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Telehealth Insurance in North Carolina

North Carolina treats telemedicine as practice where the patient is physically located, so physicians and PAs generally need North Carolina licenses to treat patients there. A 2025 law separately lets state-licensed telehealth-only providers enroll in Medicaid without maintaining a North Carolina physical presence. 1,2

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 North Carolina

  • A North Carolina Patient Usually Requires North Carolina Authority

    The Medical Board states that North Carolina law applies when the patient is in the state and physicians or PAs generally need a North Carolina license, subject to limited statutory exceptions. Track patient location and credential status for every encounter and ask the broker to include cross-border telehealth exposure. 1

  • Medicaid Enrollment No Longer Requires a Local Office for Telehealth-Only Providers

    Session Law 2025-64 directs DHHS to allow a state-licensed provider delivering services exclusively by telehealth to enroll as a Medicaid provider without maintaining a physical presence in North Carolina. This changes enrollment, not licensure; ask the carrier to distinguish remote-only clinicians from the North Carolina license requirement. 2

  • The In-Person Standard Still Governs Remote Care

    The Medical Board says telemedicine must meet the same or similar standard of care as in-person medicine and the clinician must gather enough information to diagnose and treat. Document escalation to in-person care when remote assessment cannot support the needed diagnosis. 1,3

Who Regulates Insurance in North Carolina

North Carolina Department of Insurance

The North Carolina Department of Insurance administers insurance laws, licenses insurance producers and companies, reviews insurance filings and handles consumer complaints. The Commissioner is elected statewide. 4,5,6,7

Surplus-lines tax and stamping office

Reported tax rate: 5% of gross premium, less return premium, plus 0.4% NC Stamping Office fee for ordinary filed placements When North Carolina is the insured’s home state, surplus-lines tax is 5% of gross premium less return premium; ordinary broker-placed filings also carry a 0.4% stamping fee, while risk-purchasing-group and independent-procurement filings follow separate procedures. A diligent search is generally required; an exempt commercial purchaser may bypass it only after the broker discloses the admitted-market protection difference and receives the purchaser’s subsequent written request. The policy warns that the state guaranty or solvency fund will not pay surplus-lines losses. 8,9,10,11

North Carolina Surplus Lines Association / NC Stamping Office

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 North Carolina

  1. Which North Carolina licenses or statutory exceptions cover each clinician treating a patient in the state?
  2. Are telehealth-only providers enrolled under the 2025 Medicaid rule while still holding all required state licenses?
  3. How does our workflow refer a patient for in-person evaluation when remote information is insufficient?

Virtual Care And Telehealth in North Carolina: FAQ

Do physicians need a North Carolina license to treat a patient there by telehealth? 1

Yes, generally. North Carolina says medical practice occurs where the patient is physically located, so an NC professional license is required except in limited situations allowed by law. 1

Does a North Carolina telehealth-only Medicaid provider need a physical office in the state? 2

No. Since 2025, state-licensed providers who furnish services exclusively through telehealth may enroll in Medicaid without a North Carolina physical presence. 2

Virtual Care And Telehealth in Other States

Other Coverage in North Carolina

Sources

  1. Telemedicine Consumer FAQs. North Carolina Medical Board; Patient location, licensure, same standard of care and clinical-information requirements. Accessed 2026-09-29.
  2. Session Law 2025-64 (HB 546). North Carolina General Assembly; Part III, § 3.1: Medicaid eligibility without in-state physical presence; effective July 7, 2025. Accessed 2026-09-29.
  3. North Carolina General Statutes, Chapter 90. North Carolina General Assembly; Medical practice, licensure, and telehealth provisions. Accessed 2026-09-29.
  4. North Carolina Department of Insurance. North Carolina Department of Insurance; Official department homepage. Accessed 2026-09-28.
  5. Insurance Producer and Adjuster Licensing. North Carolina Department of Insurance; Official licensing landing page provides license status lookup, producer licensing and SBS resources. Accessed 2026-09-28.
  6. File a Complaint. North Carolina Department of Insurance; Official insurance complaint form and consumer assistance page; toll-free line 855-408-1212. Accessed 2026-09-28.
  7. Commissioner of Insurance. North Carolina Department of Insurance; Official commissioner biography says officeholder was elected statewide. Accessed 2026-09-28.
  8. N.C. Gen. Stat. §58-21-85. North Carolina General Assembly; 5% tax on gross premiums less returns when insured’s home state is North Carolina; treatment of reciprocal allocation also provided. Accessed 2026-09-28.
  9. Surplus Lines. North Carolina Department of Insurance; Current DOI surplus-lines page identifies NC Stamping Office; states a 0.4% fee for ordinary new/renewal filings; excludes RRG and independent procurement. Accessed 2026-09-28.
  10. N.C. Gen. Stat. §58-21-16. North Carolina General Assembly; ECP diligent-search waiver requires broker disclosure that admitted insurance may provide greater protection and purchaser subsequent written request; ECP definition appears in subsection (b). Accessed 2026-09-28.
  11. Surplus Lines. North Carolina Department of Insurance; Required surplus-lines policy language says state guaranty or solvency fund will not pay losses on policy. Accessed 2026-09-28.
  12. Licenses. At-Bay; Current producer introduction and state table; At-Bay Insurance Services LLC; P&C and surplus-lines identifiers. Accessed 2026-09-21.
  13. 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.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. 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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