States That Mandate E-Prescribing for Every Script, and the Waiver
Summary
Whether every prescription must be issued electronically is a question of state law, and the answer varies: New York and California require it for all prescriptions, not only controlled substances, while other states draw the line elsewhere. Read your own state's prescribing statute. Federal DEA rules permit electronic prescribing of controlled substances and do not compel it. Both leave a route for a practice whose software is not live yet: New York grants a waiver for up to a year, California takes an annual registration.
By Gale Editorial · Updated 2026-09-01. Every figure cited to a dated source. How we write.
Does your state's mandate reach every prescription or only controlled substances?
That depends on the state, and the two possible answers are far apart. New York requires that a prescription be issued as an electronic prescription, with the exceptions written into the same statute 1Ref 1New York State Legislature (2026).New York Public Health Law § 281 — Electronic prescribing.New York's statutory rule that a prescription must be issued as an electronic prescription, and its statutory exception categories including veterinarian, temporary technological or electrical failure, a commissioner-granted waiver, patient timeliness, an out-of-state dispensing pharmacy, and a low-volume certification.. California requires a prescription to be issued as an electronic data transmission prescription, subject to eleven exemptions 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment.. Both reach every drug, the controlled ones included. What your own state requires is a separate question with its own answer.
The lookup is short. A state's e-prescribing rule sits in its own code, usually under the public health or the pharmacy title, and the agency that enforces it publishes a practitioner page for it. New York's rule is Public Health Law section 281 1Ref 1New York State Legislature (2026).New York Public Health Law § 281 — Electronic prescribing.New York's statutory rule that a prescription must be issued as an electronic prescription, and its statutory exception categories including veterinarian, temporary technological or electrical failure, a commissioner-granted waiver, patient timeliness, an out-of-state dispensing pharmacy, and a low-volume certification., worked out in 10 NYCRR Part 80; California's is Business and Professions Code section 688, as amended by AB 852 and effective January 1, 2023 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment.. Read the exception list in the same section as the mandate, because that is where a new practice learns whether it has to file anything at all.
But a neighboring state's rule tells you nothing about yours. States differ on whether the mandate reaches only controlled substances or every prescription, on what excuses a paper prescription, and on whether relief is granted or merely registered. The two states worked through below are here because their statutes and their forms are public and specific. They are the two shapes the relief takes, not a national rule.
The federal rules are a separate question, and they do not require an all-electronic practice
Nothing in a DEA registration requires a prescriber to send prescriptions electronically. DEA's own answer is that its regulations permit electronic prescribing of controlled substances and do not mandate it, and that a practitioner who chooses to do it must be identity-proofed, hold a two-factor authentication credential issued only to an identity-confirmed individual, and use an application meeting 21 CFR part 1311 3Ref 3U.S. Drug Enforcement Administration, Diversion Control Division (2026).Electronic Prescriptions for Controlled Substances (EPCS) — Questions & Answers.The federal DEA position that its regulations permit but do not mandate electronic prescribing of controlled substances, and the preconditions for a practitioner who chooses to do it: identity proofing, a two-factor authentication credential issued only to an identity-confirmed individual, and an application meeting 21 CFR part 1311.. The compulsion in an all-prescriptions mandate comes from the state.
One federal rule does set a threshold, and it is narrower than it sounds. Under Medicare Part D, beginning January 1, 2021, a prescriber must conduct at least 70 percent of their Schedule II through V controlled-substance prescribing for Part D drugs electronically, with long-term care carved out until January 1, 2028 4Ref 4Centers for Medicare & Medicaid Services (Code of Federal Regulations) (2026).42 CFR 423.160 — Standards for electronic prescribing.The Medicare Part D rule at paragraph (a)(5): the at-least-70-percent electronic prescribing threshold for Schedule II through V controlled substances that are Part D drugs beginning January 1, 2021, the long-term-care carve-out until January 1, 2028, and the three exemptions (100 or fewer such prescriptions per calendar year, a declared emergency or disaster address, and a CMS-approved waiver).. Three exemptions sit in the same paragraph: 100 or fewer such prescriptions in a calendar year on CMS claims data, an address in an area with a declared emergency or disaster, and a CMS-approved waiver for a prescriber unable to prescribe controlled substances electronically for reasons beyond their control 4Ref 4Centers for Medicare & Medicaid Services (Code of Federal Regulations) (2026).42 CFR 423.160 — Standards for electronic prescribing.The Medicare Part D rule at paragraph (a)(5): the at-least-70-percent electronic prescribing threshold for Schedule II through V controlled substances that are Part D drugs beginning January 1, 2021, the long-term-care carve-out until January 1, 2028, and the three exemptions (100 or fewer such prescriptions per calendar year, a declared emergency or disaster address, and a CMS-approved waiver)..
