Harold Robert Meyer Reviewed: September 14, 2026 · Published: September 15, 2026
A federal deadline almost no one has heard of could change who is allowed to keep prescribing ADHD medication by video visit after this year — and the specialty you or your child sees may not make the list.
You’ve been doing your ADHD medication check-ins by video for years now. It has worked so well that you’ve stopped thinking about it as a temporary accommodation.
It was always temporary. And the clock on it just moved.
Key Takeaway
A permanent federal rule on telemedicine prescribing of stimulant medication is now in its final stage of White House review, and the pandemic-era flexibility it replaces expires December 31, 2026 — but the last public draft of that rule did not include family medicine or internal medicine physicians among the clinicians allowed to prescribe stimulants this way.
Key Findings
- The Drug Enforcement Administration (DEA) sent its final “Special Registrations for Telemedicine” rule to the White House Office of Information and Regulatory Affairs (OIRA) on August 25, 2026; the Justice Department’s own regulatory agenda projects final action around November 2026.
- The telehealth prescribing flexibility now in place — extended four times since 2023 — expires December 31, 2026, leaving a possible gap of only weeks between the rule’s publication and that deadline.
- The DEA’s January 2025 proposed version of this rule would have restricted telemedicine prescribing of Schedule II medications — the category that includes Adderall, Vyvanse, Ritalin, and Concerta — to seven specific categories of clinicians. Family medicine and internal medicine physicians were not among them.
- The text now under OIRA review is not public. The DEA received more than 6,475 comments on its 2025 proposal, and no outside party — including the medical associations that filed those comments — knows how the agency revised the rule in response.
What the 2025 proposal would have restricted
The January 2025 proposal created a new “Advanced Telemedicine Prescribing Registration” specifically for Schedule II drugs — the DEA’s most tightly controlled category for medications with an accepted medical use but a high potential for abuse. Every major ADHD stimulant falls into it.
Under that proposal, only these clinicians could qualify: psychiatrists, hospice care physicians, palliative care physicians, physicians treating patients at long-term care facilities, pediatricians, neurologists, and mid-level practitioners board-certified in one of those areas. The American Hospital Association raised, in its formal comments, the same concern ADDRC families will recognize immediately: the list excludes entire fields of medicine that routinely manage patients who cannot easily get to an office, and it urged the DEA to expand it.
Pediatricians made that list. Many families’ actual prescriber did not. A substantial share of ADHD medication in this country is prescribed and managed not by psychiatrists or pediatricians specifically, but by family medicine and internal medicine physicians — and by nurse practitioners working under them — often because that clinician had a telehealth slot open, or has known the family for years and doesn’t require starting over with a specialist. If the final rule preserves this list, a video-visit stimulant prescription from that doctor could become a Ryan Haight Act violation the moment the temporary flexibility lapses, unless an in-person evaluation happens first.
Why the uncertainty itself is the problem
Nothing here is decided. The version of the rule now sitting with OIRA has not been made public, and the process gives outside groups no way to see how the DEA revised its proposal in response to the thousands of comments it received. It is entirely possible the final rule broadens the specialty list or extends the deadline again, as it has three times before. It is also possible it does not — and treating anything in the 2025 proposal as settled policy would be a mistake.
What’s certain is the calendar. If the rule publishes anywhere close to its projected November timeline, families and prescribers could have only a few weeks to absorb new requirements — credentialing, state-by-state registration, possibly an in-person visit — before the December 31 flexibility ends. That is not enough runway to switch prescribers, book a new-patient appointment with a specialist, or arrange a first in-person visit if one turns out to be required.
What to do while the rule is still unwritten
You don’t need to panic, and you don’t need to change anything today. But you do have time now that you may not have in December.
Find out, specifically, what kind of clinician prescribes the medication — not just “the doctor,” but their actual specialty and board certification. If it’s a family medicine or internal medicine physician, or a nurse practitioner not board-certified in one of the seven listed areas, ask directly whether their practice has a plan for December 31 regardless of what the final rule says. Ask whether an in-person visit before then would preserve continuity no matter how the rule lands — an evaluation already on the books is worth more than a promise to schedule one later, if thousands of other families are trying to do the same thing in the same few weeks.
The next step
Put one date on your calendar: mid-November, when the final rule is expected. That’s when this stops being speculation. Between now and then, a single question to your child’s prescriber — “does the new DEA telemedicine rule affect how you can prescribe by video?” — costs you nothing and may save you a scramble in the last weeks of the year.
Synopsis
A federal rule that will permanently govern telemedicine prescribing of ADHD stimulant medication is now in final White House review, with a decision expected around November 2026 — just before the temporary flexibility that currently allows it expires on December 31, 2026. The last public draft of the rule would have limited video-visit prescribing of Schedule II medications to seven specialist categories, including psychiatrists, pediatricians, and neurologists, but not family medicine or internal medicine physicians, who prescribe and manage a substantial share of ADHD medication nationally. Because the final rule’s text is not public, families cannot yet know whether this restriction survives, but the timeline leaves little room to adjust if it does. Parents are advised to confirm their prescriber’s specialty now and ask about contingency plans well before the December deadline.
Topic: Medication Audience: Parents & caregivers Keywords: telemedicine prescribing, DEA special registration, Schedule II stimulants, telehealth flexibility deadline, family medicine prescriber
Bibliography
Drug Enforcement Administration. (2025, January 16). DEA announces three new telemedicine rules that continue to open access to telehealth treatment while protecting patients [Press release].
Special Registrations for Telemedicine and Limited State Telemedicine Registrations, Notice of proposed rulemaking, 90 Fed. Reg. 6541 (proposed January 17, 2025).
Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, Final rule, 90 Fed. Reg. 61301 (December 31, 2025).
Office of Information and Regulatory Affairs. (2026, August 25). Regulatory review: Special Registrations for Telemedicine and Limited State Telemedicine Registrations. reginfo.gov.
American Hospital Association. (2025, March 18). AHA comments on DEA proposed rule on special registrations for telemedicine prescribing.
Fox, A. (2026, August 27). DEA seeks to finalize framework for e-prescribing of controlled substances. Healthcare IT News.
Drug Enforcement Administration. Drug scheduling.
Resources
- Your ADHD Needs One Appointment a Year That Isn’t About the Prescription (ADDRC)
- DEA Prescribing of Controlled Substances tracker (Alliance for Connected Care)
- DEA Special Registration for Telemedicine (American Psychiatric Association)
About the Author
Harold Robert Meyer founded The ADD Resource Center in 1993 and has spent more than thirty years translating the lived experience of ADHD into practical guidance for individuals, families, and the clinicians and educators who work with them. He co-founded CHADD of New York in 1989 and went on to serve on CHADD National’s board and executive committee, including as Vice President of Finance. He was later elected to lead the Institute for the Advancement of ADHD Coaching. An author and international speaker, he has presented at the American Psychiatric Association Annual Meeting, CHADD national and local conferences, NYU Langone, Mount Sinai Medical Center, and Weill Cornell Medical College. Reach him at [email protected].
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