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Telehealth has taken the spotlight with the onset of the global COVID-19 pandemic, which rendered traditional, in-person health care visits potentially unsafe in the face of a highly communicable virus. Because many conditions can be adequately diagnosed and treated via telehealth, the use of this mechanism of health care delivery became desirable for telehealth providers and patients alike. Concurrently, a myriad of laws and regulations governing health care practice were relaxed in an attempt to make use of telehealth easier for telehealth providers and patients. Nonetheless, a patchwork of varying standards governing the practice of telehealth in the United States and across the globe is the norm, which makes practicing telehealth and telerehabilitation potentially confusing for the newly initiated.

The expansion of health care services delivered through telehealth is impacted by numerous legal, regulatory, and reimbursement frameworks. Standard medical practices for consent, privacy, credentialing, and licensing apply to telehealth; however, the opportunity for cross-state practice complicates their application. Hospital-specific rules for credentialing and emergency stabilization must also be considered. Delivery of medical services is often driven by reimbursement, which for telehealth is governed by a complicated web of rules that vary by service, payer, and location. Temporary changes to these rules in association with the public health emergency (PHE) declared in response to the COVID-19 pandemic has rapidly reshaped the telemedicine regulatory landscape. Advocacy for smart legislation that improves and simplifies access to care is important to ensure equity of telehealth services.