Quick answer: Yes. A psychiatric provider licensed in Maryland can evaluate you by secure video and prescribe many mental health medications, as long as you are in Maryland during the visit. Most non-controlled medications, such as antidepressants and non-stimulant ADHD medications, can be prescribed after a telehealth evaluation. Controlled substances follow stricter federal and state rules.
Who can prescribe psychiatric medication online in Maryland?
Psychiatrists and psychiatric mental health nurse practitioners (PMHNPs) can both prescribe psychiatric medication through telehealth in Maryland. The key requirement is a Maryland license. Maryland’s licensing boards are clear that you must be licensed in Maryland to treat patients located in Maryland, including through telehealth (Maryland Board of Physicians).
Since October 2015, Maryland nurse practitioners have been able to practice without a collaborating physician. That means a board-certified PMHNP can evaluate you, make a diagnosis and prescribe medication on their own. A PMHNP and a psychiatrist follow the same diagnostic criteria and treat the same conditions; the main difference is their training path.
Two practical rules apply to every online visit:
- Your location matters. Your provider must be licensed in the state where you are during the visit, so a Maryland-only practice can see you only while you are in Maryland.
- The standard of care is the same. Maryland holds telehealth to the same standard as an in-person visit, and providers must also verify your identity, get your consent and have an emergency plan.
Which medications can be prescribed online?
Most medications used to treat depression, anxiety, ADHD, bipolar disorder, OCD and PTSD are not controlled substances, so they can be prescribed after a telehealth evaluation when they are clinically appropriate.
| Medication type | Used for | Controlled substance? | Can be prescribed online? |
|---|---|---|---|
| SSRIs and SNRIs | Depression, anxiety, OCD, PTSD | No | Yes, if appropriate |
| Other antidepressants | Depression (sometimes used off-label for ADHD) | No | Yes, if appropriate |
| Non-stimulant ADHD medications | ADHD | No | Yes, if appropriate |
| Mood stabilizers and some antipsychotics | Bipolar disorder | No | Yes, if appropriate, with any required lab monitoring |
| Buspirone | Anxiety | No | Yes, if appropriate |
| Stimulants (such as Adderall) | ADHD | Yes, Schedule II | Only under federal and state controlled-substance rules |
| Benzodiazepines (such as Xanax) | Anxiety, panic | Yes, Schedule IV | Only under federal and state controlled-substance rules |
“Can be prescribed” does not mean “will be prescribed”. Your provider decides based on your diagnosis, your health history and any other medications you take. Some medications also need lab tests or closer monitoring, which your provider will arrange. For a closer look at two of the most common options, see our guide to SSRIs vs SNRIs.
What about controlled substances?
Controlled substances, such as stimulants and benzodiazepines, follow stricter rules. Under the federal Ryan Haight Act, prescribing a controlled substance through telemedicine normally requires an in-person medical evaluation first. During and since the COVID-19 public health emergency, the DEA and HHS have temporarily relaxed that requirement, and the current extension runs through December 31, 2026 (Federal Register). After that date, the rules may change again.
Maryland adds its own limits. For example, a Schedule II opioid for pain can be prescribed by telehealth only in narrow cases, such as when the provider has an ongoing relationship with the patient and has already assessed them in person (Maryland General Assembly).
Because these rules keep changing, some online practices choose not to prescribe controlled substances at all. Thrive Telepsychiatry is one of them: Thrive does not prescribe stimulants, benzodiazepines or any other controlled substances. Instead, Thrive focuses on longer-term, non-controlled options. For ADHD, that means non-stimulant ADHD treatment. For anxiety, it means options such as SSRIs, SNRIs or buspirone, described on our online anxiety treatment page.
How an online prescription works, step by step
- Book a visit. Choose a time online. Most practices ask a few questions about your symptoms, location and insurance.
- Have a full evaluation. Your first visit is usually a longer video appointment. The provider reviews your symptoms, history, current medications and goals, and may use screening tools.
- Agree on a plan. If medication is appropriate, your provider explains the options, how long they take to work and possible side effects.
- Pick up your prescription. The prescription is sent electronically to the pharmacy you choose.
