California good faith exam requirements

Who can perform a good faith exam in California

Licensed California physicians (MD/DO), nurse practitioners operating under either standardized procedures (Cal. Bus. & Prof. Code §2746.51) or 100 practice authority (AB 890), and physician assistants under physician delegation. The performing provider must be licensed in California and authorized to prescribe within the relevant scope.

Visit format rules in California

Synchronous visit required: Yes. Audio-only permitted: No. Prior in-person exam required: No. Synchronous audio-visual is required. Audio-only is not accepted for new-patient GFE. In-person is not required for non-controlled prescribing but may be required for Schedule II controlled substances under California-specific rules.

When a good faith exam is required in California

A good faith examination is required before any new prescription medication is issued via telehealth, before any aesthetic medical treatment (Botox, fillers, IV therapy, body contouring), before ordering laboratory diagnostics that inform treatment decisions, and before initiating any therapeutic intervention that requires medical decision-making.

What must be documented

Patient identification and verification of identity Comprehensive medical history including current medications and allergies Chief complaint and clinical assessment relevant to the prescribed treatment Medical decision-making with rationale for the prescription or treatment Treatment plan including dosing, frequency, and titration if applicable Patient-provider relationship documentation including consent Provider signature, credentials, and date of service

Enforcement context in California

The Medical Board of California has been active in enforcing GFE requirements against telehealth aesthetic and weight-loss programs in 2025-2026. Common deficiencies cited include async-only intake, inadequate medical decision-making documentation, and template chart notes without individualized clinical rationale. The Board can suspend or revoke licenses for systemic non-compliance.

Statutes and rules cited

Cal. Bus. & Prof. Code §2242.1 — Prescribing without prior examination: Prohibits prescribing dangerous drugs without an appropriate prior examination and medical indication, the statutory foundation for California's GFE requirement. Cal. Bus. & Prof. Code §2290.5 — Telehealth practice: Defines telehealth practice in California and establishes that the standard of care applicable to in-person practice applies equally to telehealth, including examination requirements. Cal. Code Regs. tit. 16 §1300 — Medical Board telehealth rules: Medical Board regulations clarifying telehealth practice standards, examination requirements, and documentation expectations for prescribing California physicians.

Frequently asked questions

Can a Botox or filler clinic in California use an async-only GFE?

No. The Medical Board of California has issued enforcement actions against aesthetic clinics using asynchronous-only GFE for botulinum toxin and dermal filler treatments. Synchronous audio-visual examination is required, and the performing provider must document a real-time clinical interaction with the patient.

Who is legally allowed to perform a good faith exam in California?

Licensed California physicians, nurse practitioners (under standardized procedures or 100 practice authority), and physician assistants (under delegation) can perform GFE within their scope. Aestheticians, registered nurses without prescriptive authority, and unlicensed personnel cannot perform a GFE — even if a physician later 'signs off.'

Is FaceTime acceptable for a California good faith exam?

FaceTime can satisfy California's synchronous audio-visual GFE requirement if the platform supports real-time two-way video and the encounter is documented in compliance with Cal. Bus. & Prof. Code §2290.5. HIPAA-compliant platforms are strongly preferred for patient privacy and to avoid additional regulatory exposure.

What chart documentation does California expect from a GFE?

California expects a chart note that documents: patient identification verified, medical history reviewed, chief complaint and clinical assessment, medical decision-making with rationale for treatment, treatment plan including dosing and titration, patient consent, and provider signature with credentials. Template-only notes without individualized clinical reasoning have been cited in Medical Board disciplinary actions.