Telehealth businesses more than doubled their applications for LegitScript's telemedicine certification over the past year, the Portland, Oregon company said on September 22, 2026, a rise of 101% that outpaced the 59% increase recorded across all of its certification programmes.

In Short

LegitScript checks health businesses, and Google, payment firms and other platforms rely on that check before letting those businesses run ads or take card payments in many countries. The company said on September 22, 2026 that requests for the check from telehealth providers roughly doubled in a year, which points to more health businesses lining up to advertise and take payments online. Its own figures show approvals growing more slowly than requests, and for health advertisers in those countries, no approval means no ads. One number does not line up: the release says addiction treatment certifications rose 80%, while the email sent with it says addiction treatment applications rose 58%.

What LegitScript reported

The figures arrived in a release dated September 22, 2026, the opening day of the Behavioral Health Tech Conference in Nashville, Tennessee, where LegitScript said it would be at booth #730 from September 22 to 24. According to LegitScript, applications across its certification programmes rose 59% over the past year, and applications for telemedicine certification specifically rose 101%.

Completed certifications grew too, though more slowly. Total certifications were up 43% over the same period, according to the company, while telemedicine certifications were up 80%. LegitScript also said it had recently passed 10,000 certified websites across healthcare, addiction treatment and other highly regulated industries. No date was given for when that threshold was crossed.

The company, which describes itself as the leader in merchant and product certification and monitoring across advertising, e-commerce and payments, attributed the growth to a change in the shape of telehealth. According to LegitScript, virtual care has expanded into a much broader ecosystem of providers, infrastructure platforms and specialty healthcare companies, giving businesses new ways to reach patients.

Scott Roth, chief executive of LegitScript, framed the shift as one of timing. "We're seeing companies think about certification earlier than they used to," Roth said. "When you're building a business, you want to know from the start that you'll be able to advertise, accept payments, and reach the people you serve. More companies are recognizing that compliance needs to be part of that foundation."

The gap between requests and approvals

Set side by side, the four percentages tell a consistent story. In both categories the company disclosed, certifications grew more slowly than applications: 43% against 59% overall, a gap of 16 percentage points, and 80% against 101% for telemedicine, a gap of 21 points.

The release does not explain the difference. Several mechanisms could produce it. An application filed late in the measurement period may not have cleared review by its end, which would show up as lag rather than rejection. Some applications are refused or withdrawn. A growing queue would produce the same pattern. Without absolute counts, none of these readings can be tested, and the release provides none apart from the 10,000 websites figure.

Other gaps in the disclosure matter for anyone trying to size the trend. LegitScript does not say which twelve months "the past year" covers. It gives no split by country, although its telehealth certification functions as an advertising prerequisite in markets as different as the United States, India and South Africa. It publishes no processing times, approval rates or pricing.

The unit of measurement also shifts between releases. When LegitScript and Google expanded their partnership to pharmacies in India and telemedicine providers in New Zealand on April 8, 2026, the company reported a 103% increase in certified healthcare organisations over the preceding year. The September release counts certifications and certified websites instead. One organisation can hold certification for several websites, so the April and September figures cannot be read as points on the same line. Is the growth rate accelerating, holding or slowing? The public numbers do not say.

An addiction treatment figure that does not reconcile

The most specific claim about behavioural health appears in two versions. The email distributed with the release, sent on LegitScript's behalf, stated that applications for Addiction Treatment Certification rose 58% over the past year. The body of the release says instead that Addiction Treatment Certifications were up 80%.

Both could be accurate, since one figure counts applications and the other counts completed certifications. That reading carries an oddity of its own. If both numbers hold, addiction treatment would be the only category in the disclosure where certifications grew faster than applications, the reverse of the pattern in the overall and telemedicine figures. The 80% figure is also identical to the telemedicine certification growth rate stated one paragraph earlier in the same release, which leaves open the possibility of a transcription error. Neither document reconciles the two numbers, and PPC Land has not independently verified either.

Behavioural health as the stated driver

LegitScript presented behavioural health as the clearest example of how virtual care models are changing. According to the company, mental health providers are adding substance use disorder treatment services, substance use disorder providers are expanding into broader behavioural health, and new models are emerging that address both.

That overlap has advertising consequences. Addiction treatment has long been one of the most tightly gated health categories on the major platforms. When Google opened advertising to Canadian addiction treatment centres holding LegitScript certification in early 2025, PPC Land reported that LegitScript served as the exclusive verification partner for addiction treatment advertising on Google, Meta and Microsoft. A mental health practice that adds substance use services moves into that gated category, with a separate credential attached.

