Medicare Patients Can Still Fill Controlled Substance Prescriptions via Telehealth Through Year-End as Permanent Rules Await Finalization

Medicare beneficiaries who receive controlled substance prescriptions through video appointments, including medications for mental health conditions, anxiety, sleep disorders, and opioid use disorder, can continue doing so through December 31, 2026. The Drug Enforcement Administration, jointly with the Department of Health and Human Services, published a fourth temporary extension of telemedicine prescribing flexibilities on December 31, 2025.

Under the extension, DEA-registered practitioners may prescribe Schedule II through V controlled substances to patients via audio-video telehealth without a prior in-person evaluation. For opioid use disorder treatment, audio-only telehealth is also permitted for qualifying Schedule III through V medications, a provision that supports access for patients in areas with limited broadband or technology resources.

The temporary extension has been renewed repeatedly since the end of the federal Public Health Emergency in 2023, when the original COVID-era prescribing flexibility expired. Each renewal has been paired with stated intentions to finalize a permanent regulatory pathway, known as the proposed Special Registration for Telemedicine, which would allow qualified practitioners to prescribe controlled substances remotely under clearly defined standards.

That permanent rule was proposed in the Federal Register in January 2025, but DEA and HHS had not published a final version as of mid-2026. The agencies face a year-end deadline. If a final rule is not published by December 31, 2026, another extension or congressional action would be needed to avoid disruption for patients who rely on telehealth for ongoing controlled substance management.

For Medicare patients, the current system remains in effect through the end of this year.