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.
For a deeper dive, check out this webinar from August 2, 2024 on Cross-State Licensure & Compacts:
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 Telehealth Practice: When providing telehealth services across state lines, understanding state-specific telehealth laws is crucial—but it's not the whole picture. Here are some key policy considerations to keep in mind:
- Interstate Licensure Compacts: With the growth of telehealth, many states and professional organizations have developed licensure compacts to facilitate interstate practice. States that participate in these agreements, known as "compact states," allow licensed professionals to more easily practice across state lines within the compact. Learn more....
- Scope of practice laws: Each state defines the scope of practice for licensed providers differently. Practitioners who are licensed in multiple states and provide telehealth services must adhere to the scope of practice laws in the state where the patient or client is located during the service.
- The NCSL Scope of Practice Policy website offers detailed, state-by-state information for behavioral health providers, nurse practitioners, oral health providers, pharmacists, and physician assistants.
- In some states, certain providers must have collaborative practice agreements with physicians. When this is required, the collaborating physician must also be licensed in the state where the patient is located (with occasional exceptions).
- Malpractice coverage: Providers—and collaborating physicians, if applicable—should verify that their malpractice insurance covers telemedicine services provided across state lines.
- While most malpractice policies include telehealth coverage, some may require an additional rider for interstate practice.
- Coverage limits can vary widely. Some states cap the amount of damages for malpractice claims, while others have no limits at all. To ensure adequate protection, it's best to carry malpractice coverage that meets or exceeds the highest damage cap among the states where you are licensed.
