# Telehealth IME vs In-Person Exam — What States Allow | IME Hub

> Telehealth has entered workers' comp IME-adjacent work narrowly: Texas allows MMI certification by telemedicine only for minor, non-impairment cases, and Washington's fee schedule lists specific telehealth-eligible services — most IMEs still require in-person examination.

Canonical page: https://medrecords.ai/ime-hub/compare/telehealth-vs-in-person/

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## Why impairment ratings stay in person

Rating depends on reproducible clinical measurement (ROM, DRE findings) and observation of effort — both hard to validate remotely. Texas explicitly excludes impairment-rating exams from the telemedicine allowance.

## What to check

State telehealth rules change quickly; the tracker on this hub will be refreshed quarterly. Verify current rules before scheduling.

## Key facts

- **Texas (2025):** MMI by telemedicine allowed for minor injuries, no impairment; impairment ratings excluded (28 TAC 133.30)
- **Washington (2025):** MARFS Chapter 24 lists telehealth-eligible IME-adjacent services; most IMEs in person
- **Impairment rating:** Not permitted via telemedicine in the verified rules
- **Verdict:** Telehealth is an exception, not the default

## Sources

- [28 TAC 133.30](https://regulations.justia.com/states/texas/title-28/part-2/chapter-133/subchapter-b/section-133-30-d-1/)
- [WA MARFS Chapter 24 (2025)](https://www.lni.wa.gov/patient-care/billing-payments/marfsdocs/2025/2025MARFSChapter24.pdf)

Last verified: 2026-08-15