- Follow up. Early follow-ups, often every 2 to 4 weeks, are used to adjust the dose and check side effects. Ongoing medication management follow-ups keep your plan on track.
An online provider who prescribes without a real evaluation, or without any follow-up, is a warning sign.
Does insurance cover online psychiatric care in Maryland?
For many Maryland plans, yes. Maryland’s Preserve Telehealth Access Act of 2025 made two protections permanent from June 1, 2025: telehealth services must be reimbursed on the same basis and at the same rate as in-person care, and audio-only calls that result in a covered service count as telehealth (Chapter 482 of 2025, Maryland General Assembly). This applies to Maryland Medicaid and state-regulated commercial plans. Self-funded employer plans and Medicare follow their own rules, so check your benefits.
What you pay still depends on your plan’s copay, coinsurance and deductible. The Maryland Health Care Commission has a short guide to understanding coverage and out-of-pocket costs for virtual care. For Thrive’s own prices, see plans and pricing or our guide to telepsychiatry costs and copays in Maryland.
How to tell if an online prescriber is legitimate
Use this checklist before you book:
- Maryland license: look the provider up on the Maryland Board of Nursing or Board of Physicians license lookup.
- A real evaluation: the first visit should cover your history and symptoms in depth, not just a short questionnaire.
- No promised prescriptions: a legitimate provider never guarantees a specific medication before evaluating you.
- Follow-up care: there should be scheduled check-ins to monitor how the medication works.
- A crisis plan: the practice should tell you what to do in an emergency, such as calling or texting 988.
- Clear pricing: you should know what a visit costs, and whether insurance applies, before you book.
Online prescribing at Thrive Telepsychiatry
Thrive Telepsychiatry is a Baltimore-based practice that has focused on telepsychiatry since 2015. Care is provided by a board-certified PMHNP licensed in Maryland, by secure video.
- Who we see: teens and adults aged 13 and up who are in Maryland at the time of each visit.
- What we treat: ADHD, anxiety, depression, bipolar disorder, panic disorder, OCD, PTSD and eating disorders, through evaluation and medication management.
- What we prescribe: non-controlled medications only. Thrive does not prescribe stimulants, benzodiazepines or other controlled substances.
- Cost: $250 for the first one-hour evaluation and $175 for each 30-minute follow-up if you self-pay. Thrive accepts Blue Cross Blue Shield and the Johns Hopkins Hospital Employee Health Plan, and there is no upfront payment (your plan’s usual copay or deductible may still apply).
Meet our provider, or book a visit to start.
FAQs
Can an online psychiatrist prescribe medication on the first visit?
Yes, if it is clinically appropriate. After a full evaluation, a Maryland-licensed provider can prescribe non-controlled medications at the first visit. Sometimes they will ask for lab results or records first.
Can a nurse practitioner prescribe psychiatric medication in Maryland?
Yes. Since October 2015, Maryland nurse practitioners have been able to practice without a collaborating physician. A board-certified PMHNP can diagnose mental health conditions and prescribe medication independently.
Can I get Adderall or Xanax from an online psychiatric provider in Maryland?
It depends on the practice and the current federal rules, which are temporarily relaxed through December 31, 2026. Many online practices, including Thrive, do not prescribe controlled substances at all and use non-controlled options instead.
Do I need to be in Maryland for my online appointment?
Yes. Your provider must be licensed in the state where you are during the visit, and Thrive can only see you while you are in Maryland. If you are travelling, check before your visit.
Will my pharmacy accept an online prescription?
Almost always. Prescriptions from telehealth visits are sent electronically to the pharmacy you choose, just like prescriptions from an office visit.
What if I’m in crisis?
Online psychiatric care is not an emergency service. If you are in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.
Sources
- Maryland Board of Physicians: Telehealth FAQs
- Maryland General Assembly: Preserve Telehealth Access Act of 2025 (HB 869 fiscal note)
- Federal Register: Fourth temporary extension of telemedicine flexibilities for controlled medications
- Maryland Health Care Commission: Understanding coverage for virtual care
- Maryland Board of Nursing
