asset_type: diff

body: Under the Ryan Haight Act a practitioner may normally prescribe a controlled substance only after at least one in-person evaluation of that patient. In March 2020 the DEA suspended that requirement for the COVID-19 public health emergency, and since the emergency ended on 11 May 2023 the suspension has been kept alive only by a chain of temporary rules -- four of them so far, each amending 21 CFR 1307.41 and 42 CFR 12.1 to push one expiry date to a later one, with a permanent 'special registration' rule still only a proposal. This asset is one record per temporary rule, carrying the rule's own DATES statement, the date it extended the flexibility to, and the earlier expiry date it replaced, each quoted from that rule's own Federal Register document. Two things make the history worth assembling. First, the dates are easy to get wrong: the First Temporary Rule is dated 'effective May 11, 2023, through November 11, 2024', but the general flexibility under it actually ran only to 11 November 2023 -- the extra year applied solely to practitioner-patient relationships already established by that date. Second, each rule is a standalone document that supersedes the last without amending it, so a reader who lands on any one of the first three sees a deadline that has already passed with nothing on the page to say so. The newest rule's preamble does narrate the earlier three in prose, which is where a careful reader can reconstruct the sequence; this asset states it as four dated, separately-sourced records instead.

licence: Facts extracted from the Federal Register, a US government work not subject to copyright. Each record quotes a short verbatim span of the rule it describes and links back to that document on federalregister.gov.

title: DEA telemedicine controlled-substance prescribing flexibility -- extension history

type: dataset


body:
**Temporary rule:** Extension 1: First Temporary Rule

**Published:** 05/10/2023

**Federal Register citation:** 88 FR 30037

**Document number:** 2023-09936

**Effective period as stated:** This rule is effective May 11, 2023, through November 11, 2024.

> DATES: This rule is effective May 11, 2023, through November 11, 2024.

**Flexibility extended through:** November 11, 2023

> Paragraph (c) extends the COVID-19 telemedicine prescribing flexibilities for six months, from May 12, 2023 through November 11, 2023, provided all of the conditions listed in paragraph (e) are met.

**Longer extension for a narrower group:** through November 11, 2024, but only with respect to patients with whom the prescribing practitioner has a telemedicine relationship established via COVID-19 telemedicine prescribing flexibilities on or before November 11, 2023

> Paragraph (d) provides for a partial extension of those telehealth flexibilities through November 11, 2024, but only with respect to patients with whom the prescribing practitioner has a telemedicine relationship established via COVID-19 telemedicine prescribing flexibilities on or before November 11, 2023, as defined in paragraph (b) and provided all the conditions listed in paragraph (e) are met.

> A Rule by the Drug Enforcement Administration and the Health and Human Services Department on 05/10/2023 Published Document: 2023-09936 (88 FR 30037)

Source: <https://www.federalregister.gov/documents/2023/05/10/2023-09936/temporary-extension-of-covid-19-telemedicine-flexibilities-for-prescription-of-controlled>

extension_number: Extension 1: First Temporary Rule

flexibility_extended_through: November 11, 2023

title: Extension 1: First Temporary Rule — DEA telemedicine controlled-substance prescribing flexibility -- extension history

type: diff


body:
**Temporary rule:** Extension 2: Second Temporary Rule

**Published:** 10/10/2023

**Federal Register citation:** 88 FR 69879

**Document number:** 2023-22406

**Effective period as stated:** As of November 11, 2023, the end of the effective period for the temporary rule published at 88 FR 30037 on May 10, 2023, is extended from November 11, 2024, to December 31, 2024. This rule is effective November 11, 2023.

> DATES: As of November 11, 2023, the end of the effective period for the temporary rule published at 88 FR 30037 on May 10, 2023, is extended from November 11, 2024, to December 31, 2024. This rule is effective November 11, 2023.

**Flexibility extended through:** December 31, 2024

> Paragraph (c) is amended to extend the COVID-19 telemedicine prescribing flexibilities from May 12, 2023 through December 31, 2024, provided all of the conditions listed in paragraph (e) are met.

**Expiry date this rule replaced:** November 11, 2023

> Paragraph (a) is amended to state that the authorization granted in the amended paragraph (c) expires at the end of December 31, 2024, instead of November 11, 2023.

> A Rule by the Drug Enforcement Administration and the Health and Human Services Department on 10/10/2023 Published Document: 2023-22406 (88 FR 69879)

Source: <https://www.federalregister.gov/documents/2023/10/10/2023-22406/second-temporary-extension-of-covid-19-telemedicine-flexibilities-for-prescription-of-controlled>

expiry_date_replaced: November 11, 2023

extension_number: Extension 2: Second Temporary Rule

flexibility_extended_through: December 31, 2024

title: Extension 2: Second Temporary Rule — DEA telemedicine controlled-substance prescribing flexibility -- extension history


body:
**Temporary rule:** Extension 3: Third Temporary Rule

**Published:** 11/19/2024

**Federal Register citation:** 89 FR 91253

**Document number:** 2024-27018

**Effective period as stated:** This rule is effective January 1, 2025, through December 31, 2025.

> DATES: This rule is effective January 1, 2025, through December 31, 2025.

**Flexibility extended through:** December 31, 2025

> The Drug Enforcement Administration (DEA) in concert with the Department of Health and Human Services (HHS) is issuing a third extension of telemedicine flexibilities for the prescribing of controlled medications, through December 31, 2025.

**Expiry date this rule replaced:** December 31, 2024

> Paragraph (a) is amended to state that the authorization granted in the amended paragraph (c) expires at the end of December 31, 2025, instead of December 31, 2024.

> A Rule by the Drug Enforcement Administration and the Health and Human Services Department on 11/19/2024 Published Document: 2024-27018 (89 FR 91253)

Source: <https://www.federalregister.gov/d/2024-27018>

expiry_date_replaced: December 31, 2024

extension_number: Extension 3: Third Temporary Rule

flexibility_extended_through: December 31, 2025

title: Extension 3: Third Temporary Rule — DEA telemedicine controlled-substance prescribing flexibility -- extension history


body:
**Temporary rule:** Extension 4: Fourth Temporary Rule

**Published:** 12/31/2025

**Federal Register citation:** 90 FR 61301

**Document number:** 2025-24123

**Effective period as stated:** This rule is effective January 1, 2026 through December 31, 2026.

> DATES: This rule is effective January 1, 2026 through December 31, 2026.

**Flexibility extended through:** December 31, 2026

> The Drug Enforcement Administration (DEA) jointly with the Department of Health and Human Services (HHS) is issuing a fourth extension of telemedicine flexibilities for the prescribing of controlled medications through December 31, 2026.

**Expiry date this rule replaced:** December 31, 2025

> Paragraph (a) is amended to state that the authorization granted in paragraph (b) expires at the end of December 31, 2026, instead of December 31, 2025.

> A Rule by the Drug Enforcement Administration and the Health and Human Services Department on 12/31/2025 Published Document: 2025-24123 (90 FR 61301)

Source: <https://www.federalregister.gov/documents/2025/12/31/2025-24123/fourth-temporary-extension-of-covid-19-telemedicine-flexibilities-for-prescription-of-controlled>

expiry_date_replaced: December 31, 2025

extension_number: Extension 4: Fourth Temporary Rule

flexibility_extended_through: December 31, 2026

title: Extension 4: Fourth Temporary Rule — DEA telemedicine controlled-substance prescribing flexibility -- extension history