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Today, December 30, 2025, the Federal Register  that the Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) are jointly issuing a fourth temporary extension rule (the “Fourth Temporary Extension Rule”), preserving existing COVID-era telemedicine prescribing flexibilities through December 31, 2026. Specifically, the Fourth Temporary Extension Rule will continue to allow for the prescribing of Schedule II-V controlled medications to patients via telemedicine, without an initial in-person evaluation through 2026. The Fourth Temporary Extension Rule is scheduled to be published on December 31, 2025. 

In addition, the Fourth Temporary Extension Rule will exist alongside two final rules published on January 17, 2025, titled (1) “” and (2) “” (collectively, the “Two Final Rules”). The Two Final Rules will go into effect on December 31, 2025; they create separate, unique pathways for prescribing controlled medications through telemedicine.  

Notably, publication of the Fourth Temporary Extension Rule will allow clinicians to continue using less restrictive COVID-era telemedicine flexibilities through December 31, 2026, even if a clinician could also issue that prescription under one or both of the Two Final Rules.