What is the 30/20 rule in telehealth?
The 30/20 rule is an Australian rule, introduced by Australia's Department of Health in October 2022. A doctor who bills 30 or more telephone consultations on 20 or more days within a twelve-month period is treated as practising inappropriately unless there are exceptional circumstances, and is referred for review. Video consultations are not counted.
Its purpose is to discourage high-volume phone-only practice and push doctors back toward in-person and video care. It regulates doctors, not patients, and it applies only within Australia's Medicare system. In the United States there is no equivalent federal rule.
What is the 80/20 rule for telehealth?
The 80/20 rule is the older sibling of the 30/20 rule, also from Australian Medicare. A doctor who bills 80 or more services on each of 20 or more days in a twelve-month period is presumed to be practising inappropriately and is referred to the Professional Services Review. Since July 2022, telehealth services, both phone and video, count toward the 80 services.
Again, this is a compliance threshold for Australian doctors. It is not a US law, it does not limit how many visits you can have, and it has no bearing on telehealth services in New York, Texas, Florida or any other state. If you have seen it quoted as a general telehealth rule, that was a mistake.
What are the five basic requirements for telemedicine?
There is no single statute that lists five requirements, but US state medical boards, the Federation of State Medical Boards and the major professional societies converge on the same essentials. A legitimate telemedicine visit should meet all five.
- A clinician licensed in the state where the patient is located at the time of the visit. Licensure follows the patient, not the clinician.
- Informed consent to telehealth: the patient understands they are being treated remotely, what the limits are, and agrees. Most states, including New York, require this to be documented.
- An appropriate evaluation that meets the same standard of care as an in-person visit. The clinician must gather enough history, and where needed photos, readings or tests, to make a sound decision, and must refer the patient in person when remote care is not enough.
- A secure, private platform. Health information must be protected under HIPAA and state privacy law; consumer messaging apps and email do not qualify.
- Documentation and continuity: a record of the visit, a clear treatment plan, a way for the patient to follow up, and prescriptions sent through legitimate channels such as e-prescribing to a licensed pharmacy.
Rules that do affect you as a patient in the United States
A few rules genuinely shape what a telehealth clinician can do for you.
- Location: you must be physically in a state where the clinician is licensed. Travelling across a state line can change who is allowed to treat you.
- Controlled substances: federal law and DEA rules restrict prescribing stimulants, opioids, benzodiazepines and similar medications by telehealth. Temporary flexibilities have been extended several times; many services, including Plunge Care, do not prescribe controlled substances at all.
- Insurance coverage: if you use insurance, your plan's rules decide what telehealth it covers. New York requires insurers to cover services delivered by telehealth that they would cover in person. If you pay out of pocket, the service's own pricing applies.
- Emergencies: no telehealth service is permitted to hold itself out as emergency care. If a service does not say it is not for emergencies, be cautious.
How Plunge Care meets the five requirements
Every request on Plunge Care is routed only to a clinician licensed in the state you are in. You consent to telehealth when you sign up. The clinician reviews your written history personally and asks follow-up questions in a secure thread; if remote care is not appropriate, they say so and tell you where to go. The platform is built for health information, and prescriptions, when appropriate, are sent electronically to the pharmacy you choose.
Plunge Care does not bill insurance, so Medicare billing rules such as the 7-day rule do not apply to a visit. You see the fee before you confirm, and nothing is charged until a clinician accepts your request.
