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:
- The Cross-State Licensure Continuum: Out-of-State Telehealth Provider Policies - July 2024
- Out-of-State Telehealth Provider Policies Trend Map
- Cross-State Licensing policies by 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.
The Cicero Institute has developed a 50-state telehealth innovation report card looking at telehealth laws that prioritize quality, affordability and innovation.
Resources:
- 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 for their specific professions. These include:
- Association of Social Work Boards Laws and Regulations Database
- 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, 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 Policy Considerations for Interstate Practice: When providing telehealth services across state lines, it's essential to understand more than just each state's telehealth-specific laws. Here are some key policy considerations:
- Interstate Licensure Compacts: As telehealth has expanded, many states and professional groups have created licensure compacts to simplify interstate practice. States participating in a compact, known as "compact states," allow licensed professionals to practice in muliple participating compact states more easily. Learn more...
- Scope of practice laws: Each state has its own policies regarding the scope of practice for various types of providers. Practitioners licecnsed in multiple states and delivering services via telehealth must follow the scope of practice laws in the state where the patient/client is located at the time of service. The NCSL Scope of Practice Policy website provides state-by-state information on scope of practice for Behavioral Health Providers, Nurse Practitioners, Oral Health Providers, Pharmacists and Physician Assistants. In some states, certain providers are required to have collaborative practice agreements with physicians. When this is the case, the collaborating physician must also be licensed in the patient's location state (with the occasional exception).
- Malpractice coverage: Providers (and collaborating physicians, if required) should check with their malpractice carriers to ensure they are covered for telemedicine services across state lines. While most policies cover telehealth, some may require an additional rider for interstate services. Coverage limits also vary widely by state, with some states placing caps on damages and others having no caps at all. It is best practice to carry coverage that meets or exceeds the highest damage cap in each state where you are licensed.
