Key Takeaways
The DEA’s fourth extension preserves the status quo for telemedicine prescribing, allowing clinicians to continue prescribing Schedule II-V controlled substances without a prior in-person visit through December 31, 2026.
By issuing a clean, one-year extension that includes audio-video and certain audio-only pathways, the DEA avoided an immediate “telehealth cliff.” At the same time, it continues to work on a permanent teleprescribing solution.
One-Year Extension Avoids Disruption to Telemedicine Prescribing
The U.S. Drug Enforcement Administration (DEA) and the Department of Health and Human Services have issued a fourth temporary extension of telemedicine prescribing flexibilities, which will continue to allow clinicians to prescribe controlled substances without a prior in-person visit through December 31, 2026. The fourth extension was published on the last day of the previous flexibility period, although prior reporting expected that an extension was nearly guaranteed.
With the newly issued rule taking effect on January 1, 2026, DEA-registered clinicians may continue to remotely prescribe Schedule II-V controlled medications over telemedicine through December 31, 2026. Essentially, this is a clean extension as it moves the flexibility end date by another whole year. The DEA press release notes that the extension works in conjunction with two earlier rules published in January 2025, which were set to take effect at the end of 2025. The extension is intended to prevent an abrupt “telehealth cliff,” as we saw occur in October 2025, that would interrupt patient access to essential medications while the agency continues work on permanent telehealth prescribing regulations.
In brief, the extension applies broadly to controlled medications and permitted prescriptions issued via audio-video telemedicine encounters. It also continues established pathways for prescribing medications for opioid use disorder, such as allowing audio-only telemedicine encounters, as part of related regulatory frameworks. As always, this latest extension allows for prescribing flexibility, provided it is done in compliance with DEA guidance and regulations, as well as all applicable state and federal laws.
Disclosures:
This article was developed with AI-assisted research tools and edited by the Telehealth News editorial team for accuracy and clarity.
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