That threshold counts Part D controlled substances and nothing else. It says nothing about the antibiotic sent on paper, and nothing about a cash-pay panel. A federal exemption does not lift a state mandate, and a state waiver does not satisfy Part D.
Can a new solo practice get a waiver in New York?
Yes, on one of three showings, and never for longer than a year. New York's commissioner may grant a waiver where a practitioner's ability to issue an electronic prescription is unduly burdened by economic hardship, technological limitations not reasonably within the practitioner's control, or another exceptional circumstance the practitioner demonstrates 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement.. The showing goes in as a sworn statement of facts. A granted waiver runs for a specified period and in no event more than one year 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement..
A waiver can be renewed with an updated statement of facts 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement.. The filing is the Electronic Prescribing Waiver, an online application reached through the Health Commerce System, the same portal a New York practitioner already uses for the Prescription Monitoring Program; a paper form can be requested by phone from the Bureau of Narcotic Enforcement 6Ref 6New York State Department of Health, Bureau of Narcotic Enforcement (2022).Waiver Request for Electronic Prescribing.What New York's Electronic Prescribing Waiver application asks for and how it is filed: online through the Health Commerce System with a paper form available by request, the waiver-site address, reasons and supporting documentation, and the department's example of documenting when electronic prescribing is expected to be in place and operational.. The application asks for the address of the site the waiver would cover, the reasons, and supporting documentation. Among the department's own examples of that documentation is when electronic prescribing is expected to be in place and operational 6Ref 6New York State Department of Health, Bureau of Narcotic Enforcement (2022).Waiver Request for Electronic Prescribing.What New York's Electronic Prescribing Waiver application asks for and how it is filed: online through the Health Commerce System with a paper form available by request, the waiver-site address, reasons and supporting documentation, and the department's example of documenting when electronic prescribing is expected to be in place and operational..
That example is the one a not-yet-live practice is answering. Which of the three grounds fits an install that has not gone live is the practitioner's showing to make and the commissioner's to decide, and the department is asking for a date either way.
Registration is a separate duty from the waiver. A New York practitioner who does e-prescribe registers the certified e-prescribing application with the Bureau of Narcotic Enforcement 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement., so a practice that files for a waiver while its system is being certified is running two tracks at once.
California registers an exemption instead of granting a waiver
California does not grant waivers for this. The relief in Business and Professions Code section 688 is a registration the prescriber files annually with the California State Board of Pharmacy, stating that they practice in an area with a declared emergency or disaster, that they issue 100 or fewer prescriptions per calendar year, or that they are unable to issue electronic prescriptions due to circumstances beyond their control, and the prescriber keeps documentation of the qualifying circumstances 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment..
The difference is in who carries the burden. A New York waiver is an application somebody grants or denies, and the file closes when the commissioner acts. A California registration is an assertion the prescriber makes, renews every year, and has to be able to support afterwards from their own documentation.
Subdivision (e) also carries eleven exemptions covering situations no registration touches, and subdivision (f) adds a records duty: where a controlled-substance prescription is issued other than electronically, the reason is documented in the patient's record as soon as practicable and no later than 72 hours after the end of the technological or electrical failure that prevented electronic transmission 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment.. That clock runs from the end of the failure, not from the next chart review.
The section has been in force since January 1, 2023 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment.. Statutes in this area move, so read the current text on the legislature's own site before relying on any summary of it, this one included.
The exceptions that need no application
Some exceptions need no application at all, and they sit in the statute beside the mandate. New York's categories cover a veterinarian, a temporary technological or electrical failure, a waiver granted by the commissioner, a prescription the patient could not obtain in a timely manner electronically, a prescription dispensed by a pharmacy located outside the state, and a certification by a low-volume prescriber 1Ref 1New York State Legislature (2026).New York Public Health Law § 281 — Electronic prescribing.New York's statutory rule that a prescription must be issued as an electronic prescription, and its statutory exception categories including veterinarian, temporary technological or electrical failure, a commissioner-granted waiver, patient timeliness, an out-of-state dispensing pharmacy, and a low-volume certification..
