Licensure. In general, a clinician must be licensed in the state where the patient/client is physically located at the time of service. The Center for Connected Health Policy (CCHP) has created this video discussing licensure as it pertains to telehealth:
CCHP has also created this Frequently Asked Questions on Licensure video:
A few additional resources from CCHP:
- Tracking of Cross-State Licensing policies for every state.
- Telehealth Policy Finder where you can look up all telehealth-related policies and regulations across all 50 states and the District of Columbia, as well as at the federal level.
- Provider Bridge is a platform developed to streamline the process for mobilizing health care professionals during the COVID-19 pandemic and for future public health emergencies. It will offer a dedicated customer service hub to help clinicians navigate current state licensure requirements, including those specific to telehealth during states of emergency and provide access to a database of information for verified, betted, volunteer clinicians willing to provide telehealth services during emergencies.
- Several professional organization that have been tracking and updating state licensure policies and policy changes (either in general or in response to the pandemic) for their specific professions. These include:
- American Speech-Language-Hearing Association Tracking of State Laws and Regulations for Telepractice and Licensure Policy
- Association of Social Work Boards Laws and Regulations Database
- Federation of State Medical Boards (FSMB) List of States Waiving Licensure Requirements/Renewals in Response to COVID-19.
- Federation of State Medical Boards (FSMB) List of States Modifying In-State Licensure Requirements for Telehealth in Response to COVID-19.
- National Society of Genetic Counselors State Licensure for Genetic Counselors
- The Multi-Discipline Licensure Resource Project has been developed to serve as an information hub for Occupational Therapists, Physical Therapists, Psychologists and Social Workers
If you are a behavioral health professional, we have a behavioral health provider state licensing regulations database that has licensing information for six different provider types (addictions therapists, counselors, nurses, psychiatrists, psychologists and social workers). The Telehealth Certification Institute has created a resource for locating States' Telemental Health Laws, Rules and Regulations for counselors, social workers, marriage and family therapists and psychologists.
Other Interstate Practice Policy Considerations: In additional to understanding the telehealth specific laws and rules in each state, there are a few other policy considerations that need to be researched and understood when going across state lines. A few of these include:
- Scope of practice laws: Each state has different policies related to Scope of Practice for different types of providers. If a practitioner is licensed in multiple states and is using telehealth to provide services across state lines, that practitioner needs to keep in mind what he/she may or may not do based on the laws of the state where the patient/client is located at the time of service. The NCSL Scope of Practice Policy website provides good information about Behavioral Health Providers, Nurse Practitioners, Oral Health Providers, Pharmacists and Physician Assistants by state. Please note that providers for some professions and in some states are required to have collaborative practice agreements with a physician. In this case, the collaborating physician must also be licensed in the State where the patient is physically located at the time of service.
- Malpractice coverage:The provider/practitioner (and collaborating physician if one is required) needs to check with their malpractice carrier to make sure they are covered for telemedicine services (most do, but some require an additional rider) and that the coverage extends beyond state lines. Additionally different states have caps on damages. and these amounts may vary widely. Some states don’t have caps at all. While state laws often do not require practitioners to carry medical malpractice insurance, it is best practice to ensure that you have malpractice coverage and that the coverage extends up to the highest cap per claim in each state for which you are licensed.