As of September 18, 2020, there are no federal provisions that allow mental health professionals to practice teletherapy over state lines; you must register or become licensed in your client’s state to provide teletherapy.
However, there have been federal recommendations for states to relax licensure requirements. The federal Center for Medicare and Medicaid Services (CMS) has also implemented policies expanding telehealth access and delivery across states. As a result, certain states have ordered waivers on certain licensure requirements for the duration of the crisis or beyond.
See below for updates on teletherapy status by state.
- Rhode Island has issued an expedited 90-day license: Beginning March 18, 2020, out-of-state licensees were able to apply for 90-day licenses to practice in Rhode Island. As of now, applications for the 90-day licenses are restricted to professionals directly treating patients with COVID-19. Behavioral health providers must now apply for full Rhode Island licenses to continue providing telehealth services to patients in Rhode Island. However, an executive order from March which served to increase coverage for behavioral health services to meet COVID-19 demands, was made permanent by the Rhode Island Senate in June. The bill now requires health insurance companies to comprehensively cover telemedicine visits, including audio-only phone calls.
- Washington DC has temporarily waived licensure requirements for out-of-district providers who are providing a continuation of care for an individual who has returned to DC and who was previously in their care. This order is expected to remain through early October. However, no other out-of-district telehealth services are allowed at this time.
- New Jersey has allowed practitioners to apply for an expedited NJ license by completing this one-page form and sending it via email to firstname.lastname@example.org. The New Jersey Office of the Attorney General website indicates that your application will be reviewed and responded to within 24 hours. New Jersey’s waiver of certain regulatory requirements for out-of-state practitioners of telehealth services is expected to remain in effect until the end of December.
- Connecticut suspended licensure/certification requirements for being an approved telehealth provider in CT to increase patient access to out-of-state telehealth providers. The Department of Public Health issued an order stating that the requirements for licensure, certification, and registration are all suspended for 60 days in CT. The suspension of these requirements was extended to January 2021 through another order signed in July.
- Illinois' Department of Financial and Professional Regulation interprets Governor Pritzker's Executive Order 2020-9 to mean that out-of-state providers may practice via telehealth to maintain a continuation of care with clients previously in their care: "The Department interprets Executive Order 2020-9 to permit an out-of-state health care provider not licensed in Illinois to continue to provide health care services to an Illinois patient via telehealth where there is a previously established provider/patient relationship. The Department deems such a provider to be 'authorized to practice in the State of Illinois' pursuant to Section 5 of the Executive Order without further need to obtain licensure in Illinois." This order is currently scheduled to expire on September 20, 2020.
- Massachusetts issued an order from the Commissioner of Public Health allowing out-of-state providers who "present to the corresponding Massachusetts licensing authority verification that such license is in good standing in that other State where it was issued shall forthwith be issued a corresponding Massachusetts license that shall remain valid during the state of emergency. All health care providers licensed under this provision may provide services within the scope of practice authorized by the license in such profession, both in-person in Massachusetts and across State lines into Massachusetts using telemedicine where appropriate." The application for out-of-state emergency temporary licenses closed in July, but privileges will remain active until 30 days after the state of emergency is terminated, or December 31, 2020, whichever occurs last.
Note: Although these changes have been announced, there may be some lag or discrepancy during implementation. Not all states consider mental health providers "healthcare providers" so make sure that your state, or the state you hope to practice in, includes your profession in their definition.
It may also be the case that a client will be required to connect with a local provider after a certain amount of time.
It's always best to stay up-to-date and contact your licensing board if you have any doubts! This list of changes from the Association of American Medical Colleges is also a good reference. Some states may relax licensure rules for providers who will go in person to assist in the COVID-19 treatment effort, but these new rules may not apply to telehealth.
Coronavirus changes to licensure requirements for out-of-state providers
Many thanks to The Shrink Space for this helpful table!