Illinois Telehealth Compliance for Cash-Pay Clinics: Licensure and the Rule Against Percentage-Based Management Fees
Illinois requires an Illinois license for patients in Illinois, holds telehealth to the in-person standard of care, and has one of the most direct statutory limits in the country on percentage-based management fees.
Key Highlights
- A professional treating a patient located in Illinois by telehealth must be licensed or authorized to practice in Illinois, with narrow exclusions and no registration or telehealth license route.
- The Telehealth Act requires services consistent with the standards of care for in-person services and includes asynchronous store-and-forward, and we found no questionnaire-only ban.
- The Medical Practice Act bars a licensee from paying a percentage of fees, revenues or profits for marketing or management of the practice, and violations are Consumer Fraud Act violations enforceable by the Attorney General.
- Testosterone is not covered by the prescription monitoring check, and we found nothing on ketamine.
Licensure
Illinois's Telehealth Act says a professional treating a patient located in Illinois by telehealth must be licensed or authorized to practice in Illinois, and only temporary-permit holders get a carve-out. The Medical Practice Act penalizes unlicensed telemedicine, with exclusions for periodic consults, second opinions for Illinois licensees, follow-on care after treatment originally given where the provider is licensed and a traveling existing patient. Out-of-state providers submit to Illinois courts. We found no registration or telehealth license route. Illinois joined the Interstate Medical Licensure Compact in 2015.
Standard of Care and Definitions
The Telehealth Act sets no specific relationship or exam rule. Telehealth must be consistent with the standards of care for in-person services. The Act's definition of telehealth services expressly includes asynchronous store-and-forward, e-visits and virtual check-ins, and its interactive-system definition excludes fax, email and text. We found no questionnaire-only ban in the Telehealth Act, and we did not fully check the Medical Practice Act's grounds for discipline on remote prescribing.
Consent
We found no consent requirement in the Telehealth Act. Document informed consent anyway.
Prescribing
We found no Illinois-specific telehealth schedule bar. Prescribers must register with the prescription monitoring program and document an attempt to access it before initial Schedule II narcotic prescriptions, and a 2025 law effective January 1, 2027 changes the trigger to initial Schedule II stimulants and all Schedule II opioids and Schedule IV benzodiazepines. Testosterone is not covered by the check, and we found nothing specific on ketamine.
NPs and PAs
Advanced practice registered nurses can reach full practice authority with 250 hours of continuing education and 4,000 clinical hours, and otherwise need a written collaborative agreement. Physician assistants always need a written collaborative agreement with monthly consultation.
The Rule That Matters for Management Fees
Section 22.2 of the Medical Practice Act allows a licensee to practice through an entity only if every owner is licensed and the entity is organized under one of the state's professional entity acts. It bars a licensee from paying a percentage of fees, revenues or profits for the marketing or management of the practice, while allowing fair-market-value billing and collection fees, and it makes violations Consumer Fraud Act violations enforceable by the Attorney General. That directly affects percentage-based management fees, and it is one of the clearest statutory reasons to use a flat, fair-market, invoiced management fee in Illinois. We found no IDFPR or Attorney General action specific to telehealth management companies. A 2026 law extended the Medical Practice Act's sunset to 2032, and from our read it made only sunset or housekeeping changes to these sections.
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.
MedGrid MSO provides management services to independently owned practices; it does not practise medicine and does not direct clinical decisions. Requirements vary by state and by service, and change over time — nothing on this page is legal or medical advice. Talk to us or your own counsel before making a structural decision for your clinic.