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Some states have additional requirements beyond the federal baseline: States requiring in-person examination before initial prescription (as of April 2026): Texas (telemedicine allowed only after one in-person visit) Arkansas (telemedicine allowed only after one in-person visit) States with additional controlled substance monitoring: California, New York, Massachusetts, and 12 other states require providers to check the Prescription Drug Monitoring Program (PDMP) database before prescribing any Schedule V medication, including tirzepatide
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