Using one of them does not mean telling anyone. The Department of Health does not require a practitioner to notify it when a listed exception is used, and no waiver request is necessary for those exceptions; the practitioner indicates the non-electronic prescription in the patient's health record instead 7Ref 7New York State Department of Health, Bureau of Narcotic Enforcement (2016).Practitioner Notification Process - Use of an Electronic Prescribing Exception.That using a listed New York exception no longer requires notifying the Department of Health and needs no waiver request, and that the practitioner must instead indicate the non-electronic prescription in the patient's health record.. California's subdivision (e) list works the same way for its own categories, with the annual Board of Pharmacy registration attached to only one of them 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment..
So the question on a bad afternoon is which file carries the answer: the exception list, when the connection drops mid-transmission, or the waiver, when the practice has no certified system yet.
Where this belongs in a new practice's setup order
Put the transmission rule into the setup order after DEA approval, before the first patient. The credential that signs an electronic controlled-substance prescription is issued only to an identity-confirmed individual and rests on identity proofing and an application meeting the federal part 1311 requirements 3Ref 3U.S. Drug Enforcement Administration, Diversion Control Division (2026).Electronic Prescriptions for Controlled Substances (EPCS) — Questions & Answers.The federal DEA position that its regulations permit but do not mandate electronic prescribing of controlled substances, and the preconditions for a practitioner who chooses to do it: identity proofing, a two-factor authentication credential issued only to an identity-confirmed individual, and an application meeting 21 CFR part 1311.. The state layer sits on top of that: registration of the application with the bureau in New York 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement., an exemption registration in California where one of the listed circumstances applies 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment..
| Relief | Who acts on it | What it rests on | How long it lasts |
|---|---|---|---|
| New York Electronic Prescribing Waiver | The commissioner grants or denies it | Economic hardship, technological limitations outside the practitioner's control, or another exceptional circumstance, sworn to 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement. | A specified period, in no event more than one year, renewable 5Ref 5New York State Department of Health (2013).Section 80.64 - Who may issue.New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement. |
| California section 688 exemption registration | The prescriber registers with the State Board of Pharmacy | Declared emergency or disaster area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, documented 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment. | Filed annually 2Ref 2California State Legislature (2022).California Business and Professions Code § 688.California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment. |
| Medicare Part D EPCS exemption | CMS, from claims data or an approved waiver | 100 or fewer Part D controlled-substance prescriptions in the calendar year, a declared emergency or disaster address, or an approved waiver 4Ref 4Centers for Medicare & Medicaid Services (Code of Federal Regulations) (2026).42 CFR 423.160 — Standards for electronic prescribing.The Medicare Part D rule at paragraph (a)(5): the at-least-70-percent electronic prescribing threshold for Schedule II through V controlled substances that are Part D drugs beginning January 1, 2021, the long-term-care carve-out until January 1, 2028, and the three exemptions (100 or fewer such prescriptions per calendar year, a declared emergency or disaster address, and a CMS-approved waiver). | As set by 42 CFR 423.160 4Ref 4Centers for Medicare & Medicaid Services (Code of Federal Regulations) (2026).42 CFR 423.160 — Standards for electronic prescribing.The Medicare Part D rule at paragraph (a)(5): the at-least-70-percent electronic prescribing threshold for Schedule II through V controlled substances that are Part D drugs beginning January 1, 2021, the long-term-care carve-out until January 1, 2028, and the three exemptions (100 or fewer such prescriptions per calendar year, a declared emergency or disaster address, and a CMS-approved waiver). |
Two adjacent questions sit outside this one. Whether your prescribing authority runs through a collaborative agreement or protocol is a state question of its own, and a state can require one while saying nothing about how a prescription is transmitted. And an e-prescribing mandate governs the transmission; what is prescribed stays where it was, with the prescriber.
