5 Things You Should Know About Practicing Telemedicine While Abroad

Want to admire Roman aqueducts on your morning run, pluck pomegranates from your backyard, and see patients in the US – all in the same day? Telemedicine can help you do just that! Here are five things to know about practicing telemedicine while abroad.

1. Know About Health Insurance Reimbursement

Physicians are ineligible to bill Medicare and Medicaid if located outside of the United States during the patient encounter. Some Private insurance companies, like Optum, will allow physicians on their panel to be located outside of the US. Healthcare systems that do not bill Medicare or Medicaid may allow you to work outside of the US.

2. Avoid Prescribing Controlled Substances

According to the Ryan Haight Act, a provider may prescribe controlled substances via telemedicine to a patient as long as the physician has seen the patient at least once in person in the prior 24 months. This in-person evaluation is not required during a public health emergency.

Per DEA regulations, physicians are ineligible for DEA registration if they are located outside of the United States. Per my communications with the DEA, one possible interpretation of this regulation is that prescribing controlled substances from abroad is forbidden.

3. Ensure Your Malpractice Insurance Covers Practicing Telemedicine While Abroad

Malpractice insurers may not cover you if you are practicing telemedicine from abroad. This is, in part, because insurance is based on spreading individual risk across a population. That said, there are some malpractice insurers that will cover you while residing abroad.

4. Consider Obtaining Multiple State Licenses

Having multiple state licenses will likely be required to work with a telemedicine company, as physicians are only legally allowed to practice in states in which they are licensed. Most state medical boards allow physicians located outside the US to see patients in their state through telemedicine but be sure to double-check with your state’s medical board.

Consider getting license in one of the more populous states which will likely have higher telehealth utilization: California, New York, Texas, Florida. Also consider obtaining a license in an Interstate Medical License Compact State – the compact includes 29 states and streamlines licensure in other member states if you meet the eligibility criteria.

5. Some Telemedicine Companies Allow Physicians to Be Abroad

Some telemedicine companies allow physicians to work from abroad. These companies typically contract with payers, healthcare systems or employers that do not utilize Medicare or Medicaid for reimbursement and will not object to you working from outside of the United States. For physicians who are not US citizens or US Green Card holders, here is a guide to help navigate practicing telemedicine abroad.

Check out our Job Board and join our Facebook group for more information!

Bottom Line

Practicing telemedicine while abroad is possible as long as you can overcome the challenges.


Dr. Ashwini Bapat is a palliative care physician, Founder and CEO of EpioneMD, which provides virtual advanced care planning and serious illness coaching to individuals and telepalliative care consultation to healthcare organizations. She resides in Portugal.

For a personalized approach to moving abroad, learn about how our Guidance Service can help.

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