<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.41.06.05" title_num="10" subtitle_num="41" chapter_num="06" heading="Patient Evaluation.">
  <paragraph num="A.">
    <text>Except when providing asynchronous telehealth services or remote patient monitoring, a telehealth practitioner shall:</text>
    <paragraph num="(1)">
      <text>Perform a clinical patient evaluation adequate to establish a diagnosis and identify underlying conditions or contraindications to recommended treatment options before providing treatment or services through telehealth; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If clinically appropriate for the patient, provide or refer a patient to:</text>
      <paragraph num="(a)">
        <text>In-person health care services; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Another type of telehealth service.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>If the evaluation is adequate to comply with §A of this regulation, a telehealth practitioner may use:</text>
    <paragraph num="(1)">
      <text>Telehealth devices;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Live synchronous audio-visual communication;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Other methods of performing a patient examination remotely; or</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A patient evaluation performed by another licensed health care practitioner providing coverage.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A telehealth practitioner shall comply with all applicable laws and regulations governing referrals, testing, and evaluation of patients including, but not limited to, the requirements of:</text>
    <paragraph num="(1)">
      <text>COMAR 10.41.08; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Health Occupations Article, §2-314.1, Annotated Code of Maryland.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>A telehealth practitioner may not treat a patient based solely on an online questionnaire.</text>
  </paragraph>
</regulation>