WASHINGTON—The U.S. Drug Enforcement Administration (DEA), in partnership with the Department of Health and Human Services (HHS), announced it has issued a fourth temporary extension of the COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications, extending the current telemedicine flexibilities through Dec. 31, 2026.
Under these telemedicine flexibilities, DEA-registered practitioners are permitted to remotely prescribe Schedule II-V controlled medications via audio-video telemedicine encounters, including Schedule III-V narcotic controlled medications approved by the Food and Drug Administration (FDA) for maintenance and withdrawal management treatment of opioid use disorder via audio-only telemedicine encounters, without having ever conducted an in-person medical evaluation, provided that such prescriptions otherwise comply with the requirements outlined in DEA guidance documents, DEA regulations, and applicable federal and state law.
“DEA supports telehealth access for patients who need medication, but not at the expense of public safety,” said DEA Assistant Administrator Cheri Oz. “These rules aim to protect patients, expand access to care and close the door on diversion into the illicit drug market.”
DEA recognizes that the expiration of the current telemedicine flexibilities without further regulation could disrupt patient care. This extension provides critical benefits, including:
- Ensuring continuity of care for patients who rely on telemedicine, particularly those in rural and underserved areas, the elderly, and patients with mobility limitations
- Preventing a backlog of patients needing in-person appointments
- Allowing time to finalize and implement regulations that balance access to care with the necessary safeguards against drug diversion.
On Jan. 17, 2025, DEA and HHS published two final rules titled Expansion of Buprenorphine Treatment via Telemedicine Encounter and Continuity of Care via Telemedicine for Veterans Affairs Patients (collectively referred to as the “Two Final Rules”). These rules took effect December 31, 2025.
ATA Action, advocacy arm of the American Telemedicine Association, released a statement praising the extension saying that it ensures Americans "can maintain access to the care they have depended on since early 2020."
“This critical federal action came down to the wire, and we appreciate the Trump Administration for preventing interruption of this life-saving care," said Alexis Apple, deputy executive director of ATA Action and vice president of federal affairs at the ATA. "This one-year extension is a major relief for patients and healthcare providers, restoring certainty and avoiding treatment gaps for millions of Americans. Importantly, it also gives ATA Action and other key stakeholders time to continue working with the Trump Administration, the Drug Enforcement Administration, the U.S. Department of Health and Human Services (HHS), and our bipartisan champions in Congress to establish a permanent and workable framework that guarantees appropriate and necessary access to care. This extension came within hours of expiration, placing patients, providers, and health systems on the brink of unnecessary disruption. ATA Action is deeply grateful for the extension and recognizes that it was offered in good faith, as allowing these flexibilities to lapse for any extended period would have constituted a predictable and preventable public health crisis."
The Fourth Temporary Extension, along with the two final rules, provides three sets of authorities for telemedicine prescribing, each with unique requirements. Practitioners covered by one or both of the two final rules may continue to utilize the telemedicine flexibilities under the fourth temporary rule, which the DEA said imposes fewer requirements than the two final rules.