By: Christopher Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, MA
A Health Care Provider Defense and Compliance Firm

Telehealth providers just received welcome news. The DEA is preparing to issue a fourth extension of the pandemic-era telemedicine flexibilities that allow DEA-licensed clinicians to prescribe controlled substances via telehealth without an initial in-person visit. This new extension is expected to run for one full year, carrying the current rules through December 31, 2026, and preventing a service-disrupting gap as the agency continues to craft a permanent framework.

The rule, titled the “Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” has been formally posted for forthcoming publication, although the final text is still under Office of Management and Budget review. Once cleared, it will be published in the Federal Register and take effect before the current authority expires on December 31, 2025. In short, the DEA is buying itself more time and keeping telehealth prescribing stable while doing so.

This is a critical development for mental health providers, addiction-treatment programs, MAT prescribers, psychiatric practices, digital health platforms, and rural telemedicine groups that rely heavily on the post-COVID prescribing flexibilities. Without this extension, a sudden reversion to pre-pandemic rules would force thousands of patients into brick-and-mortar visits, jeopardize continuity of care, and overwhelm already strained in-person practices. The DEA understands this, which is why it is issuing yet another “clean” extension without major modifications.

If you prescribe controlled substances via telehealth, this is your call to action. Confirm that every prescriber has an active and accurate DEA registration tied to the appropriate practice locations. Audit your telehealth workflows to ensure that identity verification, patient-location documentation, and prescription-monitoring-program checks are consistently performed and recorded. Update your policies for controlled-substance telehealth encounters so they reflect both current temporary flexibilities and anticipated permanent requirements. Strengthen your medical-necessity documentation, particularly for stimulants, benzodiazepines, and MAT medications, which continue to draw heightened scrutiny from DEA and commercial payers. And start planning for a hybrid model in case future DEA rules require selective in-person evaluations.

This upcoming extension is good news, but it is not a signal to relax. It is a signal to prepare. A permanent DEA rule is coming, and providers who build sturdy compliance structures now will be in the best position to transition smoothly, continue prescribing safely, and avoid regulatory missteps.

If you have any questions or comments about the subject of this blog, please contact Parrella Health Law at 857.328.0382 or Chris directly at cparrella@parrellahealthlaw.com.