registrations open to therapists; Kansas has a waiver for PTs and OTs; Delaware's registration is for OTs only, and Louisiana's and West Virginia's for SLPs only.
• Only DC, Idaho, Kentucky, New Hampshire, North Dakota, Washington and Virginia (OTs) have a rule for an existing patient who is temporarily in the state.
• In home health, a telehealth session can be on the plan of care but is never a visit. Part B therapist telehealth is authorized through December 31, 2027.
• This isn't legal advice. I checked these rules on November 9, 2026, and your board's current rule is the one that counts.

Frequently asked questions

Can I treat a patient in another state by telehealth?

Only if you hold a license or compact privilege in the state where the patient is, or that state gives you another route. In 46 of the 50 states and DC, a statute, rule or board statement says the patient's location decides for at least one of the three professions, and the other five still require their own license to practice. Eight offer a telehealth registration or waiver for at least one profession, and seven let you keep treating an existing patient who is only there for a while.

Do I need a license where I am or where the patient is?

Where the patient is, at the time of the session. Every state that addresses it looks to the patient's location, and North Carolina's speech rule says telepractice happens in both places. Your own state may still have rules for licensees who treat from there. A compact privilege counts as authorization in a member state that is issuing privileges.

Which states let out-of-state therapists register for telehealth instead of getting a full license?

Arizona, Colorado, Florida and Vermont have a telehealth registration for PTs, OTs and SLPs, though Colorado's own FAQ leaves SLPs off its list. Kansas offers PTs and OTs a telemedicine waiver. Delaware's registration reaches only OTs, and Louisiana's and West Virginia's only SLPs. All of them are for telehealth only, with no in-person care.

Can I keep seeing my patient by telehealth if they travel to another state?

Without a license there, only in a few places. DC, Idaho, Kentucky, New Hampshire and North Dakota have exceptions for an existing patient who is temporarily in the state or for follow-up care, each with its own conditions. Washington's follow-up exception names primary care, mental health and clinical specialists, and Virginia's covers OTs who examined the patient in person in the past 12 months. Everywhere else, the rules of the state the patient is in apply from the first session there.

Does Medicare pay for PT, OT and speech therapy by telehealth?

In home health, a telehealth session is never a visit: it can be on the plan of care, but it cannot replace a home visit or count as one for eligibility or payment. Under Part B, PTs, OTs and SLPs can bill Medicare telehealth through December 31, 2027, under the extension in the Consolidated Appropriations Act, 2026. CMS says that from January 1, 2028, they can no longer furnish Medicare telehealth services unless Congress acts again.

Sources

Every state's rule is linked in the table, to the state's legislature, its official administrative code publisher or its licensing board. Where a board's own file is no longer on its site (New Jersey's PT and OT rules), the link is an archived copy of that file. All were read on November 9, 2026.

• 42 CFR 409.43 (opens in a new tab) and 409.46 (opens in a new tab), eCFR: the plan of care and telecommunications technology in home health.
• Consolidated Appropriations Act, 2026, Public Law 119-75 (opens in a new tab), Division J, section 6209.
• 42 U.S.C. 1395m(m) (opens in a new tab), Social Security Act section 1834(m), 2024 edition.
• CMS, Telehealth FAQ (opens in a new tab), updated October 8, 2026.
• Compact status: this site's licensure compact tool, from the PT Compact, OT Compact and ASLP-IC commissions' maps, checked October 10, 2026.