Channel assessment and selection for wireless communication is made between two or more medical devices, such as between an implantable medical device (IMD) and a non-implanted medical device, between two IMDs, or between two non-implanted medical devices. A telemetry module of a medical device operating in accordance with the techniques of this disclosure obtains measured ambient power levels on a plurality of channels of a frequency band regulation, such as the ten channels of the MICS band regulation. The telemetry module computes channel assessment values for at least a portion of the plurality of channels based on the measured ambient power levels on at least one other channel of the plurality of channels and selects a channel to transmit on based on the channel assessment values.
