Telehealth Across State Lines: Navigating Telehealth State Policies

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Teletherapy Across State Lines: Navigating Telehealth State Policies

In recent years, the number of private practices implementing telehealth has grown significantly, and the COVID-19 pandemic has accelerated its adoption even further. As patients seek ways to continue their treatment while adhering to physical distancing guidelines, teletherapy has emerged as a valuable tool for delivering healthcare services.


This has raised important questions about the regulations and policies surrounding the practice of teletherapy across state lines. This article explores the key considerations and guidelines for practicing teletherapy across different states, delving into the various state policies and regulations governing this emerging field.

Understanding Temporary Practice Laws

One of the primary concerns when providing teletherapy across state lines is ensuring compliance with the laws and regulations of both the psychologist's home state and the state where the patient is located. Temporary practice laws play a crucial role in facilitating interstate practice.


These laws allow psychologists licensed in one state to practice for a limited period in another state, typically for a specific number of days per year. However, it is important to note that not all states have provisions for temporary practice. Psychologists should consult the respective state's board of psychology to understand the specific temporary practice laws in place.

Permanent Interstate Practice and Transitioning Care

When a patient permanently moves to another state, psychologists must consider the implications of providing teletherapy in this new context. While the rules for interstate practice apply regardless of whether the patient's relocation is temporary or permanent, the clinical considerations may differ.


In cases of permanent relocation, it may be beneficial for the patient to transition their care to a psychologist in their new state of residence. This ensures continuity of care and allows patients to access local resources that may better support their mental health needs.

Initiating Treatment with Out-of-State Patients

Psychologists often receive requests from patients located in different states who wish to initiate treatment via teletherapy. While most states do not have strict requirements regarding initiating care, psychologists must consider the patient's best interests. If local psychologists with the necessary expertise are available, it may be beneficial for the patient to receive in-person care.


However, in cases where specialized expertise is scarce, initiating treatment with an out-of-state psychologist may be a viable option, provided all applicable licensing and regulatory requirements are met.

Providing Teletherapy While Temporarily Out of State

Healthcare professionals may find themselves temporarily out of their home state for reasons such as vacations, business trips, or family visits. In such cases, the ability to provide teletherapy to patients in their home state depends on the licensing and legal permissions in both the provider's physical location and the patient's location.


Some states consider teletherapy as practicing in both locations, while others only consider the patient's location. Providers should consult the relevant state's board of psychology to understand the rules and regulations in this situation.

Transitioning from State A to State B

Therapists and psychologists who permanently move from one state to another must consider the implications of continuing to provide teletherapy to patients in their previous state of residence. As mentioned earlier, practicing psychology is typically considered to be based on the psychologist's location.


If a psychologist permanently relocates to a new state, obtaining licensure in that state is advisable to ensure clear authority to practice and to provide in-person care when necessary.

COVID-19 and Temporary Waivers

The COVID-19 pandemic has led to temporary changes in regulations to facilitate the provision of teletherapy across state lines. Some states have relaxed their rules during this public health emergency, allowing for increased flexibility in interstate practice. However, these temporary waivers vary by state, and psychologists should regularly check the telehealth guidance provided by their state board of psychology to stay updated on the current rules and regulations.

The Psychology Interjurisdictional Compact (PSYPACT)

To address the challenges of practicing teletherapy across state lines, the Psychology Interjurisdictional Compact (PSYPACT) has been established. This multi-state licensing compact enables psychologists licensed in participating states to provide telepsychological services or temporary in-person services to patients in other PSYPACT states.


Psychologists must obtain authority to practice through the compact by applying for an E.Passport for telepsychology practice or an Interjurisdictional Practice Certification (IPC) for temporary, in-person practice. Compliance with the regulations set by the PSYPACT Commission is mandatory for psychologists operating under this compact.

State-by-State Telehealth Requirements

In the United States, the professional requirements for practicing telehealth vary from state to state. Each state has its own set of regulations and licensing requirements that healthcare professionals must meet in order to provide telehealth across state lines. These requirements are in place to ensure that patients receive safe and high-quality care and that healthcare professionals maintain the necessary skills and qualifications to practice telehealth effectively.


California Telehealth Guidelines


For example, in California, healthcare professionals who wish to practice telehealth must be licensed by the appropriate professional licensing board. This includes physicians, nurses, psychologists, and other healthcare professionals. In addition to licensing requirements, California also has specific regulations regarding telehealth technology use and patient privacy and confidentiality protection.


Texas Telehealth Guidelines


Similarly, in Texas, healthcare professionals must hold a valid license to practice telehealth. They must also comply with the Texas Medical Board's rules and regulations concerning the use of telemedicine. This includes obtaining informed consent from patients, maintaining patient records, and complying with all applicable state and federal laws related to telehealth.


Telehealth Guidelines for Various Other States


Other states, such as New York and Florida, have their own specific requirements for practicing telehealth. In New York, for example, healthcare professionals must be licensed in the state and adhere to the standards of professional conduct outlined by their respective licensing boards. Florida requires healthcare professionals to register with the state's Department of Health and obtain a telehealth provider certificate.


It is important for healthcare professionals to familiarize themselves with the specific requirements for practicing telehealth in each state where they plan to provide services. This may involve obtaining additional licensure or certifications, completing specific training programs, or adhering to certain guidelines and regulations. The United States Department of Health and Human Services has a helpful website for navigating licensure requirements in every state.

Emergency Situations and Jurisdictional Compliance

When a patient reaches out for immediate clinical support in emergencies, providers must prioritize patient welfare and take prompt action to address the emergency. Compliance with jurisdictional rules should be pursued as soon as possible afterward. 

Healthcare providers must know that failure to comply with interstate practice regulations could result in accusations of practicing psychology without a license. It is advisable to consult professional liability companies for guidance on risk management in these situations.

Key Takeaways about Practicing Telehealth Across State Lines

In conclusion, practicing telehealth across state lines requires careful consideration of the various regulations and policies in place. Temporary practice laws, permanent relocation, international teletherapy, and the implications of initiating treatment with out-of-state patients all contribute to the complexity of interstate practice.


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