What are the Best States for Telemedicine?

The United States continues to become friendlier to the practice of telehealth, helping foster the growth of virtual care businesses and products one state at a time. And, these industry-impacting changes are occurring rapidly. The American Telemedicine Association recently reported that 80% of all US states have moved to improve telemedicine coverage or reimbursements over the past two years, according to their latest survey of state laws and policies.


But, what are the characteristics that make a state telemedicine-friendly? Here, we take a look at the three most prominent “friendliness” factors:

  • State population
  • Medical licensing and practice laws
  • Medicaid policies

These insights are useful whether you’re hiring for a clinic or seeking telemedicine employment.

#1 State Population

It’s no surprise the US’ most popular states for telemedicine services align with the most populated areas overall. Throughout our several years as a telemedicine staffing company, we’ve observed the most popular states for telemedicine labor to be (in no particular order):

  • California 
  • Texas 
  • Florida 
  • New York 
  • Arizona

And it’s no coincidence that 4 of these 5 states also make up the top 4 most populated states in the entire country. Though, population is not the only factor contributing to the uptick in telemedicine services and patient users.

#2 State Medical Licensing & Practice Laws 

Evolving state laws, statutes, and corporate practice of medicine interpretations also play a role in determining which states are well-suited for telemedicine companies to thrive. Generally speaking, the least restrictive states make it easier for new telemedicine companies and startups to launch their services without the additional worry of state’s medical board oversight restrictions and legal action.

As of this writing, 16 states limit medical coverage to synchronous coverage ONLY, while 29 states have specific laws that allow for asynchronous care models or commonly known as store and forward care.

Still, business-friendly medical licensing and practice laws still play second fiddle to population in terms of telehealth-friendliness. For example:

  • The highly-populated state of California has a much more stringent application regarding the corporate practice of medicine. This state completely prohibits the corporate practice of medicine and requires “that business or management decisions and activities resulting in control over a physician’s practice of medicine, be made by a licensed California physician and not by an unlicensed person or entity.”
  • Similarly, Texas still remains one of the top states in terms of demand for telemedicine services, even though they also are known as one of the most legally restrictive states for telemedicine. For telehealth startups, Texas is likely to be one of the states that gives company operations professionals the most headaches.

#3 Medicaid Reimbursement Policies 

Naturally, individuals that rely on government-subsidized healthcare are less likely to seek services from virtual care providers if there is no reimbursement for the medical expenses incurred.

Manat, a legal and consulting firm, recently reviewed the individual state laws and Medicaid policies related to telemedicine across all 50 states. The data was then used to group states into one of 3 categories based on each state’s telehealth friendliness derived from these compiled legal intricacies.

Progressive, Moderate, Restrictive States

In Manat’s state ranking, all but 12 states ranked as either moderate or progressive, which indicates that telehealth-related state restrictions are steadily being minimized in favor of both patients seeking virtual care and physicians/companies providing virtual care.

Progressive Telehealth States

Alaska, Arizona, California, Colorado, Connecticut, Florida, Hawaii, Idaho, Maine, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, Nevada, New York, Utah, Vermont, Washington

Moderate Telehealth States

Alabama, D.C., Delaware, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, Oregon, South Dakota, Tennessee, Virginia, Wisconsin, West Virginia, Wyoming

Restrictive Telehealth States

Arkansas, Georgia, Massachusetts, Maryland, North Carolina, North Dakota, New Hampshire, Ohio, Pennsylvania, Rhode Island, South Carolina, Texas

The most restrictive State for Telehealth: Massachusetts

Massachusetts is one state where telemedicine company endeavors might experience some more regulatory hurdles, and patients might foot the telehealth medical bills more often than not. Massachusetts doesn’t have a formal Medicaid reimbursement policy for fee-for-service medical care through telehealth. Also, physicians in this state must have a pre-established relationship with a patient before they can prescribe medications.

Additionally, Massachusetts is one of the few remaining states yet to join the Interstate Medical Licensure Compact which streamlines the process for physicians to obtain multi-state medical licenses.

Best States For Telemedicine Physician Job Seekers

As previously mentioned, the most populated states generally see the most usage of telemedicine services because with more people, there are more health issues and more of a demand for virtual care. As such, telemedicine companies in these populous states hire physicians much more frequently than lower population states. Telemedicine jobs in Texas, California, Florida, and New York are almost always available (we have several openings in each of those states).

A physician showing his patient information on a computer screen

What now?

If you’re a physician seeking telemedicine opportunities, visit our telemedicine job postings board for more information or contact us to get connected with the ideal telehealth clinic.

If you are a current or prospective telemedicine organization, let’s chat! We have several years of experience in telehealth staffing and can serve as your talent resource.