What Telehealth Insurance Requirements Apply in Pennsylvania?

Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. The Act does not require payment to out-of-network providers, and it preserves the in-person standard-of-care limit.

What Is Telehealth Insurance?

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 Should You Watch for With Telehealth Insurance in Pennsylvania?

  • Pennsylvania Patient Location Determines the Rules

    The Act does not require payment to out-of-network providers, and it preserves the in-person standard-of-care limit. Record where the patient is at each encounter and ask whether the policy covers services delivered under that state-specific rule. 2

  • Keep Telehealth Within Pennsylvania Practice Rules

    Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. Ask the broker to confirm the professional-liability policy covers the modalities and services your clinicians use in {n}. 1

  • Confirm Pennsylvania Plan Payment Conditions

    Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. Verify network, authorization, and covered-service conditions before relying on payment for remote encounters. 1,2

Which Telehealth Providers Have Pennsylvania License Records?

No provider in our research has both a state license record and a listing for 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.

Who Regulates Insurance in Pennsylvania?

Pennsylvania Insurance Department

The Pennsylvania Insurance Department publishes state tools to check licensed producers, agencies, and insurers, and its Consumer Services Online portal accepts complaints about insurers, agents, brokers, and public adjusters. The department also oversees Pennsylvania insurance business and consumer services. 3,4,5

Surplus-Lines Tax and Stamping Office in Pennsylvania

Reported tax rate. 3% of gross premium (2% for eligible surplus-lines risk retention groups) 6,7,8,9

Pennsylvania charges 3% of gross surplus-lines premiums (2% for an eligible surplus-lines risk-retention group); the tax is in addition to premium, is borne by the insured, and is collected by the producer. For multistate risks, the 2025 Revenue instructions say all gross premiums are taxable when Pennsylvania is the home state, while Insurance Company Law §1621(d) says tax is levied only on premium reasonably ascribable to Pennsylvania risk; confirm allocation with your producer or the state. Surplus-lines coverage is excluded from the guaranty association, and qualifying large risks or exempt commercial purchasers may use distinct no-search routes, with the ECP route requiring disclosure and written request.

Questions to Ask Before You Buy Telehealth in Pennsylvania

  1. Does our professional-liability policy cover the telehealth modalities we use with patients in Pennsylvania?
  2. How should we document Pennsylvania patient location, consent, and required in-person follow-up?
  3. Which Pennsylvania plan rules or network terms affect reimbursement for these services?

Telehealth Insurance in Pennsylvania: Frequently Asked Questions

Do clinicians need authorization to provide telehealth to patients in Pennsylvania?

Yes. The Act does not require payment to out-of-network providers, and it preserves the in-person standard-of-care limit. 2

Does Pennsylvania require health plans to cover telehealth?

Usually, when the service is otherwise covered and meets the state’s applicable clinical and plan conditions. Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. 1

Telehealth Insurance Guides for Other States

Other coverage in PennsylvaniaEvery coverage guide for Pennsylvania, plus the regulator and surplus-lines details.

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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