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Hawai‘i has one of the most progressive telehealth laws in the nation. Act 226: Relating to Telehealth was signed into law by Governor David Ige in 2016. For more information, visit the Hawaiʻi policies and regulations page.

The US-Affiliated Pacific Islands do not currently have comprehensive telehealth laws in place and each jurisdiction differs on the allowances for health providers licensed outside of their jurisdiction. For instance, in Guam, physicians not licensed in Guam will not be subject to Guam licensure requirements as long as they are providing consultation to a Guam-licensed physician via telemedicine.

For more information on specific laws, please see: American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Hawaiʻi, Republic of the Marshall Islands, or the Republic of Palau.

During the COVID-19 Public Health Emergency, states and some US-Affiliated Pacific Islands implemented their own waivers on telehealth and licensure to respond to the pandemic. Please visit the Center for Connected Health Policy for more information on current Telehealth waivers for Federal and State-specific waivers.

For telehealth waivers in the USAPIs, please see: American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Hawaiʻi, Republic of the Marshall Islands, or the Republic of Palau.

The COVID-19 pandemic brought about many changes to the licensing laws and regulations of every state and USAPI. View the Federation of State Medical Boards resource that tracks the licensure-related changes of U.S. States and Territories.

The Public Health Emergency waivers on telehealth allow physicians licensed out-of-state to engage in telehealth with a Hawaiʻi patient without an in-person consultation or existing physician-patient relationship given that they have never had their license revoked or suspended and they have been hired by a state or county agency, facility or hospital. See Governor of Hawaiʻi David Ige’s Executive Order No. 20-02 (PDF).

For a comprehensive guidance on billing and reimbursement, such as specific codes, documentation requirements and specific payer requirements, please see our updated Telehealth Virtual Visit Reimbursement Guide.

Many telehealth services have been included in CMS’ list of reimbursable services, including audio-only communications technology for mental health. See the Medicare physician fee schedule search.