Tennessee Healthcare & Telehealth Compliance Guide
Tennessee has a strong and unambiguous ban on the corporate practice of medicine, supported by statutes, court decisions, and Attorney General opinions. There are specific exceptions that permit selected organizations such as hospitals, physician groups, and FQHCs to employ physicians. Professional corporations in Tennessee may only practice a single profession, and fee-splitting among doctors is prohibited.
- Corporate Practice of Medicine (CPOM): Strict
- Telehealth prescribing permitted: Yes
- In-person exam required first: Yes
- Audio-only visits allowed: Yes
- Nurse practitioner authority: Restricted
- Collaborative practice agreement required: Yes
- Good Faith Exam required: No
Telehealth prescribing in Tennessee
In Tennessee, prescriptions for medications, including controlled substances, can be issued through telehealth encounters if they are medically appropriate and comply with state and federal laws. Before prescribing, a physician must conduct an appropriate history and physical examination, establish a diagnosis, create a therapeutic plan, and arrange for follow-up care. An in-person examination is specifically required before prescribing controlled substances for pain management or initiating hormone replacement therapy.
Controlled substances in Tennessee
Prescriptions for controlled substances may be issued via telehealth, but a physical examination by the prescribing-physician is required for the treatment of pain. It is an ethical violation for a physician to prescribe any drug to any individual the physician has never met solely on answers to a set of questions.
Medical director requirements in Tennessee
While there is no explicit state-wide mandate for a medical director for all telehealth operations, a medical director is generally required for clinics where nurse practitioners are practicing, in which case the medical director would be the collaborating physician.
Nurse practitioner scope and collaborative practice in Tennessee
Tennessee requires a collaborative practice agreement between a physician and a nurse practitioner. The supervising or collaborating physician must have regular in-person visits with the nurse practitioner.
Key operating notes for Tennessee
A physician must perform an appropriate history and physical examination, make a diagnosis, formulate a therapeutic plan, and ensure availability for follow-up care before prescribing via telehealth. While the definition of an 'appropriate' examination is not explicitly defined, a physical examination is required prior to initiating hormone replacement therapy and for prescribing dangerous drugs or controlled substances for the treatment of pain. Written consent from the patient is also a requirement for providing telehealth services.
Recent regulatory changes in Tennessee
A recent bill (SB2580) in the 2025-2026 legislative session requires the Tennessee Commissioner of Health to study how neighboring states regulate the prescribing of medications through telehealth. No other significant recent legislative changes affecting the core aspects of telehealth compliance were found.
Frequently asked questions
How does Tennessee's strict CPOM doctrine affect my healthcare business?
Tennessee enforces strict Corporate Practice of Medicine laws, meaning non-physician entities cannot directly employ physicians or control clinical decisions. You'll need a properly structured PC-MSO arrangement to operate compliantly. TrueEval can guide you through the entity formation and management services agreements required.
Do I need a medical director for my medspa or IV therapy clinic in Tennessee?
Yes — Tennessee requires physician oversight for medical procedures performed in medspas, IV therapy clinics, and similar brick-and-mortar healthcare establishments. A medical director develops protocols, provides clinical oversight, and ensures regulatory compliance. TrueEval places board-certified medical directors licensed in Tennessee who understand both telehealth and in-person practice requirements.
Are Collaborative Practice Agreements required for NPs in Tennessee?
Yes, Tennessee requires Collaborative Practice Agreements (CPAs) between nurse practitioners and supervising physicians. NPs in Tennessee have restricted practice authority, meaning a CPA is necessary for prescriptive authority. TrueEval provides Tennessee-specific CPA templates and matches NPs with qualified collaborating physicians.
Can I prescribe medications via telehealth in Tennessee?
Yes, telehealth prescribing is permitted in Tennessee. An initial in-person visit may be required. Audio-only consultations are allowed. TrueEval ensures your prescribing protocols meet all Tennessee requirements.
What compliance requirements apply to cash-pay healthcare businesses in Tennessee?
Cash-pay healthcare operations in Tennessee — including telehealth, medspas, IV therapy, and wellness clinics — must still comply with all state medical practice acts, CPOM laws, prescribing regulations, and scope of practice requirements. The main difference is you won't deal with insurance billing compliance, but you must still maintain proper corporate structure, physician oversight, and clinical documentation. TrueEval specializes in cash-pay compliance frameworks for Tennessee.