State & Federal Laws Related to Practicing During the COVID-19 Era

During this time, some practitioners may be looking to expand the states in which they see virtual clients, whether due to a client relocating or to fill gaps in provider availability in states that are particularly affected by the emergency. Other practitioners may be wishing to serve clients in person in a state different from the one they typically practice in.

Each practitioner must ensure they are following the requirements of a law in a distant state where they accept virtual clients from and in any state they are physically practicing in. With emergency declarations nationally and in the states, there may now be some exceptions to existing state practice laws.

A license to practice individualized nutrition counseling or medical nutrition therapy is currently mandatory in 18 states and DC. If you are seeking to provide virtual or in person services in any of these following states during this state of emergency, you should determine whether a special provision is in place to allow you to do so.

You can click on each individual state to be taken to detailed information regarding the law in that state. If there is a potential pathway to practice during this time that did not exist before that the ANA is aware of, it will be noted on that state page. These states are bolded in the list below. You should read the details of that change carefully to determine if and how they may apply to you. Note that most of these temporary or special provisions will require a practitioner to hold a license in another state.


  1. Alabama
  2. Delaware (*CNSs typically eligible for licensure)
  3. District of Columbia (*CNSs typically eligible for licensure)
  4. Florida (*CNSs typically eligible for licensure)
  5. Georgia (*Exemption for certain master’s level nutritionists)
  6. Illinois (*CNSs typically eligible for licensure)
  7. Iowa
  8. Kansas
  9. Maryland (*CNSs typically eligible for licensure)
  10. Mississippi
  11. Missouri
  12. Montana
  13. Nebraska
  14. North Carolina (*CNSs typically eligible for licensure; licensure only mandatory for medical nutrition therapy)
  15. North Dakota
  16. Ohio
  17. South Dakota
  18. Tennessee
  19. Wyoming

*A list of all state practice laws is always available from the drop-down above the map on the ANA Advocacy home page.

Some of you who may not have delivered telehealth services virtually to some or any of your clients should also know that HIPAA requirements for video conferencing services have been waived by the U.S. Department of Health and Human Services, allowing you to use previously non-compliant services during this time of emergency. Practitioners treating Medicare patients may also provide services through telehealth during this time of emergency without previous rural location restrictions. Nutrition practitioners not currently enrolled in Medicare who are interested in serving this population may determine if they qualify for the program’s temporary expedited enrollment.

Just as the situation with the pandemic itself is evolving daily, so are the laws regarding health care professional practice, economic relief, sheltering in place, etcetera. So, while this information may not be comprehensive, and is subject to change daily, the ANA wishes to provide what information we can to help practitioners stay abreast of options to serve consumers in a time when health is at the forefront of everyone’s mind. We will continue to update this as we become aware of any changes.

As we continue to advocate for nutrition to be at the forefront of healthcare, the ANA is also requesting Governors in states that have not yet taken action to waive or reduce licensure restrictions do so during this state of emergency and to ensure Medicaid and private insurers follow Medicare’s lead in covering telehealth services. Information on some actions by private insurers during this time of emergency is available here.

Additional information on these practice issues may be found on the ANA’s Immune Resilience Resource Hub page.

Please note that this information is provided solely on an informational basis and is not legal advice. As always, we encourage individual practitioners to seek the advice of a state licensed attorney for individualized legal and business related questions.