In September 2025, the Court of Justice of the European Union (CJEU) issued a landmark judgment on the provision of healthcare through telemedicine within the EU. The decision clarifies the rules governing cross-border healthcare, particularly in relation to telemedicine, and sets out which laws apply to such services.
THE CONTEXT OF THE CASE
The Austrian Chamber of Dentists (Österreichische Zahnärztekammer) challenged the cooperation of an Austrian dentist with a German company that was providing orthodontic treatment (invisible braces) in Austria. The treatment combined in-person procedures with remote telemedicine. The key issue for the CJEU was whether the entire treatment should be classified as “telemedicine” and, if so, which national law would apply.
Key Conclusions of the CJEU
- Telemedicine = remote care only: According to the CJEU, only healthcare delivered remotely – without the simultaneous personal presence of the patient and provider, and exclusively through information and communication technologies – qualifies as telemedicine. If any part of the treatment is provided in person, even with the use of IT tools (for instance, taking a dental impression during a consultation), it does not qualify as telemedicine; instead, the rules governing standard healthcare apply.
- Comprehensive treatment division: Where treatment combines both face-to-face and telemedicine elements, each part must be assessed separately In-person procedures are governed by the law of the state where they are performed, while telemedicine services are subject to the law of the state in which the telemedicine provider is established.
- Law applicable to telemedicine: Telemedicine services are governed by the law of the Member State where the healthcare provider is established, rather than the law of the patient’s state of residence. This applies not only to reimbursement, but also to other aspects of healthcare provision, including regulatory authorisations, as well as quality and safety requirements.
- Professional Qualification Directive: Directive 2005/36/EC on the recognition of professional qualifications does not apply to telemedicine, unless the provider physically relocates to another Member State.
- Free movement of services: If healthcare is provided in Austria in person by an Austrian dentist, it does not qualify as a cross-border service. The EU rules on the free movement of services therefore do not apply; instead, Austrian law governs.
PRACTICAL IMPLICATIONS
This judgment marks an important step towards removing barriers to the provision of cross-border telemedicine. It confirms the principle that foreign providers of telemedicine services are subject to the law of the state in which they are established and cannot be required to comply with additional regulatory requirements imposed by the patient’s state of residence. The decision also emphasises the importance of distinguishing, in cases where treatment combines face-to-face and telemedicine elements, which parts qualify as telemedicine and which do not. For providers, this requires careful monitoring of which activities are subject to national regulation, while for patients, it ensures greater legal certainty regarding liability and standards of care.
