Veterinary Telemedicine and the VCPR: What You Can Do by Video, State by State

Can you diagnose and prescribe from a video call, for a patient you have never examined? In human medicine the answer is often yes. In veterinary medicine it depends on the state, on the drug, and on a three word legal idea: the veterinarian client patient relationship, or VCPR.

This guide explains the VCPR, the federal rule, how states have split, and what telemedicine services practices can offer safely. It is general information, not legal advice; check your state's practice act.

What a VCPR is

The AVMA's Model Veterinary Practice Act, which many states use as a template, says a VCPR exists when all of these are true:

• The veterinarian has taken responsibility for clinical judgments about the patient, and the client has agreed to follow the veterinarian's instructions.
• The veterinarian knows the patient well enough to make at least a preliminary diagnosis, through a timely examination of the patient, or timely visits to where the animals are kept.
• The veterinarian is available for follow up, or has arranged emergency coverage and continuing care.
• The veterinarian oversees treatment, compliance and outcome.
• Records are kept.

Without a VCPR, a veterinarian may give general advice, but not diagnose, give a prognosis or treat a specific animal.

The federal rule

Federal law requires a VCPR for extralabel drug use, for veterinary feed directives and for certain biologics. The FDA interprets its definition to mean a VCPR cannot be established solely through telemedicine, although it can be maintained electronically once established. So even in a state that allows a virtual VCPR, a prescription that falls under FDA rules, such as most extralabel use, still needs an in person relationship.

How the states split

The picture changes every legislative session. Two snapshots:

• The AVMA, November 2023: 43 states and DC used language essentially the same as the FDA's VCPR. Of those, 22 explicitly required an in person examination or premises visits. Six states had changed their laws or rules to allow a virtual VCPR.
• AAHA, October 2024, citing the Veterinary Virtual Care Association's map: 19 states said a VCPR cannot be established through a virtual exam; 22 required the veterinarian to have "seen" or "become acquainted with" the patient without making clear whether video counts; 8 expressly allowed a virtual VCPR; and New York did not use the term.

Some states have recently moved in each direction. The AVMA reported that in 2023, Kentucky and Illinois reaffirmed in person requirements, and Michigan's rules required an in person exam before telehealth. Earlier, West Virginia, Hawaii and Nevada enacted in person requirements. See our guide to Kentucky licensing.

States that allow a virtual VCPR, and their limits

States that allow a virtual VCPR attach guardrails, usually on prescribing:

• Arizona (law signed 2023): a VCPR may be established by telemedicine, with prescribing limited to 14 days and one refill before an in person exam, and food producing animals excluded.
• California (law signed October 2023): allows an electronic VCPR. Prescriptions based on an electronic exam can last up to six months, but antimicrobials are limited to 14 days with no refill without an in person exam. It cannot be established by audio alone or a questionnaire, and only California based veterinarians may practice telehealth on animals in the state.
• Florida (effective July 1, 2024): a live video visit may establish the VCPR. Prescriptions are limited to one month of flea and tick prevention and 14 days of other drugs before an in person exam, and compounded drugs, controlled drugs and extralabel use are not allowed without a prior in person exam.

Others are narrower: the AVMA noted that New Jersey and Virginia require an in person exam to prescribe controlled substances, and Idaho does not allow any prescribing when the VCPR was established electronically. Vermont has few restrictions and a registry for out of state providers.

The debate

For a virtual VCPR, advocates such as the Veterinary Virtual Care Association argue that many owners cannot easily get pets to a clinic, because of cost, transport, age or pet stress, and that some care is better than none when guardrails are in place.

Against it, the AVMA argues that an in person exam is one of the strongest protections for animal health, food safety and public health, and that in its own outreach work, telemedicine worked best as a supplement to hands on care, not a substitute.

What practices can offer everywhere

Within an existing VCPR, telemedicine is broadly allowed and useful:

• Rechecks and follow ups after a visit or surgery.
• Medication and chronic disease management for patients you know.
• Triage: helping a client decide whether to come in, go to an emergency hospital, or wait.
• General advice to anyone, as long as it is not specific to one animal's diagnosis or treatment.
• Specialist consultations, where the referring veterinarian holds the VCPR.

Licensing across state lines

The AVMA advises that a veterinarian doing telemedicine across state lines be licensed in both the state where they are and the state where the patient is. See moving states with a veterinary license.

What it means for hiring

Telemedicine roles are growing, from triage lines to remote relief work. If you hire for one, check the licenses the role needs in each state it serves. If you are a veterinarian considering one, ask which states you will see patients in, and whether your license covers them. Minnesota's new rules even allow licensed technicians to work remotely under a veterinarian's direction within a VCPR. See Minnesota now licenses vet techs.

How Zuse helps

On Zuse Talent, veterinarians can claim licenses in every state they hold one, and browse veterinarian jobs and relief veterinarian jobs with pay shown. Practices on Zuse Hire see each license checked against its state board.

Sources

• AVMA, Telehealth and the VCPR
• AVMA News, VCPR requirements fuel state legislative activity (November 2, 2023)
• AAHA NEWStat, The patchwork quilt of state veterinary telehealth laws (October 2024)
• AVMA, Federal requirements for the veterinarian client patient relationship

State telemedicine laws change frequently. This is general information, not legal advice.

FAQ

Can a veterinarian prescribe by video?

It depends on the state and the drug. Within an existing in person VCPR, many states allow it. Some states allow a VCPR to start by video with tight prescribing limits, and federal rules still require an in person relationship for extralabel drug use.

What is a VCPR?

The veterinarian client patient relationship: the veterinarian takes responsibility for the patient, knows it through a timely examination, is available for follow up, oversees treatment and keeps records.

Can a VCPR be established through telemedicine?

In a minority of states, such as Arizona, California and Florida, with limits. Most states require or imply an in person exam, and the FDA says a VCPR cannot be established solely through telemedicine for purposes under its rules.

What telemedicine can every practice offer?

Rechecks, follow ups, chronic disease management and triage for patients with an existing VCPR, plus general advice that is not specific to one animal.

Do I need a license in the patient's state for telemedicine?

The AVMA advises being licensed both where you are and where the patient is.