Can you get TRT through telehealth?

Yes, you can get testosterone through telehealth in 2026, but only because of a temporary federal rule. Testosterone is a Schedule III controlled substance, and federal law normally requires at least one in-person medical evaluation before a clinician prescribes a controlled substance remotely. A DEA and HHS rule suspends that requirement through December 31, 2026. Here is what the rule allows, what it requires, and what could change on January 1, 2027.

Why testosterone is treated differently

Most prescriptions can be written after a telehealth visit under state law alone. Controlled substances add a federal layer. Testosterone is listed in Schedule III among the anabolic steroids (21 CFR 1308.13), and every testosterone label carries a controlled substance section. The Depo-Testosterone label states that it “contains testosterone, a Schedule III controlled substance”, and describes the abuse and dependence risks behind the listing.

Under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, a practitioner may prescribe a controlled substance remotely only after at least one in-person medical evaluation of the patient, with some exceptions. The DEA explains in the 2025 rule that once a practitioner has done that evaluation, the remote-prescribing requirements no longer apply to that practitioner and patient, however much time has passed.

The rule that makes online TRT possible

In March 2020, at the start of the COVID-19 public health emergency, the DEA allowed practitioners to prescribe Schedule II to V medications by audio-video telemedicine without the in-person visit. The DEA and HHS have since carried those “telemedicine flexibilities” forward in a series of temporary rules. The current one is the Fourth Temporary Extension, published December 31, 2025 at 90 FR 61301 by the DEA jointly with HHS. It is effective January 1, 2026 through December 31, 2026, and it amends 21 CFR 1307.41 and 42 CFR 12.1.

Under the rule, a DEA-registered practitioner may prescribe Schedule II to V controlled substances by telemedicine without having conducted an in-person evaluation if all of these conditions are met:

• the prescription is issued for a legitimate medical purpose, in the usual course of professional practice;
• it follows a visit using an interactive telecommunications system, which for testosterone means real-time audio and video;
• the practitioner’s registration covers that class of controlled substance, or the practitioner is exempt from registration; and
• the prescription meets every other DEA prescription requirement.

The flexibilities cover audio-video visits. Audio-only visits are allowed only for certain FDA-approved Schedule III to V narcotic medications for opioid use disorder, so a testosterone prescription should follow a video visit. State law still applies on top, and some states set their own telehealth rules.

What might replace it

In January 2025, the DEA published a proposed rule, Special Registrations for Telemedicine and Limited State Telemedicine Registrations (90 FR 6541). It would let physicians and mid-level practitioners with a special registration prescribe controlled substances by audio-video telemedicine, and in limited cases audio-only, without ever seeing the patient in person, as long as they meet extra prescription, recordkeeping and reporting rules. It would also register certain direct-to-consumer telemedicine platforms. The DEA says it received more than 6,475 comments. As of October 18, 2026, it hasn’t been finalized.

The 2025 extension explains why the DEA keeps extending: ending the flexibilities without a permanent rule would create a “telemedicine cliff”. It cites stakeholder data estimating that of 44.6 million controlled-substance prescriptions across 258 organizations in 2024, more than 7 million, about 16%, were issued without a prior in-person evaluation.

What January 1, 2027 could mean for you

Three outcomes are possible: another temporary extension, a final rule such as the special registration, or no action. With no action, the Ryan Haight Act’s in-person requirement returns on January 1, 2027. For someone already on TRT through an online clinic, that would mean an in-person evaluation by the prescribing practitioner before further remote prescriptions, unless another exception applies.

Practical steps if you are starting or renewing TRT online:

• Ask the clinic what it will do if the rule lapses, and whether it can arrange an in-person evaluation in your state.
• Think twice before paying for a long plan upfront. PeterMD’s 12-month plan ($948, as of October 2026) and Hims’ 10-month plan run past December 31, 2026, and PeterMD says all sales are final once medication is received.
• Keep copies of your lab results, so a new prescriber can pick up your care.
• Expect a video visit. Rex MD, Hone Health, Fountain TRT, Maximus and MangoRx say on their pages that a video visit comes before testosterone is prescribed. TRT Nation’s FAQ also offers phone consults, and PeterMD, Henry Meds and Marek Health don’t say their visit is by video. A phone call alone doesn’t meet the DEA rule for testosterone, so ask for video. To compare two clinics’ care side by side, see Maximus vs Hone Health.

What the rule doesn’t change

The temporary rule removes the in-person visit, and nothing else. The clinician still has to decide that testosterone is medically appropriate, and every testosterone label still requires two morning blood tests, on separate days, below the normal range before treatment starts. A clinic that offers testosterone without labs isn’t following the label, whatever the DEA rule says.

The prescription also has to meet every other DEA requirement in 21 CFR part 1306 and the law of the state where you are. The rule applies to DEA-registered practitioners whose registration covers the drug’s class, so the clinician, not the website, is the one prescribing.

Treatments the rule doesn’t cover

Several treatments offered by testosterone clinics aren’t federally controlled, so the DEA telemedicine rule doesn’t apply to them:

• Enclomiphene. Not controlled. It is compounded and not FDA-approved, and it depends on a different policy: the FDA’s 503A Category 1 list of bulk substances under evaluation. See enclomiphene.
• Clomiphene. FDA-approved for women and prescribed off-label to men. See clomiphene.
• hCG. Not federally scheduled. Only FDA-approved hCG is lawful, because compounded hCG has had no lawful pathway since 2020. See hCG.
• Anastrozole. Not controlled; off-label in men. See anastrozole.

Each still needs a prescription from a licensed clinician. If a seller offers any of these, or testosterone, without a prescription, it isn’t a licensed telehealth provider.

How to check a clinic is following the rules

A legitimate online testosterone clinic will require blood tests before prescribing, hold a video visit with a licensed clinician, and use a licensed pharmacy that ships to your state. Every testosterone provider we list is LegitScript certified, and you can check any clinic yourself on LegitScript’s public certification lookup. Be wary of a seller that skips the blood test, skips the video visit, or sells testosterone as a kit you can order without a prescription. Those are signs it isn’t a licensed telehealth provider, and a prescription obtained that way isn’t covered by the DEA rule. Compare them on our best online TRT clinics list, read the step-by-step guide, and see what each charges in TRT cost.

The bottom line

Online TRT is legal in 2026 because a DEA and HHS temporary rule, 90 FR 61301, lets DEA-registered practitioners prescribe testosterone by audio-video telemedicine without an in-person exam through December 31, 2026. If it isn’t extended or replaced, an in-person evaluation will be needed from January 1, 2027. Ask your clinic about its plan, avoid long prepaid plans you can’t get back, and start from our testosterone hub.