New Hampshire Telehealth Regulations: 2024 Compliance Guide for Providers and Patients

Telehealth Service Definition

New Hampshire defines both “telemedicine” and “telehealth” as care delivered with audio, video, or other electronic technologies across distance, using synchronous (real-time) or asynchronous (store-and-forward) interactions. These definitions apply broadly across licensed professions and align with the physician-specific definition in RSA 329:1-d. For Medicaid, the law also defines “store-and-forward” and “remote patient monitoring (RPM).” ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/310/310-7.htm))

Key Medicaid definitions include: “originating site” (where the patient is located, including the home or school), “distant site” (provider’s location), “store-and-forward” (asynchronous exchange), and “RPM” (collection and interpretation of clinical data while the patient remains at the originating site). These definitions establish the framework for Store-and-Forward Telehealth Regulation and Remote Patient Monitoring Compliance. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XII/167/167-mrg.htm))

Provider Licensure Requirements

If a patient is physically in New Hampshire at the time of service, the out-of-state clinician must hold a New Hampshire license, certification, or registration—or use an applicable compact or endorsement. This rule applies unless another statute creates a specific exception (e.g., certain consultations). The standard of care must match in-person care, and providers must maintain a medical record. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/310/310-7.htm))

Compacts can streamline compliance. Physicians may use the Interstate Medical Licensure Compact (IMLC) to obtain a New Hampshire license more quickly, and nurses may practice under the Nurse Licensure Compact (NLC) if they hold a qualifying multistate license. Still, the legal authority to treat a New Hampshire patient via telehealth rests on New Hampshire licensure or compact privileges. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/329-C/329-C-mrg.htm?utm_source=openai))

For Medicaid Telehealth Reimbursement, the rendering professional must be an enrolled New Hampshire Medicaid provider to bill for services delivered via telehealth. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XII/167/167-mrg.htm))

Telepass License for Out-of-State Psychologists

New Hampshire offers a Telepass License that allows qualified, out-of-state, doctoral-level psychologists to provide telepsychology to patients located in New Hampshire without holding a full in-state license. The authority flows from RSA 329-B:16 and is implemented by Board of Psychologists rules in Part Psyc 304 (application, qualifications, ongoing requirements, and discipline). ([law.justia.com](https://law.justia.com/codes/new-hampshire/2020/title-xxx/title-329-b/section-329-b-16/?utm_source=openai))

Renewal and competency are regulated: the Telepass License has renewal standards (including continuing education with telemedicine-specific topics) and lapses if not timely renewed, after which practice in New Hampshire must cease until reinstated. ([law.cornell.edu](https://www.law.cornell.edu/regulations/new-hampshire/N-H-Admin-Code-SS-Psyc-304.08))

As an alternative pathway, New Hampshire participates in PSYPACT. A psychologist licensed in a PSYPACT state who holds an Authority to Practice Interjurisdictional Telepsychology (APIT) may provide telepsychology into New Hampshire consistent with PSYPACT rules. ([law.justia.com](https://law.justia.com/codes/new-hampshire/2023/title-xxx/chapter-329-d/section-329-d-1/?utm_source=openai))

Patient Consent and Rights

Before delivering services, providers must present basic information about telehealth and obtain the patient’s consent to participate; documentation must reflect that the patient was informed of their rights, including the right to refuse telehealth, to know who is present, how emergencies will be handled, and the right to in‑person referral when clinically appropriate. Telehealth sessions may not be recorded without the patient’s consent. ([law.cornell.edu](https://www.law.cornell.edu/regulations/new-hampshire/N-H-Admin-Code-SS-He-C-5004.07))

Across professions, you must maintain a medical record and, with the patient’s consent, forward it to the primary or treating provider when appropriate. Providers must also ensure meaningful language access when required by state or federal law. These duties apply equally to telehealth encounters. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/310/310-7.htm))

Medicaid Coverage for Telehealth

New Hampshire Medicaid covers telehealth for Medicaid-covered services within a provider’s scope, and reimburses telemedicine “on the same basis” as in‑person care, subject to program rules and medical necessity. Combined originating-site and distant-site reimbursement may not be less than the total amount for in‑person delivery. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XII/167/167-mrg.htm))