Jaylene Kunze, chief operating and financial officer of LegitScript, described the regulatory side of that expansion. "As providers add services, launch new models, and enter new markets, they can also encounter different regulatory requirements, advertising policies, and payment considerations," Kunze said. "Addressing those requirements earlier can help make compliance part of the growth process rather than something businesses must revisit later."

The release attaches a market projection to the trend: behavioural health growing from $185.03 billion in 2025 to $332.77 billion by 2034. No research source is identified. On PPC Land's arithmetic, the projection implies a compound annual growth rate of about 6.7% over nine years, or an increase of roughly 80% across the period. The pattern is familiar from LegitScript's previous announcement. When the company brought its certification to telemedicine providers in Spain in July 2026, it cited an 11.6% compound annual growth rate for Spanish telehealth without naming the underlying research either.

Why the certificate sits in front of the ad account

The practical weight of these numbers comes from where LegitScript sits in the advertising stack. LegitScript said in July that Google requires its certification for telemedicine providers and online pharmacies advertising on Google Ads in the United States, the United Kingdom, Canada, France, Australia, New Zealand, Indonesia, the Philippines, India and South Africa. Spain became the eleventh such market under a Google policy change scheduled for August 5, 2026.

The list was built one country at a time. Google allowed LegitScript-certified telemedicine providers to promote services in France from October 10, 2023. Australia followed in 2024, when Google began requiring LegitScript certification for online pharmacies and telemedicine providers, with state registration accepted as an alternative for pharmacies, and barred prescription drug terms from ad copy and landing pages. Japan added a dual pathway from January 2025, accepting either government registration or LegitScript certification. The United Kingdom and Singapore came next, after a June 25, 2025 announcement placed UK telemedicine under an "Allowed with limitations" classification that still prohibits promoting prescription drugs in ads and landing pages. Singapore relied on local licensing under its Healthcare Services Act rather than on LegitScript.

Approval runs in two stages. A provider first obtains the LegitScript credential, then applies for Google's own certification once the platform policy covers its market. The third-party credential is a prerequisite, not approval in itself.

Advertising is only part of the gate. LegitScript is recognised by Visa and Mastercard for assessing merchants that conduct card-not-present transactions, and its certification and monitoring services are used by social media platforms, marketplaces and payment providers beyond Google. Roth's reference to being able to "accept payments" points to that second function. For a telehealth business selling prescriptions online, the same review can determine both whether it can buy search ads and whether it can process a card.

Looser rules around a fixed gate

Google has spent the past year recalibrating what certified health advertisers may do, loosening more than it has tightened, while keeping the certification itself in place. On July 1, 2025, it created a restricted drug term personalisation certification for advertisers in the United States, Canada and New Zealand using personalised targeting with pharmaceutical terms. In August 2025 it deprecated the Restricted Medical Content label while leaving certification requirements unchanged.

The larger shift came on October 14, 2025. Google revised its prescription drug advertising policy so that certified advertisers targeting Canada, New Zealand or the United States may use prescription drug terms for promotional purposes, with enforcement beginning October 29 and a rollout of four to six weeks. Certification remained mandatory for online pharmacies and telemedicine providers.

The programmatic side moved in a different direction. In December 2025, Google told publishers that Authorized Buyers could promote prescription drugs without certification from January 2026, while stating that the Google Ads Healthcare and Medicines policy was unaffected. That coverage also counted 16 countries in which Google Ads allowed certified advertisers to bid on prescription drug keywords. The same channel-specific split reached gambling on July 20, 2026, when Google said it would drop end-advertiser certification for gambling ads in 37 markets on Authorized Buyers, effective August 10, 2026.

Search surfaces are opening as well. In June 2026, Google confirmed a small United States test of healthcare ads inside AI Mode for English-language queries, a category that had been blocked from ads on AI search surfaces since monetisation began in 2024. Ginny Marvin, Ads Product Liaison at Google, said Performance Max, AI Max with search terms matching, Shopping campaigns and broad match keywords were eligible to serve. Pinned assets and text disclaimers, which regulated advertisers commonly rely on to hold mandatory language in place, were excluded from the initial test.

The money flowing through these channels is substantial. US healthcare digital advertising has been projected to pass $20 billion in 2026, a figure StackAdapt cited in January. Each certification LegitScript completes creates one more business able to seek Google's approval to compete for that inventory in the markets where the credential is recognised.

