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Telehealth Insurance in Missouri

Missouri’s amended telehealth law took effect August 28, 2026: physicians must collect or review medical history and perform an adequate examination before treatment, and questionnaire-based care can trigger a report to the patient’s primary clinician within 14 days. Out-of-state physicians generally need Missouri authority unless they meet a narrow consultation or review exception. 1,3

What Is Virtual Care And Telehealth?

Telehealth liability can cover claims arising from remote health care, such as a video visit or remote monitoring. If you provide care online, match the quote to your clinicians, services and patient locations; cyber and in-person risks need separate review. Read the national Virtual care and telehealth guide.

What to Watch for in Missouri

  • A Questionnaire Alone Is Not a Sufficient Evaluation

    Effective August 28, 2026, a physician using telemedicine must evaluate the patient, review relevant history, and conduct an examination sufficient for diagnosis and treatment; questionnaires must contain equivalent information and be reviewed by a health professional. Ask the broker to list questionnaire-only triage and treatment pathways accurately. 1

  • Questionnaire Care Can Require a 14-Day Report

    When a provider uses a medical-evaluation questionnaire to establish a relationship, § 191.1146 requires a written report to the patient’s primary provider within 14 days if the patient provides that provider’s information. Add this handoff to your records and ask how coverage applies to coordinated care across businesses. 1

  • Consulting Physicians Do Not Take Over the Missouri Case

    Missouri’s cross-border exception applies when an out-of-state physician consults with a Missouri-licensed physician who retains ultimate authority and responsibility for diagnosis and treatment. Confirm the local clinician relationship and authority before relying on the exception for insured care. 3

  • Coverage Does Not Include Every Modality or Service

    Missouri prohibits denying an otherwise-covered service solely because it is delivered through telehealth, but it does not turn an uncovered service into a covered benefit. Verify the actual health plan and network terms and separately confirm your malpractice policy’s telehealth services. 4,2

Who Regulates Insurance in Missouri

Missouri Department of Commerce and Insurance

Missouri DCI licenses insurance producers and insurers, reviews property and casualty rates and forms, and investigates complaints against insurance companies and producers. 5,6,7,8

Surplus-lines tax and stamping office

Reported tax rate: 5% of premium; Missouri taxes the entire gross premium when Missouri is the home state When Missouri is the insured’s home state, the state applies its 5% surplus-lines tax to the entire gross premium of a multistate policy; the regulator’s FAQ says the tax includes applicable fees. Eligible nonadmitted insurers do not participate in the Missouri Guaranty Fund, and Missouri generally requires the full amount or kind of coverage to be unavailable from admitted insurers before placement; an exempt commercial purchaser search exception has separate disclosure and written-request conditions. 9,10,11,12

Providers With Documented State Licenses

No provider in Spot’s research documents both a state license record and this coverage line. This does not establish that providers are unlicensed. Check the regulator’s license lookup and confirm availability with a provider when requesting a quote.

Questions to Ask Before You Buy in Missouri

  1. Are our evaluation, questionnaire review, and primary-provider report workflows aligned with the August 28, 2026 amendments?
  2. Which Missouri-licensed physician retains responsibility when we rely on a consultation exception?
  3. Does our malpractice policy cover the telehealth modalities and treatments that the health plan reimburses?

Virtual Care And Telehealth in Missouri: FAQ

What does Missouri require before a physician treats a patient by telehealth? 1

The physician must evaluate the patient, review relevant history, and perform an examination sufficient for diagnosis and treatment; a questionnaire must be reviewed and contain equivalent information. 1

Can an out-of-state physician treat a Missouri patient by telehealth? 3

Generally, out-of-state physicians need Missouri authority. A consultation exception applies when a Missouri physician retains ultimate responsibility for diagnosis and treatment. 3

