Payments · Telehealth7 min readUpdated November 2, 2026

Who Can Own a Telehealth Company, and Which Licenses Do You Need?

Who can own a telehealth practice, the MSO model, the licenses clinicians need by state, and what your payment processor checks before approval.

Nick Bonnassies, CMO at Tagada · checked against 13 sources

Article summary

TL;DR

Anyone can own the brand, the software and a management company. In states with the corporate practice of medicine doctrine, only licensed physicians can own the medical practice, so most founders pair a physician-owned practice with a management services organization (MSO). Clinicians need a license in each patient's state, and your processor will ask for license numbers.

Under the usual model, a physician owns the professional corporation and the founder owns the MSO; one California firm writes that "the physician owns at least 51%".
The FSMB's model policy places the practice of medicine where the patient is, so the clinician needs that state's license.
The Interstate Medical Licensure Compact covers 44 states, the District of Columbia and Guam; it speeds up state licenses, it is not a national license.
Oregon's SB 951, signed June 9, 2025, bars MSOs from having final say over "setting policies for billing and collection" and "setting prices".
Stripe says telemedicine applicants "typically need to provide items such as license numbers and information on your processes".

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On this page

This guide is part of our hub on telehealth payment processing. The general guide, for any business: how merchant account approval works.

This page explains the rules so you can talk to your lawyer and your processor with the right vocabulary. It is not legal advice: the structure itself belongs with a healthcare attorney in each state you serve.

Who can own what in a telehealth business

The answer depends on which entity you mean. A telehealth brand is usually three or four legal pieces, and the ownership rules apply to only one of them.

Entity	Who can own it	What it does
Medical practice (professional corporation, "PC")	Licensed physicians, in states that apply the doctrine1	Employs or contracts clinicians, makes every clinical decision
Management services organization (MSO)	Anyone, including non-physician founders and investors1	Brand, website, technology, marketing, billing support, under a management agreement1 2
Pharmacy	Licensed pharmacy owners, under state pharmacy rules	Dispenses and ships the medication: see online pharmacy payment processing
Brand and IP	Anyone	Name, domain, ads, customer list

Fig. 1One patient, four legal pieces

approved declined or closed routing step

PatientFinds the brand
throughBrandName, domain, ads; run by the MSO
consultationMedical practicePhysician-owned PC, clinical decisions
prescriptionPharmacyDispenses and ships the medicationApproved

The MSO runs brand, technology and billing support under a management agreement with the practice.

Illustrative example.

The doctrine is a state rule, and it varies a lot. Some states enforce it strictly, others barely at all1. A multi-state brand typically ends up with a physician-owned practice in each strict state1.

Watch out

A practice owned by a physician on paper, with the MSO deciding everything, is what recent laws aim at. Who sets prices, who controls billing and who decides clinical protocols are the questions they ask (next section)7 9.

If you'd rather not assemble the practice, clinicians and pharmacy yourself, some brands launch on a telehealth stack with storefront, doctors, pharmacy and payments and keep only the brand and the ads.

The licenses a telehealth brand needs

Licenses attach to people and to the practice, not to the website. Here is what a processor or a platform will expect to exist before you treat a patient.

License or registration	Who holds it	Why
Medical license in the patient's state	Each prescribing clinician	Medicine is practiced where the patient is3
Compact license (IMLC)	Physicians who qualify, as an optional faster route	44 states, the District of Columbia and Guam4
Professional corporation registration	The medical practice, in its state	Required in states that apply the doctrine1
Controlled substances rules	Prescribers, if any controlled substance is involved	Federal law requires an in-person evaluation, with temporary exceptions5 6
Pharmacy license	The dispensing pharmacy, not the brand	State pharmacy boards: see online pharmacy

Watch out

As of November 2, 2026, the DEA's temporary telemedicine flexibilities for controlled substances run through December 31, 20266. No permanent rule had been published on that date. Check the Federal Register before you rely on them.

State-by-state differences in licensing are covered in telehealth laws by state.

The rules are tightening in 2025 and 2026

Three recent texts move in the same direction: less control for non-physician owners over money and medicine.

Fig. 2Three texts, five dates

June 9, 2025Oregon SB 951 signed
October 6, 2025California SB 351 signed
January 1, 2026California in force; Oregon for new PCs and MSOs
September 16, 2026HR 10444 introduced, not passed
January 1, 2029Oregon for existing PCs and MSOs

Oregon applies first to new entities, then to existing ones.

