Yes. In Michigan a good faith exam can be done by telehealth, and a prescription can follow it with no in-person visit first. MCL 333.16285(1) lets a health professional who is providing a telehealth service prescribe a drug if the professional is a prescriber acting within scope. The conditions are consent, referral when needed, follow-up availability, and the in-person standard of care.
One note on vocabulary. The sections cited here never use the phrase “good faith exam.” Michigan regulates the same event under two names: a telehealth service, and for controlled substances, a bona fide prescriber-patient relationship.
Telehealth in Michigan includes video, audio, and store and forward
Section 16283(c) defines telehealth as the use of electronic information and telecommunication technologies to support or promote long-distance clinical health care. It says telehealth may include telemedicine, and it borrows that definition from the Insurance Code.
Under MCL 500.3476(2)(b), as amended effective April 2, 2025, telemedicine means the health care professional must be able to examine the patient through a HIPAA-compliant, secure interactive audio or video, or both, telecommunications system, “or through the use of store and forward online messaging.”
So the definition reaches asynchronous exchange. That answers what counts as telehealth. It does not answer whether an asynchronous exam is good enough for a given patient. The standard of care does that, and it is covered below.
Four duties attach to every telehealth exam
1. Consent. A health professional shall not provide a telehealth service without directly or indirectly obtaining consent for treatment (MCL 333.16284). The Board of Medicine’s rule says the licensee shall obtain that consent before providing the service (Mich. Admin. Code R 338.2407(1)).
2. Proof of consent in the record. The licensee shall maintain proof of consent for telehealth treatment in the patient’s up-to-date medical record and satisfy MCL 333.16213 (R 338.2407(2)). Section 16213 requires a record for each patient, kept for a minimum of 7 years from the date of service unless a longer period applies.
3. Referral. If the prescriber considers it medically necessary, the prescriber shall provide a referral for other health care services that are geographically accessible to the patient, including emergency services (MCL 333.16285(2)(a)).
4. Follow-up. After the telehealth service, the health professional, or one acting under that professional’s delegation, shall be available to provide follow-up care or shall refer the patient to another health professional for it (MCL 333.16285(2)(b)).
The third and fourth are where national telehealth vendors fall short. A prescriber who clears the patient and disappears has not met section 16285. Your vendor contract should say who answers the patient’s question two weeks later.
The standard of care is the in-person standard
R 338.2407(4) requires a licensee providing any telehealth service to act within the scope of the licensee’s practice and to “exercise the same standard of care applicable to a traditional, in-person healthcare service.”
This is the answer to the operator who says a five-question form is a telehealth exam. Michigan’s definition admits store and forward messaging. The rule then holds the prescriber to what a prudent in-person visit would have covered: history, contraindications, relevant findings, and a treatment decision the record supports. If the questionnaire cannot carry that, the prescriber needs to move the patient to live video or to an in-person visit.
Section 16288 closes the loop. Sections 16284 to 16287 do not limit a service otherwise allowed by law, and they do not authorize a service otherwise prohibited by law. Telehealth is a way to deliver care. It does not expand what the examiner is licensed to do.
The examiner has to be a prescriber
Section 16285 speaks of a “prescriber,” and section 16283(b) points to the definition in MCL 333.17708. That list includes a licensed doctor of medicine, a licensed doctor of osteopathic medicine and surgery, a licensed physician’s assistant, and an advanced practice registered nurse subject to section 17211a. It also includes any other licensed health professional acting under the delegation, and using the name, of a delegating MD or DO.
Two consequences for your intake:
- A registered nurse is not a prescriber in the nurse’s own right. An RN-only “telehealth exam” does not produce a prescription unless a physician has delegated it and the physician’s name is on it.
- A nurse practitioner may prescribe nonscheduled drugs by telehealth. For controlled substances, section 17211a(1)(b) requires physician delegation.
Testosterone adds a second set of rules
For a controlled substance, the prescriber must also meet the Code’s controlled substance requirements (MCL 333.16285(1)(b)). Testosterone is Schedule III under 21 C.F.R. § 1308.13(f), and Michigan adopts the federal schedules by reference, with listed exceptions, in R 338.3111.
