Yes: a nurse practitioner, physician assistant or physician can open a cash-pay telemedicine hormone practice in Georgia. The gating items are a delegating physician and a Board-registered nurse protocol agreement for NPs, a Board-approved job description and supervising physician for PAs, a Georgia license for anyone treating Georgia patients, and the Composite Medical Board’s telemedicine rule, which accepts a technology-based exam in place of an in-person visit but expects diligent efforts at an annual in-person visit and never authorizes telemedicine controlled-substance prescribing for pain. This is a 2026 planning summary, not legal advice; confirm every point with the Georgia Board of Nursing, the Georgia Composite Medical Board, the Georgia Board of Pharmacy and counsel, because rules change, and the Board issued a major position statement on APP-owned practices in May 2026.
Georgia practice authority: who can run and own a telemedicine hormone practice
Nurse practitioners in Georgia
Georgia is a restricted practice state for APRNs. Every medical act an NP performs, including prescribing, is delegated by a physician through a written nurse protocol agreement under O.C.G.A. 43-34-25, which the delegating physician registers with the Georgia Composite Medical Board. The NP holds a Georgia RN license plus APRN authorization from the Georgia Board of Nursing. There is no transition-to-practice pathway to independence.
The protocol is the operating document. It names the delegating physician, who must be available for immediate consultation, lists the delegated acts and drug categories, and sets the oversight cadence under Board rule 360-32-.05: chart review at least quarterly (telecommunication is allowed), annual on-site observation of the APRN’s practice, and annual pharmacology training. House Bill 1046, effective May 1, 2024, raised the physician-to-APRN ratio; it is commonly summarized as up to eight nurse protocol agreements at one time with no more than four APRNs supervised at any one time, with practice-setting exceptions. Confirm the current numbers before relying on a collaborator’s capacity.
For a hormone practice the key detail is controlled substances. Under a protocol an NP may prescribe Schedule III through V drugs, which covers testosterone. Schedule II remains off the table except for the narrow emergency authority House Bill 557 added in July 2024, which has no role in a hormone clinic. Two items specific to this build: the protocol must document that telemedicine is within the physician’s scope and that the NP has demonstrated competence in it, and the Board’s May 7, 2026 position statement reads the statute as prohibiting an APRN or an APRN-owned company from compensating the delegating physician in any form, including through third-party physician-matching services. That statement reshapes the common NP-owned-clinic model, so get a Georgia health-care attorney’s read before you sign anything.
Physician assistants in Georgia
PAs are licensed by the Composite Medical Board and practice under a primary supervising physician with a Board-approved job description. Senate Bill 321, effective January 1, 2021, allows a physician to serve as primary supervising physician for up to four PAs and as an alternate supervisor for more. Prescribing follows the job description: Schedule III through V, with the same narrow HB 557 emergency Schedule II authority. Georgia statute has long barred a PA from employing the physician who supervises them (arrangements approved before July 1, 2009 are grandfathered), and the May 2026 position statement applies the same “genuine clinical oversight” standard to PA-owned businesses.
Physicians and the corporate practice of medicine
Georgia repealed its express corporate-practice-of-medicine statute in 1982, and the Composite Medical Board has stated it never codified a replacement. The restriction survives indirectly: the Professional Corporation Act (O.C.G.A. Title 14, Chapter 7) limits ownership of a professional corporation practicing medicine to licensed physicians, and the licensing statutes reserve the practice of medicine to licensed people. In practice a physician forms a professional corporation or an LLC rendering professional services and owns it, while any non-physician partner, investor or spouse sits in a separate management services organization (MSO) under a fair-market-value management agreement.
So who may own the practice?
A physician may own the clinical entity outright. Whether an NP or PA may own it is the open question in Georgia: some advisers read the Professional Corporation Act and the 2026 position statement as excluding non-physician ownership of an entity that practices medicine. The common structure is a physician-owned clinical entity plus an NP- or PA-owned MSO for non-clinical functions, with the delegating physician compensated by the clinical entity rather than by the APP. Have the model in writing before you file.