The state explicitly recognizes Medically Necessary Telehealth Services, including Store-and-Forward Telehealth Regulation and RPM. Following SB 258, New Hampshire Medicaid covers remote patient monitoring and store‑and‑forward services as outlined by DHHS guidance. ([nhmmis.nh.gov](https://www.nhmmis.nh.gov/portals/wps/wcm/connect/2c11d7bb-1c1a-4405-b143-a02522628d2d/NHCSR-OMBP-2-Provider-Remote%2Bpatient%2Bmonitoring%2Bstore%2Band%2Bforward%2Btelehealth%2Bservices%2BNotice-Att1-20231006.pdf?CVID=oIvt3R7&MOD=AJPERES&utm_source=openai))

Service Limits and Eligibility

For primary care telemedicine and RPM, Medicaid coverage generally requires that the patient first establish care at an originating site via an in‑person service. Statutory exceptions remove the in‑person requirement in specified settings, including VA care, state or county correctional facilities, Doorway (SUD entry points), designated community mental health centers, and DEA-registered hospitals or clinics. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XII/167/167-mrg.htm))

Other baseline conditions apply: the rendering professional must be an enrolled Medicaid provider; services must be medically necessary; and telehealth may be delivered from or to any eligible site, including the patient’s home, as defined by statute. These rules frame Service Limits and Eligibility for Medicaid Telehealth Reimbursement. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XII/167/167-mrg.htm))

Telehealth Prescreening and Practice Standards

Across professions, you must apply the same standard of care as in-person, maintain records, obtain and document consent, verify identity and location, and have a plan for emergencies and language access when required. These practice standards govern how you deliver care and communicate with other treating providers. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/310/310-7.htm))

New Hampshire law also addresses telehealth prescreening and remote signing in specific contexts. For example, under the “Right to Try” framework, consent to treat with certain drugs, biologics, or devices may be obtained via remote signing when there is a qualifying telehealth prescreening and an office presence in New Hampshire—an important intersection of telehealth and consent logistics. ([gc.nh.gov](https://gc.nh.gov/rsa/html/X/126-Z/126-Z-6.htm?utm_source=openai))

Conclusion

For 2024 compliance, anchor your program to New Hampshire’s statutory definitions, licensure pathways (including compacts and the New Hampshire Telepass License), explicit consent and patient-rights rules, and Medicaid’s coverage framework for medically necessary telehealth, including RPM and store‑and‑forward. Align day‑to‑day workflows to the state’s documentation and practice standards to keep patients protected and your telehealth operations audit‑ready. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/310/310-7.htm))

FAQs.

What are the licensure requirements for telehealth providers in New Hampshire?

If the patient is in New Hampshire, the provider must be licensed, certified, or registered in New Hampshire—or practice under a qualifying compact or endorsement. Maintain the in‑person standard of care and a medical record, and share it with the PCP when appropriate and with consent. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XXX/310/310-7.htm))

How does Medicaid cover telehealth services in New Hampshire?

Medicaid covers telehealth for Medicaid‑covered services within scope and reimburses on the same basis as in‑person care, with no blanket site restrictions and coverage for medically necessary modes such as video, audio (including audio‑only when allowed), store‑and‑forward, and RPM under state guidance. Providers must be enrolled NH Medicaid providers. ([gc.nh.gov](https://gc.nh.gov/rsa/html/XII/167/167-mrg.htm))

What is the Telepass license and who is eligible?

The New Hampshire Telepass License allows qualified, out‑of‑state doctoral psychologists to provide telepsychology to New Hampshire patients without a full in‑state license, subject to Board rules on application, renewal, and continuing education. PSYPACT with APIT is an alternative multistate pathway that also includes New Hampshire. ([law.justia.com](https://law.justia.com/codes/new-hampshire/2020/title-xxx/title-329-b/section-329-b-16/?utm_source=openai))

What patient consent is required for telehealth services?

Before treatment, providers must present basic information about telehealth and document the patient’s consent, ensure the patient knows who is present, how emergencies will be handled, and that sessions will not be recorded without consent. Document rights and consent in the record and forward records to the PCP when appropriate and with the patient’s permission. ([law.cornell.edu](https://www.law.cornell.edu/regulations/new-hampshire/N-H-Admin-Code-SS-He-C-5004.07))