The state requirements are these:
- A bona fide prescriber-patient relationship. A licensed prescriber shall not prescribe a schedule 2 to 5 controlled substance without one (MCL 333.7303a(2)). The definition requires that the prescriber has reviewed the patient’s relevant records and completed an assessment of history and current condition, “including a relevant medical evaluation of the patient conducted in person or through telehealth as that term is defined in section 16283,” and has created and maintained records (MCL 333.7104(1)). The narrow exceptions are in R 338.3161a.
- Follow-up care. The prescriber shall provide follow-up care to monitor efficacy, or refer the patient to the patient’s primary care provider or to another licensed prescriber who is geographically accessible (MCL 333.7303a(2)).
- A question about other controlled substances, asked before prescribing and recorded in the chart (MCL 333.7303a(3)).
- A report from the state’s electronic monitoring system, obtained and reviewed before prescribing more than a 3-day supply (MCL 333.7303a(4)).
Michigan’s text allows the evaluation by telehealth. The federal rule is separate. As of October 2026, the DEA telemedicine flexibilities in 21 C.F.R. § 1307.41 run through December 31, 2026. If they lapse, a Michigan telehealth start for testosterone would meet state law and still face a federal in-person question. Plan your hormone therapy program for both.
What goes in the chart
| Requirement | Source | Chart evidence |
|---|---|---|
| Consent before the service | MCL 333.16284; R 338.2407(1) | Dated consent to telehealth treatment |
| Proof of consent retained | R 338.2407(2); MCL 333.16213 | Consent stored in the record, 7-year minimum |
| Prescriber acting within scope | MCL 333.16285(1)(a) | Prescriber name, license type, Michigan license |
| In-person standard of care | R 338.2407(4) | History, findings, contraindications, plan |
| Referral if medically necessary | MCL 333.16285(2)(a) | Referral note, local and emergency options |
| Follow-up availability | MCL 333.16285(2)(b) | Named follow-up route and contact |
| Controlled substances only: bona fide relationship | MCL 333.7303a(2); MCL 333.7104(1) | Records reviewed, evaluation documented |
| Controlled substances only: monitoring report | MCL 333.7303a(4) | Date the report was reviewed |
Discipline is aimed at the telehealth privilege itself
If a disciplinary subcommittee finds that a health professional violated section 16284 or 16285, it may place restrictions or conditions on that professional’s ability to provide a telehealth service (MCL 333.16286). For an online brand, that is the prescriber’s entire function. The prescribers you rely on have a direct interest in your consent flow and follow-up process being real.
What this means for you
You can run Michigan good faith exams by telehealth, including for patients who never visit a site. Build the consent into intake and store it in the chart. Put a named follow-up route and a local referral step into every protocol, because section 16285 requires both. Hold your asynchronous flows to the in-person standard and escalate to video when the form cannot support the decision. For testosterone, add the relationship, follow-up and monitoring-report steps, and watch the December 31, 2026 federal date. See how it works, weight management, what we provide to online brands, and medical director services in Michigan.
Frequently asked questions
Can a good faith exam be done by telehealth in Michigan?
Yes. MCL 333.16285 allows a health professional providing a telehealth service to prescribe a drug if the professional is a prescriber acting within scope. The prescriber must obtain consent, refer the patient to geographically accessible care if medically necessary, and be available for follow-up or refer for it. The in-person standard of care applies.
Does Michigan require an in-person visit before prescribing by telehealth?
No in-person visit is required by MCL 333.16283 to 16288. For controlled substances, MCL 333.7104 defines the required bona fide prescriber-patient relationship to include a medical evaluation conducted in person or through telehealth. Federal DEA rules are separate, and the current telemedicine flexibilities run through December 31, 2026.
Is an online questionnaire enough for a prescription in Michigan?
Michigan’s telemedicine definition in MCL 500.3476 includes store and forward online messaging, so asynchronous care is telehealth. Board of Medicine rule R 338.2407 still requires the same standard of care as a traditional in-person service. A questionnaire is enough only if it supports the decision an in-person visit would have supported.
Can a registered nurse do a telehealth good faith exam in Michigan?
Not as the prescriber. MCL 333.16285 requires a prescriber acting within scope, and MCL 333.17708 lists physicians, physician’s assistants, and advanced practice registered nurses subject to section 17211a. Another licensed health professional qualifies only when acting under the delegation, and using the name, of a delegating MD or DO.
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This is general information, not legal advice. Rules vary by state and change. Confirm your own facts with counsel.