Kentucky good faith exam requirements

Who can perform a good faith exam in Kentucky

Kentucky-licensed physicians (MD/DO), advanced practice registered nurses (APRNs) with prescriptive authority, and physician assistants under physician supervision. APRNs in Kentucky have prescriptive authority for non-controlled and Schedule III-V controlled substances under their own license once they have completed the CAPA-NS or CAPA-CS process.

Visit format rules in Kentucky

Synchronous visit required: Yes. Audio-only permitted: Yes. Prior in-person exam required: No. Synchronous audio-visual is the standard for GFE. Audio-only telehealth is permitted in limited circumstances per 201 KAR 9:260, but is generally not sufficient for new-patient GFE establishing a prescribing relationship for aesthetic or weight-loss programs.

When a good faith exam is required in Kentucky

GFE is required before any new prescription via telehealth, before initiating compounded medication therapy, before performing aesthetic medical procedures, and before ordering laboratory or imaging studies that inform treatment. Kentucky's prescribing-without-prior-examination prohibition (KRS 311.597) is a frequent basis for disciplinary action against telehealth programs.

What must be documented

Verification of patient identification and consent to telehealth Medical history and current medication review Chief complaint and clinical assessment Medical decision-making with rationale Treatment plan with dosing and follow-up Documentation of the synchronous telehealth encounter (modality, duration) Provider signature with Kentucky license number

Enforcement context in Kentucky

The Kentucky Board of Medical Licensure has issued disciplinary actions against telehealth aesthetic and weight-loss prescribers for inadequate GFE, particularly when the chart note shows no synchronous interaction or no documented medical decision-making. KBML enforcement has accelerated in 2026 alongside increased compounded GLP-1 telehealth activity.

Statutes and rules cited

KRS 311.597 — Kentucky prescribing without examination prohibition: Prohibits prescribing without a documented prior medical examination establishing the prescriber-patient relationship — the foundation of Kentucky's GFE requirement. 201 KAR 9:260 — Telehealth practice regulation: Kentucky Board of Medical Licensure regulation establishing telehealth practice standards, including the requirement to use synchronous communication for prescribing. 201 KAR 20:057 — APRN prescriptive authority: Establishes the CAPA-NS and CAPA-CS process for Kentucky APRNs to obtain prescriptive authority for non-controlled and Schedule III-V controlled substances.

Frequently asked questions

Who can legally perform a good faith exam in Kentucky?

Kentucky-licensed physicians (MD/DO), APRNs with CAPA-NS or CAPA-CS prescriptive authority, and physician assistants under physician supervision can perform GFE within their scope. The performing provider must be currently licensed in Kentucky and authorized to prescribe the medication or treatment in question.

Does Kentucky require synchronous video for a telehealth GFE?

Synchronous audio-visual is the standard for telehealth GFE in Kentucky. Audio-only is permitted in limited clinical circumstances under 201 KAR 9:260 but is generally not sufficient for new-patient GFE establishing a prescribing relationship for higher-risk medications including compounded GLP-1, aesthetic injections, or hormone therapy.

Can a Kentucky APRN independently perform a GFE and prescribe?

Yes — Kentucky APRNs with CAPA-NS authority can independently prescribe non-controlled medications, and APRNs with CAPA-CS can prescribe Schedule III-V controlled substances. APRNs operating independently must still meet KRS 311.597's GFE requirement and document the synchronous examination establishing the prescriber-patient relationship.

What is the Kentucky Board of Medical Licensure looking for in GFE chart notes?

KBML enforcement actions in 2025-2026 cite the following as inadequate: chart notes showing no synchronous interaction, template-only documentation without individualized clinical decision-making, missing medication history, absent medical rationale for the prescribed therapy, and signature without credentials. Compliant chart notes document the synchronous encounter, medical decision-making, and treatment plan in narrative form.