Can the pre-treatment exam be done by telehealth in Missouri?
Intake · part of The Practice Perimeter
Short answer
Yes — a telemedicine encounter can establish the physician-patient relationship if the standard of care doesn't require an in-person exam and the technology allows an informed diagnosis as if in person; a patient questionnaire alone isn't enough.
Physicians licensed under chapter 334 who use telemedicine shall ensure that a properly established physician-patient relationship exists with the person who receives the telemedicine services. The physician-patient relationship may be established by: an in-person encounter through a medical evaluation and physical examination; consultation with another physician, or that physician's delegate, who has an established relationship with the patient and an agreement with the physician to participate in the patient's care; or a telemedicine encounter, if the standard of care does not require an in-person encounter, and in accordance with evidence-based standards of practice and telemedicine practice guidelines that address the clinical and technological aspects of telemedicine.
Mo. Rev. Stat. §191.1146.1 · verified Sep 3, 2026 · regulatory monitoring, not legal advice
Related Missouri rules
In order to establish a physician-patient relationship through telemedicine the technology utilized shall be sufficient to establish an informed diagnosis as though the medical evaluation and, if required to meet the standard of care, the physical examination has been performed in person.
Mo. Rev. Stat. §191.1146.2(1) · verified Sep 3, 2026
Any questionnaire completed by the patient, whether via the internet or telephone, shall be reviewed by the treating health care professional, as defined in section 376.1350, and shall include such information sufficient to provide the information as though the medical evaluation has been performed in person, otherwise such questionnaire does not constitute an acceptable medical evaluation and examination for the provision of treatment by telehealth.
Mo. Rev. Stat. §191.1146.2(2) · verified Sep 3, 2026
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