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Is an exam required before a patient can be treated in Missouri?

Intake · part of The Practice Perimeter

⛔ MISSOURI ANSWERS THE ONLINE-INTAKE QUESTION DIRECTLY, AND THE ANSWER IS CONDITIONAL. A physician using telemedicine must ensure a properly established physician-patient relationship exists, and the statute names the three ways it may be established: an in-person encounter through a medical evaluation and physical examination; consultation with another physician who has an established relationship with the patient and an agreement to participate in that patient’s care; or a telemedicine encounter, IF the standard of care does not require an in-person encounter. To establish the relationship through telemedicine the technology must be sufficient to reach an informed diagnosis as though the evaluation, and any physical examination the standard of care requires, had been performed in person. A questionnaire — internet or telephone — must be reviewed by the treating health care professional and must itself carry information sufficient to serve as though the medical evaluation had been performed in person; otherwise the statute says in terms that it DOES NOT constitute an acceptable medical evaluation and examination for providing treatment by telehealth. Before prescribing through telemedicine or the internet, the physician must obtain a reliable medical history and, if the standard of care requires, perform a physical examination adequate to establish the diagnosis and identify underlying conditions or contraindications.

Drawn from 6 verified rules in this section · regulatory monitoring, not legal advice

The rest of what Missouri says on this

Every other rule we have verified under good-faith examination, each linked to its primary source.

  • 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

  • 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

  • Prior to providing treatment, including issuing prescriptions or physician certifications under Article XIV of the Missouri Constitution, a physician who uses telemedicine shall evaluate the patient, collect or review the patient's relevant medical history, and perform an examination sufficient for the diagnosis and treatment of the patient.

    Mo. Rev. Stat. §191.1146.2(2) · verified Sep 3, 2026

  • Prior to prescribing any drug, controlled substance, or other treatment through telemedicine, as defined in section 191.1145, or the internet, a physician shall establish a valid physician-patient relationship as described in section 191.1146. This relationship shall include obtaining a reliable medical history and, if required to meet the standard of care, performing a physical examination of the patient, adequate to establish the diagnosis for which the drug is being prescribed and to identify underlying conditions or contraindications to the treatment recommended or provided.

    Mo. Rev. Stat. §334.108.1 · verified Sep 3, 2026

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← All Missouri rules and changes · MedSpaRadar is regulatory monitoring and reference, not legal, medical, or compliance advice. Verify against the linked primary source and consult qualified counsel before acting — rules change and turn on your specific facts. Legislative data via LegiScan (CC BY 4.0).