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Telehealth Insurance in North Dakota

North Dakota requires an appropriate examination and a bona fide patient relationship before a telemedicine diagnosis or treatment; a static questionnaire or audio-only evaluation does not meet the initial-exam standard. Opioids may be prescribed remotely only for FDA-approved medication-assisted treatment or to a patient in a hospital or long-term-care facility. 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 Dakota

  • An Audio Call or Static Questionnaire Cannot Start Diagnosis

    North Dakota requires an examination equivalent to an in-person evaluation before initial diagnosis or treatment; the statute says a static questionnaire or audio conversation alone does not meet that standard. Ask the broker to include your actual evaluation tools, store-and-forward testing, and use of licensed staff at the patient site. 1

  • Remote Opioid Prescribing Has Narrow Exceptions

    North Dakota permits telemedicine opioid prescriptions only for FDA-approved medication-assisted treatment for opioid-use disorder or for a patient in a hospital or long-term-care facility. Other controlled-substance prescriptions must follow state and federal law, including participation in the state prescription drug monitoring program. 1

  • The Prescriber Must Arrange In-Person or Emergency Referral

    The telemedicine statute requires appropriate referral when a patient cannot be diagnosed or completely treated remotely, including for emergency or complementary in-person care. Make sure referral arrangements and follow-up are included in your risk description. 1

  • State Health Policies Cover Telehealth Like In-Person Services

    North Dakota requires health policies to cover telehealth on the same basis as comparable in-person services, subject to medical necessity and the policy’s terms; payment is negotiated rather than fixed by the telehealth statute. Check what each policy covers and do not assume identical reimbursement amounts. 2

Who Regulates Insurance in North Dakota

North Dakota Insurance Department

The North Dakota Insurance Department regulates insurers and producers, provides licensing and company searches, and investigates insurance complaints to assess compliance with state law and policy terms. 3,4,5

Surplus-lines tax and stamping office

Reported tax rate: 1.75% of gross premium, assessments and policy fees, less return premium, when North Dakota is home state When North Dakota is the insured’s home state, the 1.75% tax applies to the entire gross premium, assessments, membership and subscriber fees, and policy or service fees on multistate policies, less return premium. North Dakota permits independent procurement only under separate statutory conditions; the policyholder should confirm whether a licensed broker placement or independent procurement applies. Nonadmitted insurers generally do not participate in state guaranty funds. 6,7,8

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 Dakota

  1. Does each initial evaluation meet North Dakota’s in-person-equivalent examination standard?
  2. Do our opioid services fit one of the two statutory telemedicine exceptions?
  3. How are referrals documented when the patient needs in-person or emergency care?

Virtual Care And Telehealth in North Dakota: FAQ

Can North Dakota clinicians prescribe opioids through telemedicine? 1

Only for FDA-approved medication-assisted treatment for opioid-use disorder or for a patient in a hospital or long-term-care facility; other telemedicine opioid prescriptions are prohibited. 1

Can an audio-only call establish the initial diagnosis in North Dakota? 1

No. The initial exam must be equivalent to an in-person evaluation, and a static questionnaire or audio conversation alone does not satisfy the statute. 1

Virtual Care And Telehealth in Other States

Other Coverage in North Dakota

Sources

  1. North Dakota Century Code, Chapter 43-17. North Dakota Legislative Branch; §§ 43-17-44 and 43-17-45: telemedicine standard, exam, referral, opioid prescribing, PDMP. Accessed 2026-09-29.
  2. North Dakota Century Code, Title 26.1, Chapter 36. North Dakota Legislative Branch; § 26.1-36-09.15: health-policy telehealth coverage and reimbursement. Accessed 2026-09-29.
  3. North Dakota Insurance Department. North Dakota Insurance Department; Official department homepage; identifies regulation of insurance and consumer/business assistance. Accessed 2026-09-28.
  4. Print License / Search for an Agent. North Dakota Insurance Department; Official licensing page directs the public to current SBS public lookup for agent status, license number, lines and appointments; linked public lookup is up to date. Accessed 2026-09-28.
  5. Complaints. North Dakota Insurance Department; Official complaint process; Department reviews compliance with insurance laws and policy coverage; directs online filings to state-specific SBS complaint form. Accessed 2026-09-28.
  6. Surplus Lines. North Dakota Insurance Department; Current official page: ND home-state rate 1.75% on total premium including assessments and policy fees for multistate coverage; explains home-state allocation and nonadmitted insurer guaranty status. Accessed 2026-09-28.
  7. N.D.C.C. Chapter 26.1-44, Surplus Lines Insurance. North Dakota Legislative Branch; §26.1-44-03.1 sets 1.75% tax base, home-state rule, fee inclusion, return premiums; §§26.1-44-08 and related provisions cover placements. Accessed 2026-09-28.
  8. Surplus Lines. North Dakota Insurance Department; Official page states nonadmitted insurers generally do not participate in state-created insurance guaranty funds. Accessed 2026-09-28.
  9. Licenses. At-Bay; Current producer introduction and state table; At-Bay Insurance Services LLC; P&C and surplus-lines identifiers. Accessed 2026-09-21.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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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