Online medical consultations are no longer just a simple video call with a practitioner. Since 2024, teleconsultation has become an activity under strict regulatory oversight, with billing rules, limits on sick leave, and platform approvals subject to renewal. Measuring what this framework concretely changes for the patient allows us to distinguish real gains from often underestimated constraints.
Regulation of teleconsultation platforms since 2024
Most articles on online consultations focus on user comfort. The legal framework that conditions this comfort is rarely detailed, even though it directly determines what the patient pays and what they can obtain.
You may also like : Everything You Need to Know About Deferred Checks at Cora: Benefits, Conditions, and Alternatives
Decree No. 2024-164 of February 29, 2024, regulates teleconsultation companies on a specific point: the patient can only be liable for the conventional amounts for the medical act itself. Additional services (referrals, reminders, document storage) must be clearly announced as optional. A platform that integrates additional fees without prior information is subject to sanctions.
A decree from July 2026 further strengthens this system. The approval of platforms is now limited to two years, then three years upon renewal, with the obligation to submit the application four months before the deadline. The ministry can revoke the approval in case of non-compliance with the Public Health Code or billing rules. The employment contracts of salaried doctors are among the elements controlled.
See also : Everything You Need to Know About What the Huawei ID Means and Its Usefulness
For the patient, this means that a platform active today may lose its approval tomorrow. Checking that the service used has up-to-date approval is not a common reflex, but it becomes relevant in a market where several actors have already been reported for questionable pricing practices, according to France Assos Santé.
A guide detailing the advantages of online medical consultations usefully complements this regulatory reading with practical benchmarks on reimbursement and care pathways.
Teleconsultation and in-office consultation: comparative table
Directly opposing the two modes of consultation helps identify situations where teleconsultation provides a real gain and those where it reaches its structural limits.
| Criterion | In-office consultation | Teleconsultation |
|---|---|---|
| Physical examination | Palpation, auscultation, complete clinical tests | Limited to visual observation (throat, skin, swelling) |
| Access time | Several days to several weeks depending on the specialty | Several minutes to a few hours |
| Sick leave | Duration based on clinical evaluation, with no specific regulatory ceiling | Limited to 3 days if the doctor is not the treating physician (since January 2024) |
| Health Insurance reimbursement | Standard coverage in the care pathway | Identical if the care pathway is respected (treating physician or referral by them) |
| Medication prescription | Without restriction | Possible, with sending a dematerialized prescription |
| Risk of under-evaluation | Reduced by direct clinical examination | Higher for pathologies requiring a physical examination |
The most structuring point concerns sick leave. Since January 2024, a sick leave prescribed in teleconsultation by a doctor other than the treating physician cannot exceed three days. This limit does not apply to in-office consultations. For a patient who needs an extended sick leave, teleconsultation alone is not sufficient.
Sick leave in teleconsultation: a concrete limit often ignored
This three-day ceiling deserves in-depth clarification, as it directly affects employees and employers. The treating physician remains the only one who can prescribe a work stoppage without duration constraints in teleconsultation. If the patient consults a doctor from a platform without a link to their treating physician, the leave will be capped at three days, with no possibility of renewal through this same channel.
The practical consequences are multiple:
- An employee suffering from a condition requiring more than three days of leave will still need to consult in person or make an appointment with their treating physician, including in teleconsultation if they offer it.
- Platforms that highlight the ease of obtaining sick leave online do not always specify this limitation, leading to disappointments when the case is processed by the CPAM.
- Renewal of an initially prescribed leave in teleconsultation by a non-treating physician is not provided for in the current system.
This rule aims to limit complacent prescriptions, but it also restricts the patient’s autonomy in legitimate situations, such as when they find themselves in a medical desert without quick access to their treating physician.
Reimbursement for teleconsultation: conditions for coverage
Reimbursement by Health Insurance works the same as for a standard consultation, provided that the coordinated care pathway is respected. This means that teleconsultation must go through the treating physician, or be carried out on their referral.
Outside the care pathway, the out-of-pocket expenses for the patient increase significantly. The mutual insurance may cover part of this gap, but not all complementary insurances cover teleconsultations conducted outside the pathway in the same way.
A point of vigilance concerns additional fees charged by certain platforms. The 2024 decree prohibits charging more than the conventional rate for the medical act. However, additional options (file storage, automated reminders, priority connection) can be offered at an extra cost, provided they are clearly identified as optional. France Assos Santé has reported questionable pricing practices persisting among several operators.
Remote monitoring of chronic diseases: what teleconsultation allows and what it does not replace
For patients with chronic conditions (diabetes, hypertension, respiratory diseases), teleconsultation facilitates regular follow-up between two in-office appointments. Adjusting treatment, analyzing biological results sent in advance, answering a question about a side effect: these exchanges do not always require a physical examination.
The limit appears as soon as a clinical change occurs. A change in blood pressure reported by the patient via a connected blood pressure monitor does not have the same reliability as a measurement taken in-office with a calibrated device. Teleconsultation complements in-office follow-up without replacing it for conditions that require periodic physical examinations.
The current regulatory framework does not set a maximum frequency for teleconsultations for chronic follow-up, but the MACSF reminds us that the physician’s responsibility remains engaged if a remote diagnosis proves insufficient where a clinical examination could have detected a complication.