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

Short answer
The cited rules settle this only for telemedicine — there the licensee must establish a provider-patient relationship and take a sufficient medical history before treating; an in-person exam is required only where the standard of care demands it.

The sections cited here govern the pre-treatment encounter through a telemedicine definition, a telehealth authorization, and a board rule that says when a provider-patient relationship exists. The Code defines telemedicine as the practice of medicine by interactive electronic communications, information technology, or audio-only conversation between a licensee and a patient in different locations, and permits a person licensed under Title 37 to provide health care to do so by telehealth when that is appropriate, meets the standard of care, and complies with the licensing board’s rules. The Board of Medical Examiners’ telemedicine rule then sets the terms of that relationship: treatment occurs where the patient is, the same standard of care applies as in person, and a provider-patient relationship may be established by an in-person interview and examination when the standard of care requires one, by consultation with another provider who has a documented relationship with the patient, or through telemedicine if the standard of care does not require an in-person encounter. Before treating, prescribing, or delegating, the licensee must establish that relationship and obtain a medical history sufficient for diagnosis and treatment, and may delegate the patient’s care only to providers the licensee knows to be qualified, who have their own relationship with the patient, or who can reach the licensee for consultation. The pharmacy act defines compounding and says it does not prevent a medical practitioner from compounding or using drugs in the practitioner’s practice or furnishing drugs to a patient; neither cited pharmacy section names a drug or mentions office stock.