A telehealth company is not itself licensed to practise medicine, nursing or counselling; only its individual clinicians are, and licensure follows the patient's physical location at the time of the visit, not the company's home state. On top of that clinician-level rule, the company has a second, entity-level question: whether the state requires a specific professional-entity structure under its corporate practice of medicine (CPOM) doctrine. California, Texas and New York are the three states named consistently across legal sources as having a strict, statute-based CPOM restriction requiring physician ownership; Florida is named consistently as the clearest exception. A handful of states, confirmed here as Florida, Minnesota and Colorado (effective 1 January 2026), let an out-of-state clinician register for telehealth instead of obtaining a full licence, each with its own conditions. None of this is legal advice; a company's actual entity structure in each state it serves should be worked out with healthcare counsel licensed there.
Does a telehealth company itself need to be licensed in every state it serves?
No. States license individual clinicians, not the business entity, so the company's own obligation is different in kind, not just in scale, from a clinician's. What the company itself needs ranges from nothing beyond ordinary business registration to a specific professional-entity structure, depending on the state's corporate practice of medicine rules below. A company can be fully compliant on every clinician's individual licensing and still be out of compliance on its own entity structure in a state with strict CPOM rules.
Which state's rules actually govern a given telehealth visit?
The patient's location at the time of the visit, not the clinician's location or the company's home state. This is the Federation of State Medical Boards' own model telemedicine policy position, and it is why a company operating across states needs every clinician individually licensed, or holding a compact privilege, in each state where that clinician's patients are physically located, with no shortcut at the company level.
What is the corporate practice of medicine doctrine, and which states enforce it strictly?
It is a state-law doctrine restricting who can own a medical practice or employ its clinicians, and it is not applied uniformly; California, Texas and New York are the three states named consistently across legal sources as having a strict, statute-based restriction. California requires a licensed physician to hold a majority of a medical corporation's shares (Business and Professions Code Section 2400, Corporations Code Section 13401.5), with other licensed clinicians able to hold up to 49 percent and no unlicensed ownership. Florida is named consistently as the clearest exception, with no general statute prohibiting the corporate practice of medicine. Oregon added a new restriction in 2025 (SB 951), requiring licensee-majority ownership of professional medical entities. Outside these four states, legal sources disagree with each other on individual states, so this page does not publish a full 50-state table; a company expanding into a new state should confirm that state's current rule with healthcare counsel licensed there rather than rely on a generic list.
| State | CPOM posture | What it typically means for structure |
|---|---|---|
| California | Strict, by statute | A licensed physician must hold a majority stake in a medical corporation; no unlicensed ownership |
| Texas | Strict, by statute and board rule | Non-physician entities generally cannot employ or control a physician's practice of medicine |
| New York | Strict, by statute | A medical practice is generally required to be physician-owned |
| Oregon | Newly restricted (2025) | SB 951 requires licensee-majority ownership and limits management-company control |
| Florida | No general CPOM statute | The clearest named exception; no general prohibition on corporate ownership |
Does a strict CPOM state mean the company can't hire physicians at all?
No, but it usually means the company has to split the business into two parts: a physician-owned professional entity that employs the clinicians, and a separate management services organization (MSO) that the company itself can own and that handles the non-clinical business functions. The professional entity holds the clinical licensing and employment relationships; the MSO can be owned by non-physicians and typically provides administrative, billing, marketing and technology services to the professional entity under a management services agreement. How much control an MSO can exercise over the professional entity, and how that agreement has to be structured, is itself governed by the same state's CPOM rules and varies; this is a structuring decision for healthcare counsel, not something a licensing specialist resolves alone.
Do any states let an out-of-state clinician register for telehealth instead of getting a full licence?
Yes, in a handful of states, though the list and the conditions attached to it change often enough that each one needs checking directly rather than assumed. Four programs are currently confirmed: Florida requires an out-of-state telehealth provider REGISTRATION under Fla. Stat. Section 456.47, distinct from a full licence; Minnesota's telehealth registration under Minn. Stat. Section 147.032 additionally requires the out-of-state clinician to consult with a Minnesota-licensed physician who keeps ultimate authority over diagnosis and care, a real condition, not a free pass; Colorado's telehealth registration (C.R.S. Section 12-30-124, enacted by SB24-141) took effect 1 January 2026 and covers physicians, PAs, nursing licensees, mental health providers, dentists and audiologists, but allows no in-person practice or Colorado office; and Nevada's former Special Purpose Licence was renamed a telemedicine licence under AB 319 (2025). The Federation of State Medical Boards' own most recent survey counted roughly ten states plus the US Virgin Islands with some version of this, a figure that moves as states add or retire programs.
| State | What it's called | Key condition | Source |
|---|---|---|---|
| Florida | Out-of-State Telehealth Provider Registration | Registration, not a licence; current fee not confirmed this cycle | Fla. Stat. Section 456.47 |
| Minnesota | Telehealth registration | Must consult with a Minnesota-licensed physician who retains ultimate authority | Minn. Stat. Section 147.032 |
| Colorado | Telehealth registration | No in-person practice or Colorado office; effective 1 Jan 2026 | C.R.S. Section 12-30-124 |
| Nevada | Telemedicine licence (renamed from Special Purpose Licence) | Renamed under AB 319 (2025) | See board |
A telehealth-only registration is not a universal shortcut. Several of these programs restrict in-person practice entirely, require ongoing consultation with an in-state clinician, or exclude controlled-substance prescribing. Check the specific state's current conditions before assuming a registration covers what a full licence would.
Where does Telesure fit into this?
Telesure matches a telehealth company's clinicians and practice managers with independent licensing and credentialing specialists; it does not provide legal advice on entity structure or corporate practice of medicine compliance, which should go through healthcare counsel licensed in each state the company operates in. What a specialist can help with is the clinician-level work this page's entity-structure questions sit on top of: getting each clinician licensed or privileged in every state where patients are located, and keeping that roster current as the company expands.
What a licensing specialist handles
Individual clinician licensing, compact privileges, and keeping a multi-state roster current as the company adds states or clinicians.
What healthcare counsel handles
Entity structure, corporate practice of medicine compliance, and MSO/professional-entity agreements in each state.
Planning a multi-state telehealth expansion? Tell us what you need and we'll match you with a specialist for the licensing and credentialing side.
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Juney Ham is the founder and CEO of Telesure, the marketplace that matches clinicians with independent licensing and credentialing specialists. Previously co-founder of Upside and CMO at Hired. Every regulatory figure on this page is taken from the issuing state board, compact commission or CMS and was verified on 4 November 2026. Fees and compact status change; confirm with the relevant board before relying on them.
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