On 11 September 2025, the Court of Justice of the European Union (CJEU) rendered its judgment in case C-115/24 (UJ v Österreichische Zahnärztekammer). The ruling is of major importance for cross-border healthcare in the EU, especially where telemedicine (remote care via information and communication technology (ICT)) is combined with in-person treatment. For practitioners advising on tele-health models, professional-regulation and cross-border service provision, the decision marks a turning point.

1. The Case in Brief

In the underlying Austrian proceedings, an Austrian dentist (UJ) worked with German-based entities which offered dental aligner treatment to Austrian patients: initial in-person consultations and scans in Austria were followed by the remote provision of dental aligner treatment via German online/ICT tools. The Austrian Dental Chamber challenged the arrangement on the basis of Austrian regulatory rules for dentists. The Austrian Supreme Court referred questions to the CJEU concerning, inter alia, the meaning of “healthcare in the case of telemedicine” under Directive 2011/24/EU and whether a country-of-origin principle applies in respect of telemedicine services.

The CJEU held that:

• The concept of telemedicine applies only when a health service is provided entirely through ICT, without the patient’s physical presence before the healthcare provider.
• Services that are hybrid (partly in-person, partly digital) do not fall within the Directive’s framework on cross-border healthcare.
• The Directive, while primarily designed to ensure cost reimbursement for patients treated in another Member State, also governs broader aspects of cross-border health service provision, including quality, safety and information requirements.

2. Legal Implications

For practitioners, the implications are multi-layered:

• Regulatory scope – Only fully remote treatments qualify under the Directive and can invoke the country-of-origin principle, meaning partial telemedicine models remain subject to national healthcare laws.
• Freedom to provide services – Digital-health providers cannot automatically invoke the free movement of services where treatment is partly delivered domestically.
• Professional qualifications and licensing – Hybrid or cross-border models may still trigger compliance duties under national professional rules.
• Liability and patient protection – When healthcare is split between jurisdictions, responsibility for informed consent, data security, and standard of care must be contractually allocated.

3. Practical Consequences for Contract Design

The decision underscores the need for robust contractual and compliance frameworks in cross-border digital healthcare:

• Service contracts must specify the nature of the service (fully remote vs. hybrid) and identify which jurisdiction’s rules apply.
• Professional liability clauses should allocate risk clearly where multiple providers or jurisdictions are involved.
• Data-protection obligations must reflect GDPR standards for international data transfer and patient confidentiality.
• Disclosure and patient-information duties remain critical — even in purely digital contexts.

In Austria and other Member States, telemedicine is subject to specific medical-practice and licensing rules; thus, providers must verify national authorisations before offering remote consultations to foreign patients.

Conclusion

For digital-health entrepreneurs, telemedicine providers and legal advisors, the message is clear: EU law rewards clarity of structure, transparency, and compliance discipline. Those who adapt their contractual and operational models accordingly will have legal certainty which laws will apply to their services within both EU and national regulatory frameworks.