Foley & Lardner on Oregon SB 951 and California SB 351; McDermott Will & Schulte on HR 10444.

Text	Status	What it changes
Oregon SB 951	Signed June 9, 2025; applies from January 1, 2026 to newly formed PCs and MSOs, and from January 1, 2029 to existing ones7	MSOs can't hold final authority over billing and collection policies, prices or payer contracts; limits on shared officers and ownership7
California SB 351	Signed October 6, 2025; in force January 1, 20268	Private equity and hedge funds involved with a practice can't interfere with clinical judgment, with limits on their control over billing and coding8
HR 10444, Stop Corporate Takeovers of Physicians Act of 2026	Introduced September 16, 2026; not passed9	Would create a federal ban on the corporate practice of medicine and limit MSO control over billing and payer contracting9

Oregon's law includes a telemedicine exception for entities with no Oregon patient-care location, as summarized by Foley7. Read it with counsel: exceptions are narrow.

What your payment processor sees

Your processor underwrites one legal entity. It wants that entity's documents to match what the patient sees at checkout.

Stripe restricts "Telemedicine and telehealth services" and reviews each case: applicants "typically need to provide items such as license numbers and information on your processes"10. Other processors ask for the same kind of file.

Before you apply, decide and document:

Which entity is the merchant
The practice, the MSO collecting on its behalf, or a platform. One firm notes that routing all customer payments through the MSO has become common2; in Oregon, the practice must keep final say over billing and collection policies7.
The license list
Clinician names, license numbers and states covered, matching the states you sell to.
The management agreement
Underwriters may ask who provides care and who gets paid for what.
A consistent descriptor and site
The company name in your terms, on the receipt and on the card statement should match the merchant on file.
What you sell
A consult, a membership or the medication itself: each can change the merchant code and the review. See consultation and medication billing.

Your approval file is covered step by step in how to get a telehealth merchant account approved.

How Tagada helps

Payments for the structure you choose

TagadaPay runs "enhanced review for regulated verticals"13: each file is still underwritten, whatever the structure behind the brand.

Fraud and security: "Native 3DS2, device intelligence, and rules engine: approve real customers, block the rest"
Routing across TagadaPay and processors such as Stripe, NMI and Airwallex, with a cascade to another processor when one is down or times out
Your vault, portable: "Switch processors without re-onboarding customers"

Tagada follows Visa and Mastercard rules and the laws that apply to payments.

On the operations side: the telehealth tech stack. Don't want to build the clinical side? Tagada Rx brings clinicians "licensed in the patient's state" and a licensed US pharmacy11; in its "Merchant of Record" mode, Tagada is the seller of record12. US patients only, by selection.

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Updated on November 2, 2026

Nick Bonnassies

CMO at Tagada

CMO at Tagada. Before Tagada, Nick built direct-to-consumer brands that generated over $115M in sales, raised over $25M in crowdfunding and sold two of them. He also works as a fractional CMO on marketing operations and AI systems.

Frequently asked questions

Can a non-physician own a telehealth company?

Yes, but usually not the medical practice itself in states that apply the corporate practice of medicine doctrine. The common model is a non-physician-owned MSO that runs the brand and technology, under a management agreement with a physician-owned practice. Rules vary by state, so confirm with a healthcare attorney.

What licenses do I need to start a telehealth business?

Each prescribing clinician needs a license in every state where patients are located. The practice registers as a professional corporation where required. If you sell medication, the dispensing pharmacy holds its own license. Controlled substances add federal rules, with temporary DEA flexibilities through December 31, 2026.

Is there a national telehealth license?

No. The Interstate Medical Licensure Compact offers "a voluntary, expedited pathway to licensure" in 44 states, the District of Columbia and Guam. Each state still issues its own license.

Can the MSO collect patient payments?

Often, yes: one firm notes that payments flowing through the MSO have become common. New laws limit how much control the MSO has over billing policies and prices, for example in Oregon. Your processor will want to know which entity is the merchant and why.

Does my processor check clinician licenses?

Stripe says telemedicine applicants "typically need to provide items such as license numbers and information on your processes". Expect underwriters to compare the states your clinicians cover with the states you sell to.

Sources

Checked November 2, 2026

TagadaPay

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