Neither the New York waiver page nor the California statute states a fee or a decision time for any of this, so treat both as unknown and file early. The one date a new practice can put in writing is the one the waiver application already asks for: when electronic prescribing is expected to be in place and operational 6Ref 6New York State Department of Health, Bureau of Narcotic Enforcement (2022).Waiver Request for Electronic Prescribing.What New York's Electronic Prescribing Waiver application asks for and how it is filed: online through the Health Commerce System with a paper form available by request, the waiver-site address, reasons and supporting documentation, and the department's example of documenting when electronic prescribing is expected to be in place and operational..
Common questions
Run your practice on Gale
The software is free. Gale earns one flat 3.5% all-in per paid transaction — only on transactions that actually pay. No subscription, no setup fee, no network cut.
Start or manage a practice →References
- 1.New York State Legislature (2026). New York Public Health Law § 281 — Electronic prescribing. New York State Senate, Consolidated Laws of New York, Public Health (PBH). linkNew York's statutory rule that a prescription must be issued as an electronic prescription, and its statutory exception categories including veterinarian, temporary technological or electrical failure, a commissioner-granted waiver, patient timeliness, an out-of-state dispensing pharmacy, and a low-volume certification.
- 2.California State Legislature (2022). California Business and Professions Code § 688. California Legislative Information (Amended by Stats. 2022, Ch. 518, Sec. 1 (AB 852), effective January 1, 2023). link ✓California's requirement that a prescription be issued as an electronic data transmission prescription, the eleven exemptions in subdivision (e) and the annual State Board of Pharmacy registration in (e)(11) for a declared emergency area, 100 or fewer prescriptions per calendar year, or inability beyond the prescriber's control, and the 72-hour record-documentation duty in subdivision (f); also the January 1, 2023 effective date of the AB 852 amendment.
- 3.U.S. Drug Enforcement Administration, Diversion Control Division (2026). Electronic Prescriptions for Controlled Substances (EPCS) — Questions & Answers. DEA Diversion Control Division (undated FAQ page; retrieved 2026-09-01). link ✓The federal DEA position that its regulations permit but do not mandate electronic prescribing of controlled substances, and the preconditions for a practitioner who chooses to do it: identity proofing, a two-factor authentication credential issued only to an identity-confirmed individual, and an application meeting 21 CFR part 1311.
- 4.Centers for Medicare & Medicaid Services (Code of Federal Regulations) (2026). 42 CFR 423.160 — Standards for electronic prescribing. eCFR (Electronic Code of Federal Regulations), Title 42, Chapter IV, Subchapter B, Part 423, Subpart D. link ✓The Medicare Part D rule at paragraph (a)(5): the at-least-70-percent electronic prescribing threshold for Schedule II through V controlled substances that are Part D drugs beginning January 1, 2021, the long-term-care carve-out until January 1, 2028, and the three exemptions (100 or fewer such prescriptions per calendar year, a declared emergency or disaster address, and a CMS-approved waiver).
- 5.New York State Department of Health (2013). Section 80.64 - Who may issue. New York Codes, Rules and Regulations, Title 10, Part 80 (effective date 03/27/2013). link ✓New York's waiver mechanics: the three grounds (economic hardship, technological limitations not reasonably within the practitioner's control, other exceptional circumstance), the sworn statement of facts, the maximum term of one year with a renewal path, and the duty to register a certified e-prescribing application with the Bureau of Narcotic Enforcement.
- 6.New York State Department of Health, Bureau of Narcotic Enforcement (2022). Waiver Request for Electronic Prescribing. New York State Department of Health (page revised February 2022). link ✓What New York's Electronic Prescribing Waiver application asks for and how it is filed: online through the Health Commerce System with a paper form available by request, the waiver-site address, reasons and supporting documentation, and the department's example of documenting when electronic prescribing is expected to be in place and operational.
- 7.New York State Department of Health, Bureau of Narcotic Enforcement (2016). Practitioner Notification Process - Use of an Electronic Prescribing Exception. New York State Department of Health (revised September 30, 2016). link ✓That using a listed New York exception no longer requires notifying the Department of Health and needs no waiver request, and that the practitioner must instead indicate the non-electronic prescription in the patient's health record.
https://www.gale.care/for-providers/pq-eprescribing-mandate-waiver-new-solo · 7 sources. Competitor details are cited to dated public sources and maintained as they change; figures are estimates, not commitments. Synthetic demonstration.