The COVID-19 pandemic precipitated a rapid expansion in telehealth-delivered care which is likely to leave a permanent mark on how opioid use disorder (OUD) care is delivered. Policymakers are currently debating what telehealth policies for OUD should look like in the future with recently proposed regulations by the DEA requiring changes to what has been allowed during the public health emergency. This symposium aims to inform clinical practices and policy debates on improving access and quality of OUD care in the era of fentanyl amid a changing regulatory landscape. Leaders in the addiction field will present their recent research and build on prior studies to describe evidence on effectiveness of telehealth models for OUD care, recent policy changes and how they may impact telehealth for OUD care, and examples of new innovative telehealth models implemented in different settings to improve OUD care access and quality. This presentation will include perspectives from a diverse group of clinician scientists who practice in settings from the Veterans Health Administration, to academic centers, to telehealth companies and from specialty addiction settings to treatment integrated in primary care. Throughout all settings, we focus on considerations for evidence-based OUD care, including implementing harm reduction approaches and lowering treatment barriers. This symposium will provide critical research evidence and clinical insights to help the audience determine what constitutes high quality telehealth care for OUD and innovations needed in our field to address disparities in access to high quality OUD care.