California Telehealth Compliance for Cash-Pay Clinics: Licensure, the Prior Exam Rule, Consent, CURES and Corporate Practice

Licensure

California requires a California license to treat patients located in California, and Medical Board analyses cite the licensing statutes for that rule. The only exceptions are a consultation in which the out-of-state physician has no ultimate authority over the patient's care and a narrow exemption for life-threatening illness telehealth. The Board has opposed bills that would widen the exemptions. There is no telehealth-specific license or registration, and a secondary source reports that California is not a member of the Interstate Medical Licensure Compact.

The Prior Examination Rule

Business and Professions Code section 2242 requires an appropriate prior examination and a medical indication before prescribing. According to a secondary reading of the 2019 version, the exam need not be synchronous and can be done by telehealth, including through a questionnaire or self-screening tool, if the standard of care is met. A separate section on internet prescribing carries penalties of up to $25,000 per occurrence. The Medical Board's internet prescribing page still says questionnaires are no substitute for an exam and is undated, so the Board's stated caution and the statute's text do not line up perfectly. We found no statutory in-person requirement. In practice a documented clinician evaluation, with live video for anything beyond routine, is the defensible approach.

Consent

Section 2290.5 requires the provider to inform the patient about telehealth and obtain verbal or written consent, and the consent must be documented. Noncompliance is unprofessional conduct.

Prescribing and CURES

• CURES checks: prescribers must check California's prescription monitoring system, CURES, before the first Schedule II through IV prescription and every six months after.
• Testosterone and ketamine: both are Schedule III in California.
• Testosterone reporting change: under AB 82, from January 1, 2026 testosterone dispensing must not be reported to CURES, and older records are to be deleted by January 1, 2027. We could not confirm how this affects the prescriber's consultation duty for testosterone.
• Out-of-state pharmacies: pharmacies shipping into California need a nonresident pharmacy license, and our California 503A and 503B guide covers compounded drug shipping.

NPs and PAs

Nurse practitioners can practice independently, including prescribing controlled substances, after three years or 4,600 hours under the state's transition-to-practice rules. Physician assistants need a written practice agreement.

Corporate Practice

California's corporate-practice rule comes from Business and Professions Code section 2400, which bars corporations from professional rights. On June 26, 2026 the attorney general announced a $4.4 million settlement with Carbon Health, plus $100,000 against its co-founder, that targeted a friendly-PC and management-company model: assignable options, management-company control of advertising and captive financing, with a requirement to restructure. The release does not mention telehealth, and Carbon Health operates clinics. SB 351, effective January 1, 2026, limits private equity and hedge fund interference and gives the attorney general injunctive power, and AB 1415 requires notice of certain management-company transactions. We found no telehealth-specific corporate-practice authority.

Disclaimer

This article is general educational information, not legal advice. Telehealth rules change often and differ by state, and parts of this summary rest on secondary sources, so confirm specifics with health care regulatory counsel in the state before you rely on them.