Texting is one of the quickest ways for a practice to reach patients and new inquiries, and it is also regulated. The Telephone Consumer Protection Act (TCPA) and the FCC’s rules under it decide when a practice needs consent to send automated texts and calls, what kind of consent, and how fast it must honor an opt-out. This guide summarizes the federal rules for dental, eye and aesthetic practice teams, with links to the primary sources.
Not legal advice. This is a plain-language summary of federal rules as of October 2026. State laws can add stricter rules, and how the rules apply depends on your tools and messages. Check your texting setup with a lawyer who knows the TCPA before you start a campaign.
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Why it matters
The TCPA lets a person sue for actual losses or $500 for each violation, whichever is greater, and a court may award up to three times that amount if the violation was willful or knowing (47 U.S.C. 227(b)(3)). Each unwanted text can count, so a single campaign to a large list can add up quickly.
The rules depend on what the message is
The FCC’s rule, 47 CFR 64.1200, separates automated calls and texts into kinds. The rule covers texts as well as calls: its consent and revocation provisions refer to “calls or text messages”.
Marketing texts: prior express written consent
A text or call that advertises or is telemarketing, sent with an autodialer or an artificial or prerecorded voice to a mobile number, needs the person’s prior express written consent (64.1200(a)(2)). Promotions, specials and “come back for a treatment” messages usually fall here. Under 64.1200(f)(9), written consent is a signed agreement (an electronic signature counts) that names the number and clearly authorizes marketing messages by automated means, and it must tell the person that they do not have to agree in order to buy anything.
Health care messages from a HIPAA covered entity
The same paragraph carves out calls that deliver a “health care” message made by or on behalf of a HIPAA covered entity or its business associate: those need prior express consent rather than prior express written consent. Appointment reminders to your own patients may qualify; ask counsel which of your messages do. Prior express consent is still consent, so collect and record it, and be careful: a message that is really a promotion does not become a health care message by being sent to a patient.
What counts as an autodialer
In Facebook, Inc. v. Duguid (2021), the Supreme Court held that an “automatic telephone dialing system” under the TCPA must be able to store or produce numbers using a random or sequential number generator. That narrowed the federal definition, but the separate rules for artificial or prerecorded voice calls still apply, some state laws define automated systems more broadly, and whether a particular texting platform is covered is a legal question. The safe default is to have consent for every text you send.
Opt-outs: what the rule now requires
Under 64.1200(a)(10), a person can revoke consent by any reasonable method, and you may not require one exclusive way of opting out. In particular:
- A reply of “stop”, “quit”, “end”, “revoke”, “opt out”, “cancel” or “unsubscribe” revokes consent. Other wording counts too if a reasonable person would understand it as a request to stop.
- Opt-out requests must be honored within a reasonable time, no later than ten business days after you receive them.
- Under 64.1200(a)(12), you may send one confirmation text with no marketing in it. If it goes out within five minutes it is presumed to be within the person’s consent.
Calling hours and the Do Not Call registry
For telephone solicitations to residential subscribers, 64.1200(c) sets calling hours of 8 a.m. to 9 p.m. in the called person’s local time, and protects numbers on the national Do Not Call registry. A call to someone who gave prior express invitation or permission, or with whom you have an established business relationship, is not a “telephone solicitation” under 64.1200(f)(15), but keep records that show it.
A practical checklist for the front desk
- Ask for texting consent on intake and web forms with clear wording, and keep marketing consent separate from appointment reminders.
- Record who consented, when, to which number, and the exact wording they saw.
- Text only the number the person gave you, and only the kinds of messages they agreed to.
- Set up your texting tool so that stop words opt people out automatically, and log opt-outs that arrive by phone or email too.
- Keep texts free of treatment details: practice name, time, and how to reply or reschedule.
- Send campaigns during daytime hours in the patient’s time zone, and check your state’s rules, which may be stricter.
- Ask your texting vendor how its platform sends messages and how it handles consent and opt-outs, and have counsel review the setup.
Where MediLeadGen fits
Each MediLeadGen request goes to one practice only, with the person’s consent to be contacted by that practice. Check how that consent fits the kind of message you plan to send, and send marketing texts only to people who gave written consent to receive them.
See how it works for practices
Questions practices ask
Do we need consent to text patients?
For automated texts, generally yes. Marketing texts need prior express written consent under 47 CFR 64.1200(a)(2); health care messages such as appointment reminders from a HIPAA covered entity need prior express consent. Check your setup with counsel.
What counts as prior express written consent?
A signed agreement, which can be electronic, that names the phone number, clearly authorizes marketing messages by automated means, and tells the person they do not have to agree in order to buy anything (47 CFR 64.1200(f)(9)).
How fast must we honor a STOP reply?
Within a reasonable time, no later than ten business days, under 47 CFR 64.1200(a)(10). You may send one confirmation text without marketing.
What can a TCPA violation cost?
The statute allows actual losses or $500 per violation, whichever is greater, and up to three times that if the violation was willful or knowing (47 U.S.C. 227(b)(3)).
General information for practice teams, not legal advice. Check your texting and calling practices with counsel. Last reviewed October 2026.
More resources
- How to reduce consultation no-shows in a medical practice
- Speed to lead for medical practices: how fast to answer a new patient request
- Missed calls in a medical practice: how to measure them and a callback routine
- New patient phone script for dental, eye and aesthetic practices
- Email marketing for medical practices: CAN-SPAM and HIPAA basics