Georgia telehealth rules for a remote hormone practice
Licensure and patient location. Georgia treats the patient’s location as the place of practice, and Board rule 360-3-.07 requires that all treatment and consultation by electronic means be performed by Georgia-licensed practitioners. The Board does offer a telemedicine license for physicians holding a full, unrestricted license in another state (rule 360-2-.17): it is issued at the Board’s discretion, covers telemedicine only. Most out-of-state physicians use the Interstate Medical Licensure Compact for a full Georgia license instead. The Nurse Licensure Compact covers the RN license only; an APRN still needs Georgia APRN authorization and a registered protocol.
Establishing the relationship. Rule 360-3-.07 lets a provider treat a patient remotely if, among other conditions, the provider has personally examined the patient in person or can examine the patient using technology and peripherals equal or superior to an in-person examination within the standard of care. The provider must have the patient’s history available, give the patient the provider’s name, credentials and emergency contact information, give clear follow-up instructions for emergent care, and make diligent efforts to have the patient seen in person by a Georgia-licensed physician, PA or NP at least annually. The standard of care is the same as in person. The Georgia Telehealth Act (O.C.G.A. 33-24-56.4) is mainly an insurance statute that defines telemedicine, originating site and distant site; it imposes no special consent form on a cash-pay practice, though a signed telemedicine consent is sound practice for everyone.
Controlled substances and registrations. Testosterone is Schedule III, so each prescriber needs a DEA registration tied to a Georgia practice address. Georgia does not issue a separate state controlled-substance registration to licensed prescribers as the statutes are commonly read; confirm with the Board of Pharmacy rather than assuming. Rule 360-3-.07 does not authorize prescribing controlled substances for pain by telemedicine; federal telemedicine rules for controlled substances have been extended and revised repeatedly, so confirm the current federal position on in-person evaluation before prescribing. Every prescriber with a DEA number must register with the Georgia PDMP; checks are mandatory before the first prescription of a Schedule II opioid or a benzodiazepine and at least every 90 days after, documented in the chart. Testosterone is not on that list as commonly read, but checking the PDMP on every controlled prescription is sound practice.
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Entity options, registered agent and Georgia taxes
Georgia has no separate PLLC statute. Physicians choose between a professional corporation under Title 14, Chapter 7, whose shareholders, officers and directors must be licensed in the profession, and an ordinary LLC rendering professional services, which O.C.G.A. 14-11-1107 permits. Any MSO is an ordinary LLC. Entities file with the Secretary of State’s Corporations Division, name a registered agent with a physical Georgia street address, and file an annual registration between January 1 and April 1 for a modest fee.
Georgia has no franchise or margin tax. The state levies a flat income tax on individuals and corporations that House Bill 463 cut to roughly 4.99 percent for 2026; pass-through owners pay it on their share of practice income. C corporations also owe a small net worth tax. Treat these as typical figures to confirm with a Georgia CPA.
Labs and pharmacy in Georgia
Georgia generally does not permit direct-access laboratory testing: laboratories accept specimens on the order of a licensed practitioner and return results to that practitioner, so a patient cannot simply buy a hormone panel. For a cash-pay hormone clinic this is no obstacle, because the clinic orders the panel under its own lab account, the patient visits a nearby draw site, and results return to the EHR. The quirk to plan for is authority: an NP needs diagnostic studies written into the protocol, and a PA needs them in the job description.
The pharmacy detail that trips new practices up is nonresident permitting. A compounding pharmacy outside Georgia that ships to Georgia patients must hold a nonresident pharmacy permit from the Georgia Board of Pharmacy, and a compounding applicant submits a recent inspection report showing compliance with USP sterile and non-sterile standards. Ask any pharmacy for its Georgia permit number before routing the first prescription, and keep a Georgia-based 503A compounder as a backup.
