50-State Telehealth Compliance-Difficulty Index
10 states rank in the hardest tier for launching a compliant telehealth practice. The toughest: Arkansas, New York, South Carolina, Tennessee, New Jersey. Scored across CPOM, NP scope, GFE, in-person, and audio-only rules.
Full ranking
| # | State | Score | Tier |
|---|---|---|---|
| 1 | Arkansas | 9/11 | Hardest |
| 2 | New York | 9/11 | Hardest |
| 3 | South Carolina | 9/11 | Hardest |
| 4 | Tennessee | 9/11 | Hardest |
| 5 | New Jersey | 8/11 | Hardest |
| 6 | North Dakota | 8/11 | Hardest |
| 7 | Indiana | 7/11 | Hardest |
| 8 | Minnesota | 7/11 | Hardest |
| 9 | Texas | 7/11 | Hardest |
| 10 | West Virginia | 7/11 | Hardest |
| 11 | Iowa | 6/11 | Moderate |
| 12 | Massachusetts | 6/11 | Moderate |
| 13 | Michigan | 6/11 | Moderate |
| 14 | North Carolina | 6/11 | Moderate |
| 15 | Oklahoma | 6/11 | Moderate |
| 16 | Pennsylvania | 6/11 | Moderate |
| 17 | Colorado | 5/11 | Moderate |
| 18 | Georgia | 5/11 | Moderate |
| 19 | Illinois | 5/11 | Moderate |
| 20 | Louisiana | 5/11 | Moderate |
| 21 | Mississippi | 5/11 | Moderate |
| 22 | California | 4/11 | Moderate |
| 23 | District of Columbia | 4/11 | Moderate |
| 24 | Kansas | 4/11 | Moderate |
| 25 | Missouri | 4/11 | Moderate |
| 26 | Nevada | 4/11 | Moderate |
| 27 | Oregon | 4/11 | Moderate |
| 28 | Washington | 4/11 | Moderate |
| 29 | Wisconsin | 4/11 | Moderate |
| 30 | Wyoming | 4/11 | Moderate |
| 31 | Alabama | 3/11 | Easiest |
| 32 | Florida | 3/11 | Easiest |
| 33 | Kentucky | 3/11 | Easiest |
| 34 | Nebraska | 3/11 | Easiest |
| 35 | Ohio | 3/11 | Easiest |
| 36 | Virginia | 3/11 | Easiest |
| 37 | Arizona | 2/11 | Easiest |
| 38 | Connecticut | 2/11 | Easiest |
| 39 | Delaware | 2/11 | Easiest |
| 40 | Maryland | 2/11 | Easiest |
| 41 | Montana | 2/11 | Easiest |
| 42 | Rhode Island | 2/11 | Easiest |
| 43 | South Dakota | 2/11 | Easiest |
| 44 | Hawaii | 1/11 | Easiest |
| 45 | Idaho | 1/11 | Easiest |
| 46 | Maine | 1/11 | Easiest |
| 47 | New Mexico | 1/11 | Easiest |
| 48 | Utah | 1/11 | Easiest |
| 49 | Vermont | 1/11 | Easiest |
| 50 | Alaska | 0/11 | Easiest |
| 51 | New Hampshire | 0/11 | Easiest |