How do telehealth prescriptions work?

What are the steps of a telehealth prescription?

Most programs follow the same path: an online intake, a clinician review, labs when needed, a prescription sent to a pharmacy, and follow-ups by message or visit. The clinician can decline to prescribe at any step. Ro

• Intake: an online questionnaire about your history, conditions and medications, sometimes with photos. Ro
• Review: a licensed clinician reviews it, by message or in a live visit, depending on the program and your state. Hims
• Labs: some programs ask for recent results or send an at-home kit before or soon after prescribing. LifeMD
• Pharmacy: the prescription goes to a mail-order or local pharmacy. Amazon Pharmacy
• Follow-up: messages or visits as your clinician adjusts or stops treatment. Ro

What is the difference between asynchronous and synchronous telehealth?

Synchronous telehealth is a live interaction between a clinician and a patient, by video, phone or real-time chat. Asynchronous telehealth, also called store and forward, means information is shared at different times: you submit answers or photos and the clinician reviews them later. Telehealth.HHS.gov

Synchronous care is a live interaction between a provider and a patient. Telehealth.HHS.gov

Asynchronous (store-and-forward) care is communication between providers and patients that happens at different points in time. Telehealth.HHS.gov

Does a telehealth clinician need a license in my state?

Yes. Clinicians must meet the licensure rules of the state they are in and be licensed or otherwise permitted to practice in the state where the patient is located. That is why many programs ask for your state first and are not available everywhere. Telehealth.HHS.gov

The Interstate Medical Licensure Compact offers qualified physicians a voluntary, faster path to licenses in multiple member states. Interstate Medical Licensure Compact

Can a telehealth clinician prescribe controlled drugs like testosterone?

For now, yes, under temporary federal rules. The Ryan Haight Act generally requires an in-person evaluation before a controlled substance is prescribed online, but DEA has extended pandemic-era flexibilities through December 31, 2026, letting registered practitioners prescribe Schedule II to V drugs by audio-video telemedicine without a prior in-person visit. Federal Register (Dec 31, 2025)

The underlying law requires at least one in-person medical evaluation for a valid online prescription of a controlled substance, with limited exceptions. 21 U.S.C. 829(e)

Testosterone is a Schedule III controlled substance, so it falls under these rules. States can add their own requirements. DEA (Dec 31, 2025)

Which pharmacy fills a telehealth prescription?

It depends on the drug. Brand-name drugs are usually filled by a mail-order or local retail pharmacy, sometimes one you choose. Compounded drugs come from a compounding pharmacy or outsourcing facility, and are not FDA-approved. FDA

Some pharmacies fill prescriptions from your own clinician and do not prescribe at all. Amazon Pharmacy

What should a good telehealth program tell you?

A good program tells you who the prescribing clinician is and where they are licensed, whether a drug is brand-name or compounded and who makes it, and the full cost, including any membership. FDA says telehealth companies should not imply they are the compounder, or that a compounded drug is FDA-approved or the same as an approved drug. FDA

• The clinician’s name, credentials and state license. Telehealth.HHS.gov
• Whether the product is FDA-approved or compounded, and the pharmacy that makes it. FDA
• The total price: medication, membership, labs and follow-ups. Some programs charge a membership separately from the medication. Hims
• What happens if the clinician decides the treatment is not right for you, and how to cancel.
• Whether the site that sent you there is paid for the link. DiscoverMedica states its own policy once, on its Disclosures & privacy page.

How telehealth prescriptions work: questions, answered

Sources

1. Telehealth.HHS.gov: Getting started with telehealth
2. Telehealth.HHS.gov: Getting started with licensure
3. Interstate Medical Licensure Compact
4. Federal Register (Dec 31, 2025): Fourth temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications
5. DEA (Dec 31, 2025): DEA extends telemedicine flexibilities to ensure continued access to care
6. 21 U.S.C. 829(e): Controlled substances dispensed by means of the Internet (Ryan Haight Act)
7. FDA: Compounding and the FDA, questions and answers
8. FDA: Telehealth companies, what to know when promoting compounded drugs
9. Ro: Weight loss, how it works
10. Hims: Weight loss
11. Hims: Weight loss FAQ
12. LifeMD: Weight management
13. Amazon Pharmacy
14. AUA: Testosterone Deficiency guideline (2018, validity confirmed 2024)

Last reviewed September 23, 2026. Every source above was checked on or before that date. Educational information only, not medical advice; it does not replace a conversation with a licensed clinician. DiscoverMedica does not employ clinicians.