Enforcement pressure on telehealth marketing

The rise in certification demand is running alongside heavier scrutiny of how health products are sold online. On September 9, 2025, a presidential memorandum directed the Department of Health and Human Services and the Food and Drug Administration to step up enforcement against pharmaceutical advertising aimed at consumers. The FDA sent more than 100 enforcement letters, including 59 warning letters over brand website content and 34 untitled letters over television advertising, with 96% of formal warning letters targeting digital and social platforms. Prescription drug brands subsequently raised multiscreen television spending 53% to $4.95 billion between October 2025 and March 2026, according to Video Advertising Bureau analysis of Nielsen Ad Intel data.

LegitScript's own monitoring work documents the other end of the market. Research the company published on December 10, 2025 found that online advertisements for unapproved peptides rose 208% in 2024 compared with 2023, while peptide-related sales on e-commerce marketplaces grew 276% over five years. The certification business and the monitoring business are two sides of the same proposition: the more visible the unlicensed sellers, the stronger the case platforms and payment firms have for requiring a credential from the licensed ones.

The white-label layer

The release also quoted Dr. Marc Serota, founder and chief executive of MD Integrations, which LegitScript described as a white-label telehealth platform. Such platforms supply clinical and operational infrastructure that lets a brand offer virtual care under its own name, one route by which direct-to-consumer companies enter health categories without building a medical practice from scratch.

"We're seeing telehealth expand into categories that barely existed as virtual care options a few years ago," Serota said. "As brands launch new services and move into new areas of care, certification gives them a clear, defined path instead of another unknown to navigate while they scale."

The release does not describe the commercial relationship between MD Integrations and LegitScript. A platform serving telehealth brands has a direct interest in those brands clearing advertising and payment review, the two functions certification governs. Infrastructure providers of this kind can also multiply the number of consumer-facing brands in a category, each of which faces that review on its own.

Why this matters for the marketing community

For media buyers and agencies with health clients, the September figures function as a rough leading indicator. Applications signal intent to advertise. Certifications, in the markets where Google recognises the credential, move that intent one step from eligibility to bid. A doubling of telemedicine requests suggests that the pool of health advertisers seeking entry to Google's regulated auctions is growing quickly, at the same moment that Google is widening what those advertisers may say in three markets and testing where their ads may appear.

The slower growth in completed certifications carries its own implication. As PPC Land noted when Spain was added, campaign timelines become dependent on an approval process that advertisers cannot escalate through platform support. If applications keep outrunning completions, the wait before a certified campaign can start would lengthen. The numbers disclosed are consistent with such a trend, though they do not prove it.

The broader pattern extends well beyond healthcare. A PPC Land review of late July 2026 observed that eligibility is increasingly decided by external certification rather than platform review, with LegitScript for telemedicine, crypto-asset licensing and jurisdiction-specific gambling certification all following the same structure. Platforms keep the enforcement switch. The substantive judgement moves to a third party with a commercial interest in demand for its service.

That interest is worth holding in view. Every figure in the September 22 release is self-reported by the company that sells the certification, none comes with independent verification, and the only absolute number is a round-figure milestone without a date. The direction of travel is plausible and consistent with a year of policy changes documented in PPC Land's coverage. How many providers are waiting, for how long, and in which countries remains undisclosed.

Timeline

Summary

Who: LegitScript, a Portland, Oregon merchant and product certification company whose credential Google requires for telemedicine and online pharmacy advertising in 11 markets. Scott Roth, chief executive, and Jaylene Kunze, chief operating and financial officer, were quoted, alongside Dr. Marc Serota of the white-label telehealth platform MD Integrations. The figures affect telehealth and behavioural health providers, the agencies running their campaigns, and the platforms and payment firms that rely on the certification.

What: LegitScript reported a 59% rise in certification applications over the past year, including a 101% rise for telemedicine, alongside 43% growth in total certifications, 80% growth in telemedicine certifications and more than 10,000 certified websites. Its materials give two conflicting addiction treatment figures, 58% for applications and 80% for certifications, and disclose no absolute counts, processing times or country split.

When: The release is dated September 22, 2026, the first day of the Behavioral Health Tech Conference, which ran through September 24.

Where: The announcement was issued from Portland, Oregon, and LegitScript exhibited in Nashville, Tennessee. The certification applies as an advertising prerequisite on Google in the United States, the United Kingdom, Canada, France, Australia, New Zealand, Indonesia, the Philippines, India, South Africa and Spain.

Why: LegitScript attributed the growth to telehealth expanding into new areas of care, particularly the overlap between mental health and substance use treatment, and to companies addressing compliance earlier. For the advertising market, the figures indicate a growing pool of health businesses seeking eligibility to bid in regulated auctions, at a time when Google is loosening what certified advertisers may say and testing new placements, while completed certifications grow more slowly than demand for them.