Short answer
Most US states with medical cannabis programs allow the evaluation by video. You need three items: a qualifying condition, proof of state residency, and a government ID. A licensed provider reviews your records, enters the certification in the state registry, and you pay the state fee. The card comes by email or mail.
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As of 2025, 38 states and the District of Columbia run comprehensive medical cannabis programs, per the National Conference of State Legislatures. Rules differ by state. Some states bar telehealth for this evaluation. Some do not accept out-of-state cards.
Step 1: Check your state rules
Open your state health department page. Confirm three items:
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- Telehealth is allowed for the certification visit.
- The provider must hold a license in your state.
- Your diagnosis appears on the qualifying condition list.
Condition lists spread across cancer, HIV/AIDS, epilepsy, multiple sclerosis, Crohn's disease, glaucoma in some states, and chronic pain or PTSD in others.
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Step 2: Gather documents
- State driver's license or state ID.
- Medical records, prescription history, or a letter from a treating provider.
- Payment method. Evaluation fees run about $50 to $200. State registration fees run about $25 to $100. Several states cut fees for veterans and low-income patients.
Step 3: The video appointment
Sessions last 10 to 30 minutes. The provider asks about symptoms, prior treatments, and current medications. The provider does not write a federal prescription for cannabis. The provider certifies that you meet state criteria. If you do not meet criteria, the provider should say so. Refund policies vary by service and are set by each company.
Step 4: State registration
After the provider submits the certification, the state sends a registration link or application. You upload ID and residency proof, then pay the fee. Approval runs from same day to 30 days. Cards stay valid for 6 to 24 months. One year is standard. Renewal follows the same path, often with a shorter visit.
What an online card does not do
- Cannabis stays Schedule I under federal law. Possession on federal land, including national parks, is a federal offense.
- A card from one state does not transfer to another. Some states let visiting patients buy for a set period under their own rules.
- A card is not a prescription. Retail pharmacies do not fill it.
Cost and time
First-year total: about $100 to $300. Time: one video call plus state processing.
Sites to avoid
Skip any site that promises approval before a provider sees you. The evaluation must come from a licensed provider in your state. A site that sells a card with no consultation is not legitimate.