Georgia at a glance
| Item | Georgia (confirm with the board or counsel) |
|---|---|
| NP practice authority | Restricted; nurse protocol agreement registered with the Composite Medical Board; Schedule III–V; quarterly chart review; no independent practice as of 2026 |
| PA model | Primary supervising physician and Board-approved job description; up to four PAs per primary supervisor; Schedule III–V |
| Corporate practice of medicine | No express statute since 1982; ownership limited through the Professional Corporation Act; physician-owned PC or LLC plus MSO; APP ownership unsettled after the May 2026 position statement |
| Telehealth registration | Full Georgia license required; discretionary telemedicine license for out-of-state physicians; IMLC member; NLC covers RN only |
| In-person exam before prescribing | Not required if a technology-based exam is equal or superior to in-person; diligent efforts at an annual in-person visit; no telemedicine controlled substances for pain |
| State controlled-substance registration | None separate for licensed prescribers as commonly read; DEA registration plus PDMP registration |
| PDMP check | Mandatory for Schedule II opioids and benzodiazepines at first prescription and every 90 days; recommended for all controlled prescriptions |
| Direct-to-consumer labs | Generally not permitted; practitioner-ordered model works normally |
| State tax | No franchise tax; flat income tax near 4.99% for 2026; corporate net worth tax; local occupation tax |
The 12-week Clinic In A Box map applied to Georgia
Clinic In A Box™ is a private, 1-on-1, done-with-you 12-week build led by an operator-mentor who runs active telemedicine clinics in the US, Colombia and Australia. The Georgia items land in the weeks shown.
- Weeks 1–4, Foundation. Niche and patient avatar; ownership model (physician-owned PC or LLC, MSO for non-physician owners) settled with counsel; entity filed and registered agent named; Georgia license or IMLC application confirmed; delegating or supervising physician identified, protocol or job description drafted with telemedicine-competence and diagnostic-ordering language, and Board registration queued; DEA, PDMP and NPI registrations; HIPAA framework, BAAs, and an EHR with Georgia consent language.
- Weeks 5–8, Operations. Intake and telemedicine consent built to rule 360-3-.07, including the required patient notices and the annual in-person-visit workflow; quarterly chart review and annual on-site observation calendared; lab account opened and Georgia draw sites mapped; compounding pharmacies vetted by Georgia nonresident permit; PDMP step built into prescribing; cash-pay service menu, subscription option and payment processing live.
- Weeks 9–12, Launch. Patient acquisition for Georgia metros and rural counties (Google Business where eligible, referrals, organic search); soft launch and first patients seen; revenue and retention tracking; a 90-day roadmap including the April 1 annual registration and the protocol review calendar.
By week 12 the practice has a compliant Georgia entity, a registered protocol or job description, a configured EHR, lab and pharmacy relationships, a priced service menu and its first patients. Read the telemedicine hormone clinic compliance guide for the national layer under these Georgia rules, and how to start a telemedicine hormone clinic for the full sequence. Georgia NPs can start with the nurse practitioner practice startup program page; physicians should read the physician telemedicine practice launch program page. The investment is $10,000 for two hours a week of direct work plus messaging between sessions; details are on the Clinic In A Box™ program page.
Frequently asked questions
Can a nurse practitioner open a telemedicine hormone clinic in Georgia without a physician?
No. Georgia requires a delegating physician and a nurse protocol agreement registered with the Composite Medical Board. An NP can build and operate the business, but the Board’s May 2026 position statement reads the statute as barring an APRN or APRN-owned company from compensating the delegating physician, so the ownership and payment structure needs a Georgia health-care attorney before launch.
Does Georgia require an in-person visit before prescribing testosterone by telemedicine?
Not necessarily. Rule 360-3-.07 allows treatment without a prior in-person visit when the provider can examine the patient with technology and peripherals equal or superior to an in-person exam, and it expects diligent efforts at an annual in-person visit. Testosterone is a federally controlled Schedule III drug, so federal telemedicine prescribing rules also apply; confirm the current federal position and the Board’s rule before prescribing.
Do I need a Georgia controlled-substance registration in addition to my DEA number?
Not as the statutes are commonly read: your Georgia license, DEA registration and Georgia PDMP registration are the set. Confirm with the Georgia Board of Pharmacy, and for NPs and PAs make sure the protocol or job description actually authorizes the schedules you intend to prescribe.
Can I treat Georgia patients from another state?
Only with Georgia licensure. Physicians can apply for the Board’s discretionary telemedicine license or, more commonly, obtain a full Georgia license through the Interstate Medical Licensure Compact. APRNs apply to the Georgia Board of Nursing for APRN authorization and need a Georgia delegating physician with a registered protocol; PAs need Georgia licensure and a Board-approved job description.
Request your free info session
The next step is a free 30-minute info session covering your credential, your Georgia licensing and delegation situation, your timeline and whether this is the right vehicle. Either way you leave with a clearer picture of what to do next. Call 844-734-2112 or use the form below.