--- title: "What Is Synchronous Telehealth? Live Video Visits Explained" description: "Synchronous telehealth is a live, real-time visit between patient and provider. When a rule requires one, how it differs from async, and how Cuvo runs it." canonical: "https://cuvo.co/glossary/synchronous-telehealth" last-updated: "Oct 26, 2026" --- **Definition:** Synchronous telehealth is care delivered in real time, with the patient and a licensed provider at different locations communicating live, usually by two-way audio and video and in limited cases by audio only. # What is synchronous telehealth? A live video visit costs a patient a scheduled slot, and some programs cannot run without one. Federal controlled substance rules call for real-time care, and so does a treating provider who wants to see a patient live. Cuvo Health includes live video visits on every plan alongside asynchronous consults, so a brand can run both from one storefront. Published Oct 26, 2026. Facts reviewed Oct 26, 2026. Synchronous telehealth is care delivered in real time: the patient and a licensed provider are at different locations but present at the same moment, usually on two-way audio and video. Medicare's rule calls the technology an interactive telecommunications system, meaning audio and video equipment permitting two-way, real-time interactive communication, with audio-only allowed in limited cases for patients at home (42 CFR 410.78(a)(3)). It matters most where a rule requires a live encounter, and the clearest federal example is a controlled substance prescribed by telemedicine. On Cuvo Health, live video visits are included on every plan alongside asynchronous consults, at $25 per completed consult. **At a glance** - What it is: A live, real-time encounter between patient and provider - Federal definition: Interactive telecommunications system, 42 CFR 410.78(a)(3) - Formats: Two-way audio and video; audio-only in limited cases - When required: Controlled substances by telemedicine under 21 CFR 1307.41, through December 31, 2026 - On Cuvo: Live video visits on every plan, routed to providers licensed where the patient is **Where a synchronous visit is required or chosen** | Situation | Why it is synchronous | Source | | --- | --- | --- | | **Controlled substance by telemedicine, no prior in-person exam** | The prescription must follow a communication over an interactive telecommunications system | 21 CFR 1307.41(c)(2) | | **Medicare telehealth services** | Part B pays for telehealth furnished by an interactive telecommunications system | 42 CFR 410.78(b) | | **The provider's clinical judgment** | The treating provider decides the case needs a live visit | Standard of care | ## 01. Why does synchronous telehealth matter for a telehealth brand? Because some of the strongest consumer categories cannot run without it. Testosterone is a Schedule III controlled substance, and under the DEA and HHS telemedicine flexibilities a practitioner may prescribe it without an in-person evaluation only after a real-time communication over an interactive telecommunications system (21 CFR 1307.41(c)(2)). That section expires at the end of December 31, 2026 (21 CFR 1307.41(a)), and the rule that follows it is tracked in Cuvo's DEA telemedicine post. A brand that adds hormone therapy to a weight loss line is adding a live-visit program. ## 02. How is synchronous different from asynchronous telehealth? Timing is the whole difference. California's telehealth statute draws the line cleanly: a synchronous interaction is a real-time interaction between a patient and a provider at a distant site, asynchronous store and forward is the transmission of the patient's medical information to the provider, and telehealth includes both (Business and Professions Code section 2290.5(a)(1), (a)(5) and (a)(6)). Both are clinical encounters documented in the same chart. A synchronous visit costs a scheduled slot for both parties; an asynchronous review does not. ## 03. Does audio-only count as synchronous telehealth? Audio-only is real-time, so it is synchronous, but rules that require real-time care do not always accept it. Medicare's definition allows two-way, real-time audio-only communication for a patient at home only when the practitioner can use video and the patient cannot or does not consent to it (42 CFR 410.78(a)(3)). Whether audio-only satisfies a particular prescribing rule depends on that rule's text, so programs prescribing controlled substances plan on video. ## 04. How does Cuvo run synchronous visits? Live video visits are included on Launch, Grow, Enterprise and Cuvo Prescribe. The patient's location is captured at intake and the visit routes only to a provider licensed where the patient is, drawn from 300+ board-certified MDs, NPs and PAs across all 50 states, DC, Puerto Rico, Guam and the US territories, available 24 hours a day. For testosterone, Cuvo pairs the visit with DEA-verified prescribers, labs through Labcorp and Quest, and EPCS on Grow and above. ## Frequently asked questions **Q: What is synchronous telehealth?** A: Synchronous telehealth is a live, real-time encounter between a patient and a licensed provider at a different location, usually by two-way audio and video. On Cuvo, live video visits are included on every plan. **Q: Synchronous vs asynchronous telehealth: what is the difference?** A: Synchronous care happens in real time; asynchronous care is a provider's later review of information the patient submitted. On Cuvo, both are included on every plan at $25 per completed consult, and the rule in force and the provider decide which a case uses. **Q: When is a live video visit required for telehealth?** A: Federally, when a controlled substance such as testosterone is prescribed by telemedicine without a prior in-person evaluation, under the DEA flexibilities in force through December 31, 2026, and whenever a state rule in force or the treating provider requires one. On Cuvo, live video is included on every plan for those cases, and testosterone runs on Grow, Enterprise and Cuvo Prescribe, where EPCS is included. **Q: Is a phone call synchronous telehealth?** A: An audio-only call is real-time and therefore synchronous, but Medicare and other rules accept it only in limited cases, so it is not a substitute for video wherever video is required. On Cuvo, controlled substance programs such as testosterone run on live video visits. **Q: Does a telehealth brand need synchronous visits?** A: A brand that prescribes a controlled substance, such as testosterone, does, and any brand needs them for cases a provider wants to see live. Cuvo Health includes live video visits and asynchronous consults on every plan, so a brand adds the modality without adding a vendor; a testosterone program also needs EPCS, included on Grow, Enterprise and Cuvo Prescribe. **Related pages** - [Async vs sync telehealth](/blog/async-vs-sync-telehealth): Which modality fits each category - [Asynchronous telehealth](/glossary/asynchronous-telehealth): Store and forward, defined - [DEA telemedicine flexibilities in 2026](/blog/dea-telemedicine-flexibilities-2026): The live-visit rule for controlled substances - [Hormone therapy and TRT](/solutions/hormone-therapy-trt): A live-visit program on Cuvo - [Telehealth glossary](/glossary): Every term a telehealth founder meets Canonical page: https://cuvo.co/glossary/synchronous-telehealth