Virtual Care And Telehealth in Other States

Other Coverage in Missouri

Sources

  1. Missouri Revised Statutes § 191.1146. Missouri Revisor of Statutes; Patient relationship, evaluation, questionnaire review, and written report; effective August 28, 2026. Accessed 2026-09-29.
  2. Missouri Revised Statutes § 191.1145. Missouri Revisor of Statutes; Telehealth definitions and service authorization. Accessed 2026-09-29.
  3. Missouri Revised Statutes § 334.010. Missouri Revisor of Statutes; Practice of medicine across state lines; consultation exception. Accessed 2026-09-29.
  4. Missouri Revised Statutes § 376.1900. Missouri Revisor of Statutes; Health-plan coverage for otherwise-covered telehealth services. Accessed 2026-09-29.
  5. Missouri Department of Commerce and Insurance. Missouri Department of Commerce and Insurance; Official insurance regulator homepage. Accessed 2026-09-28.
  6. Find an Insurance Agent/Agency. Missouri Department of Commerce and Insurance; Official DCI search page says its License & Contact Info search covers licensed agents and agencies; it links to company search. Accessed 2026-09-28.
  7. Insurance Complaints. Missouri Department of Commerce and Insurance; Complaint filing page; says Consumer Affairs investigates complaints against insurers and producers; consumer hotline 800-726-7390. Accessed 2026-09-28.
  8. Insurance Company Rate, Rule and Policy Form Filings. Missouri Department of Commerce and Insurance; Official DCI rate, rule and form filing page; identifies state oversight of insurer product filings. Accessed 2026-09-28.
  9. Surplus Lines FAQs. Missouri Department of Commerce and Insurance; FAQ states 5% of Missouri net premium including applicable fees and eligible surplus-lines companies do not participate in the Guaranty Fund. Accessed 2026-09-28.
  10. RSMo §384.061. Missouri Revisor of Statutes; Subsections 1–2: entire gross premium is taxed when Missouri is home state; Chapter 384 placement regulation applies only when Missouri is home state. Accessed 2026-09-28.
  11. RSMo §384.021. Missouri Revisor of Statutes; Admitted-market availability rule and exempt commercial purchaser due-diligence exception; exception conditions appear in subsection 2. Accessed 2026-09-28.
  12. Surplus Lines FAQs. Missouri Department of Commerce and Insurance; FAQ says eligible surplus-lines insurers do not participate in the Guaranty Fund. Accessed 2026-09-28.
  13. Licenses. At-Bay; Current producer introduction and state table; At-Bay Insurance Services LLC; P&C and surplus-lines identifiers. Accessed 2026-09-21.
  14. Licenses and Carriers. Coalition; Licenses and Carriers, re-read 22 September 2026: Insurance Licenses table for Coalition Insurance Solutions, Inc., national producer number 18419475, with producer and surplus-lines numbers for all 50 states and DC including California 0L76155, Georgia 196479, Texas 2199630 and 2205589, Pennsylvania 815731 and 817452, Colorado 539028 and Wisconsin 3000108852. Insurance Carriers table naming, with NAIC numbers, Allianz Underwriters Insurance Company 36420, Arch Specialty Insurance Company 21199, Ascot Specialty Insurance Company 45055, Ascot Insurance Company 23752, Aspen Specialty Insurance Company 10717, Chaucer Insurance Company DAC, Coalition Insurance Company 29530, Fireman's Fund Indemnity Corporation 11380, Fortegra Specialty Insurance Company 16823, Lloyd's of London, MSIG Specialty Insurance USA Inc. 34886, MS Transverse Specialty Insurance Company 41807, Steadfast Insurance Company 26387, Vantage Risk Specialty Insurance Company 16275 and Zurich American Insurance Company 16535. Accessed 2026-09-22.
  15. Insurance Producer Licenses. Corgi Insurance; Current complete Insurance Producer Licenses table for Corgi Insurance Services, Inc.; 50 rows covering 49 states and DC (DC 3003091619); no New Mexico row; no NPN or as-of date shown. Accessed 2026-09-28.
  16. About Hiscox US Insurance. Hiscox; Hiscox Insurance Company Inc. NAIC 10200 as Chicago, IL domiciled insurer admitted or licensed in all 50 states and D.C.; Hiscox Inc. as general agent and Lloyd’s coverholder for Syndicates 33 and 3624; surplus-lines placements through licensed surplus-lines brokers; A.M. Best rating statement. Accessed 2026-09-16.
  17. Licenses. ERGO NEXT Insurance; Current entity-by-state license table reopened 28 September 2026: 50 rows under Next First Insurance Agency, Inc., including Washington, DC; New York rows instead list Next Insurance Services PC-1423070 and AP Intego BR-1198885. Accessed 2026-09-28.
  18. The Pie Insurance Company — Company Details. Missouri Department of Commerce and Insurance; Company name: THE PIE INSURANCE COMPANY; status Active; NAIC 21857; license B424258; Property and Casualty; date admitted 1999-07-07. The page has no expiry/renewal field. Accessed 2026-09-28. Accessed 2026-09-28.
  19. Insurance Licenses by State. TechInsurance; Current state table; identifies TechInsurance as a division of Specialty Program Group LLC d/b/a SPG Insurance Solutions; lists DC 3000041536 and labels Rhode Island “Individual licenses,” without an agency license number. Accessed 2026-09-28.
  20. Licenses. Vouch; Effective 16 January 2025: Vouch Specialty Insurance Services, LLC, NPN 19926463; P&C table (50 states and DC); surplus-lines table includes Idaho 870820; footnote says Georgia and Idaho do not issue agency-level surplus-lines licenses; Idaho retained as producer-only due to conflict. Accessed 2026-09-15.

Updated .

This guide is informational and does not determine whether a policy is available or meets your needs. Editorial policy. To suggest a correction, contact Spot with a supporting source.

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