In Arkansas, a telemedicine visit cannot start testosterone for a new patient. The Arkansas State Medical Board’s rule, 17 CAR § 140-3201(b)(5), bars a provider using telemedicine from prescribing any Schedule II to V drug unless the provider has seen the patient for an in-person examination or a listed relationship exists. The nursing board applies the same bar to APRNs. Testosterone is Schedule III.
That holds as of September 2026, while the federal DEA flexibilities under 21 C.F.R. § 1307.41 are still in force through December 31, 2026. The federal waiver removes a federal in-person requirement. It leaves the Arkansas rule where it is. For every other state, see telehealth testosterone by state.
Two boards, one rule
Arkansas splits prescribers between two boards, and both wrote the same restriction.
| Medical Board licensees (physicians, PAs) | APRNs | |
|---|---|---|
| Rule | 17 CAR § 140-3201(b)(5) | 17 CAR § 123-1202(b)(5) |
| Schedules covered | II to V | III to V, plus hydrocodone combination products |
| Default requirement | In-person examination first | In-person exam first |
| Exception: consultation or referral | Yes | Yes |
| Exception: on-call or cross-coverage | Yes | Yes |
| Exception: ongoing personal or professional relationship | Yes | Not listed |
| Arkansas license required for an Arkansas patient | Yes, (b)(11) | Yes, (b)(11) |
The Medical Board rule defines “provider” as anyone licensed by the Arkansas State Medical Board. The APRN rule was adopted January 1, 2018 and last amended May 15, 2022. We found no 2025 or 2026 amendment to either section.
The exceptions do not fit a new cash-pay patient
Each exception assumes someone already knows the patient.
- Consultation or referral. The Board’s relationship rule, 17 CAR § 140-202(b)(8)(C)(i), describes treatment “in consultation with, or upon referral by, another provider who has an ongoing relationship with the patient, and who has agreed to supervise the patient’s treatment.” A patient who clicked an ad has no such provider.
- On-call or cross-coverage. Section 140-202(b)(8)(C)(ii) requires coverage “arranged by the patient’s treating provider.” It covers the colleague down the hall, and it does not cover a new intake.
- Ongoing personal or professional relationship. This appears in the physician rule only, and § 140-3201 does not define it. Section 140-202(b)(8)(B)(iii) uses similar words for a provider who “personally knows the patient.” Do not stretch it to cover a patient you met on a video call last week.
The telemedicine relationship route stops at noncontrolled drugs
Arkansas does let telemedicine establish a relationship. Section 140-202(b)(8)(B)(ii) allows a provider with access to the patient’s health record to use technology, including the telephone, to “diagnose, treat, and if clinically appropriate, prescribe a noncontrolled drug.” The text ends at noncontrolled drugs. For anything scheduled, § 140-3201(b)(5) controls.
Two more lines close the obvious workarounds. A patient completing a medical history online and sending it in “is not sufficient to establish the relationship” (§ 140-3201(a)(3)). A relationship built only on a questionnaire, email, text, fax or patient-generated history does not count (§ 140-202(b)(8)(B)(ii)(b)).
The path that works in Arkansas
This sequence fits the rule as written, for an operator with a physical site in the state:
- License first. The prescriber holds an Arkansas license from the board that governs them, since § 140-3201(b)(11) requires it for any patient located in Arkansas.
- Hold the first exam in person at your Arkansas site, with the prescriber who will write the testosterone. The rule says “the provider has seen the patient,” so plan for the prescriber in the room.
- Document a history and in-person physical exam adequate to establish a diagnosis and identify contraindications, the standard in § 140-202(b)(8)(B)(i), with labs and a written plan.
- Move follow-ups to synchronous video. The rule sets no fixed interval for a repeat in-person exam.
- Bring the patient back in person when it is medically indicated, and document the recommendation, as § 140-3201(b)(9) requires.
- Write the cross-coverage plan so a covering prescriber falls inside the on-call exception.
Two questions stay open. We found no Arkansas guidance on whether a video exam with a licensed nurse in the room counts as in person, and none on whether another prescriber’s exam in the same group counts. Until the Board answers in writing, assume the prescriber sees the patient.
This is separate from the aesthetics exam question
We have flagged elsewhere that Arkansas is widely reported to require an in-person good faith exam before aesthetic treatment, and that the sources for that claim are secondary. That question is still open, and it is covered in the Arkansas question to settle before you build a remote funnel and on good faith exams in Arkansas. The testosterone answer does not depend on it. It rests on the text of two published rules.
How MDside handles Arkansas
MDside is LegitScript certified, and LegitScript certification for TRT telehealth covers what reviewers check in a program like yours. Its testosterone visits are synchronous, live video with the prescriber, and offered only in states whose rules allow them. Arkansas requires an in-person exam first, so MDside does not start Arkansas patients by video. For the program design, see hormone therapy. For who holds responsibility in the state, see medical director in Arkansas.
What this means for you
Do not point Arkansas testosterone traffic at a home-video intake. Build the first visit around an Arkansas site where the prescriber examines the patient in person, then run follow-ups by live video. If an APRN prescribes, apply the same in-person step under the nursing board rule. Put the two open questions to the Board in writing before you design around them, and track the federal December 31, 2026 date, which can tighten the federal side on top of the state rule.
Related reading
Frequently asked questions
Can you get testosterone through telemedicine in Arkansas?
Only after an in-person exam, in most cases. 17 CAR § 140-3201(b)(5) bars a provider using telemedicine from prescribing any Schedule II to V drug without a prior in-person examination, unless a consultation, cross-coverage or ongoing relationship exception applies. Testosterone is Schedule III. Follow-up visits can run by live video after the in-person exam.
Can an Arkansas nurse practitioner prescribe testosterone by telehealth?
Only after an in-person exam or within a listed exception. The Board of Nursing rule, 17 CAR § 123-1202(b)(5), bars an APRN using telemedicine from prescribing Schedule III to V drugs unless the APRN has seen the patient for an in-person exam, or the case is a consultation, referral, on-call or cross-coverage situation.
Do the DEA telehealth flexibilities override the Arkansas in-person rule?
No. The DEA flexibilities under 21 C.F.R. § 1307.41 run through December 31, 2026 and waive only the federal in-person requirement for controlled substances. Arkansas’s Medical Board and nursing board rules apply on their own terms, so the in-person exam is still required before a telemedicine testosterone prescription for a new patient.
Can telemedicine establish a patient relationship in Arkansas?
Yes, for noncontrolled drugs. 17 CAR § 140-202(b)(8)(B)(ii) lets a provider with access to the patient’s health record use technology to diagnose, treat and prescribe a noncontrolled drug. An online history alone never establishes the relationship. For controlled substances such as testosterone, the in-person exam rule in § 140-3201(b)(5) governs.
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This is general information, not legal advice. Rules vary by state and change. Confirm your own facts with counsel.