Texas is opening the door to broader access to medical cannabis with the passage of House Bill 46, which takes effect on September 1, 2025. This legislation significantly expands the list of qualifying medical conditions that allow patients to qualify for medical marijuana under the state’s Compassionate Use Program (CUP) — and it gives the Department of State Health Services more authority to make future changes without requiring new legislation.
If you’re a Texas resident wondering whether you or a loved one now qualifies for a medical marijuana prescription, this guide will walk you through the updated qualifying conditions list, how physician discretion plays a role, and what the changes mean for veterans and long-term pain patients.
Background: What Was CUP Before HB 46?
Before 2025, Texas’ medical marijuana program was among the most restrictive in the nation. Only patients with a limited number of conditions qualified for medical marijuana in Texas, including:
- Epilepsy and seizure disorders
- Cancer (as a symptom-management option)
- Autism spectrum disorders
- Multiple sclerosis
- ALS
- PTSD
- Spasticity
- Incurable neurodegenerative diseases
THC was also capped at 1% by weight, and product forms were restricted to tinctures and capsules. Many patients with chronic conditions, like back pain or gastrointestinal diseases, were left out of the program.
New Qualifying Conditions Under HB 46
As of September 1, 2025, the following medical conditions have been officially added to Texas’ Compassionate Use Program:
- Chronic Pain – No longer requires prior opioid use to qualify.
- Crohn’s Disease – Inflammatory bowel conditions now included.
- Traumatic Brain Injury (TBI) – Mild to severe.
- Degenerative Disc Disease – Chronic spinal pain included.
- Glaucoma – Pressure-related ocular disorders.
- Terminal Illnesses – Including those in hospice care.
These additions reflect growing scientific consensus and patient demand, making CUP more aligned with other state programs.
Special Considerations for Veterans
Veterans in Texas now receive expanded access to medical cannabis. Under HB 46, any condition a certified CUP physician deems debilitating is now eligible for prescription approval — even if that condition is not explicitly listed in law.
This is particularly important for veterans facing:
- Chronic pain
- PTSD (often compounded by physical injury)
- Traumatic brain injuries
- Anxiety and sleep disorders stemming from service
If you’re a veteran, you may qualify more easily than in the past — and you do not need to go through the VA to access the program.
How Physicians Can Use Discretion
HB 46 empowers state-certified cannabis physicians to make judgment calls when conditions may not fall neatly under an official diagnosis. For example:
- A patient with anxiety and IBS may be approved under Crohn’s-related inflammation.
- A patient with long-term migraines may qualify under chronic pain.
- A veteran experiencing insomnia due to PTSD may be approved without a separate psychiatric diagnosis.
That flexibility allows more patients to get effective, non-opioid treatment legally.
What Documentation Helps?
While you don’t need to submit paperwork to the state directly, it helps your physician make a strong clinical case if you bring:
- Medical records related to your condition
- Lists of current prescriptions
- Surgical or imaging history (for pain-based diagnoses)
- Doctor’s notes or discharge summaries (for veterans or trauma cases)
Even if you don’t have these on hand, a licensed PrestoDoctor physician can help guide you through what’s needed during your telemedicine consultation.
Fast-Track Your Certification
Thanks to HB 46 and PrestoDoctor’s virtual platform, getting certified is faster and easier than ever. Here’s how:
- Create an account at PrestoDoctor.com
- Complete a brief intake form describing your symptoms
- Meet with a licensed physician online via secure video
- Get your prescription entered into CURT, the Compassionate Use Registry of Texas
- Visit a licensed Texas dispensary to fill your prescription — often same-day
Qualifying Conditions for Medical Marijuana In Texas
With the updates in HB 46, Texas is finally recognizing the reality of chronic and complex medical conditions — and giving patients a real alternative to opioids, anti-anxiety meds, and ineffective treatment plans. New qualifying conditions for medical marijuana in Texas allows for more people to access the medicine they need.
If you think you may qualify, don’t wait. Getting your medical marijuana card in Texas with a licensed PrestoDoctor physician could take as little as 24 hours.
