Puerto Rico changed its telemedicine rule in April 2025, and the change cuts in exactly the opposite direction for a mainland practitioner than for a local one.
Ley 168-2018 governs telemedicine and telehealth in Puerto Rico. Ley 8-2025, approved 11 April 2025, amended articles 2, 4, 5 and 6 and added a new article 13, so that any physician or health professional authorized to practise in Puerto Rico may provide consultations without obtaining an additional Certification. Practitioners licensed only in a mainland or federal jurisdiction still require that certification to operate on the island.
What Puerto Rico actually requires
- A Puerto Rico licence from the Junta de Licenciamiento y Disciplina Médica, created under Ley 139-2008, for anyone practising medicine on the island.
- For a practitioner licensed in Puerto Rico: no separate telemedicine certification, following Ley 8-2025.
- For a practitioner not licensed in Puerto Rico: the telemedicine Certification remains a live requirement.
- A licensed physician as medical director for the medical services on the menu.
- Written protocols, delegation and good faith examinations in the same way as any US jurisdiction.
Who may do what in Puerto Rico
| Licence | What they may do |
|---|---|
| MD or DO licensed in Puerto Rico | Independent; medical director; telemedicine without a separate certification since Ley 8-2025 |
| MD or DO licensed only on the mainland | Telemedicine Certification still required |
| Nurse practitioner | Within scope under the applicable Puerto Rico rules |
| Registered nurse | Within RN scope, under a valid order |
| Non-licensee | Through a management arrangement, not the clinical entity |
Puerto Rico is a US jurisdiction with its own licensing board, its own statutes and its own language of record. A national compliance chart that lists 50 states and stops has not covered you here, and the 2025 amendment is recent enough that many of those charts are describing the old rule.
What MDside provides in Puerto Rico
- A Puerto Rico-licensed MD or DO as medical director, doing the work rather than lending a name.
- A Puerto Rico-licensed physician, because the Ley 8-2025 relief runs only to practitioners already authorized to practise on the island.
- The professional entity and management agreement built to Puerto Rico rather than to a national template.
- Licensed physicians for the good faith exams behind prescriptions and injectables.
- 503A and 503B pharmacy relationships and lab draws.
See what is included, or book a call and tell us which states you operate in.
Read the detail on Puerto Rico
Frequently asked questions
Does Puerto Rico still require a telemedicine certification?
Not for physicians and health professionals already authorized to practise in Puerto Rico. Ley 8-2025, approved 11 April 2025, removed that requirement for them.
Does a mainland licence cover Puerto Rico?
No. Puerto Rico licenses through its own Junta de Licenciamiento y Disciplina Médica under Ley 139-2008.
Who still needs the telemedicine certification?
Practitioners licensed only in a mainland or federal jurisdiction.
Which law governs telemedicine there?
Ley 168-2018, as amended by Ley 8-2025.
General information about Puerto Rico practice structure and med spa regulation, not legal advice. Statutes, board rules and scope-of-practice requirements change. Confirm your obligations with healthcare counsel licensed in Puerto Rico.