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Iowa

Counselors

We are not aware of any specific rules and regulations of the practice of telemental health services for Counselors.

Social Workers

We are not aware of any specific rules and regulations of the practice of telemental health services for Social Workers.

Marriage and Family Therapists

We are not aware of any specific rules and regulations of the practice of telemental health services for MFTs.

Psychologists

We are not aware of any specific rules and regulations of the practice of telemental health services for Psychologists.

Psychiatrists

Source

653—13.11(147,148,272C) Standards of practice—telemedicine.

“Standards of practice—telemedicine. This rule establishes standards of practice for the practice of medicine using telemedicine. 1. The board recognizes that technological advances have made it possible for licensees in one location to provide medical care to patients in another location with or without an intervening health care provider. 2. Telemedicine is a useful tool that, if applied appropriately, can provide important benefits to patients, including increased access to health care, expanded utilization of specialty expertise, rapid availability of patient records, and potential cost savings. 3. The board advises that licensees using telemedicine will be held to the same standards of care and professional ethics as licensees using traditional in-person medical care. 4. Failure to conform to the appropriate standards of care or professional ethics while using telemedicine may subject the licensee to potential discipline by the board. 13.11(1) Definitions. As used in this rule: “Asynchronous store-and-forward transmission” means the collection of a patient’s relevant health information and the subsequent transmission of the data from an originating site to a health care provider at a distant site without the presence of the patient. “Board” means the Iowa board of medicine. “In-person encounter” means that the physician and the patient are in the physical presence of each other and are in the same physical location during the physician-patient encounter. “Licensee” means a medical physician or osteopathic physician licensed by the board. “Telemedicine” means the practice of medicine using electronic audio-visual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telemedicine includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telemedicine shall not include the provision of medical services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof. “Telemedicine technologies” means technologies and devices enabling secure electronic communications and information exchanges between a licensee in one location and a patient in another location with or without an intervening health care provider”

“13.11(2) Practice guidelines. A licensee who uses telemedicine shall utilize evidence-based

telemedicine practice guidelines and standards of practice, to the degree they are available, to ensure

patient safety, quality of care, and positive outcomes. The board acknowledges that some nationally

recognized medical specialty organizations have established comprehensive telemedicine practice

guidelines that address the clinical and technological aspects of telemedicine for many medical

specialties.

13.11(3) Iowa medical license required. A physician who uses telemedicine in the diagnosis and

treatment of a patient located in Iowa shall hold an active Iowa medical license consistent with state and

federal laws. Nothing in this rule shall be construed to supersede the exceptions to licensure contained

in 653—subrule 9.2(2).

13.11(4) Standards of care and professional ethics. A licensee who uses telemedicine shall be held

to the same standards of care and professional ethics as a licensee using traditional in-person encounters

with patients. Failure to conform to the appropriate standards of care or professional ethics while using

telemedicine may be a violation of the laws and rules governing the practice of medicine and may subject

the licensee to potential discipline by the board.

13.11(5) Scope of practice. A licensee who uses telemedicine shall ensure that the services

provided are consistent with the licensee’s scope of practice, including the licensee’s education, training,

experience, ability, licensure, and certification.

13.11(6) Identification of patient and physician. A licensee who uses telemedicine shall verify the

identity of the patient and ensure that the patient has the ability to verify the identity, licensure status,

Ch 13, p.2 IAC

certification, and credentials of all health care providers who provide telemedicine services prior to the

provision of care.

13.11(7) Physician-patient relationship.

a. A licensee who uses telemedicine shall establish a valid physician-patient relationship with the

person who receives telemedicine services. The physician-patient relationship begins when:

(1) The person with a health-related matter seeks assistance from a licensee;

(2) The licensee agrees to undertake diagnosis and treatment of the person; and

(3) The person agrees to be treated by the licensee whether or not there has been an in-person

encounter between the physician and the person.

b. A valid physician-patient relationship may be established by:

(1) In-person encounter. Through an in-person medical interview and physical examination where

the standard of care would require an in-person encounter;

(2) Consultation with another licensee. Through consultation with another licensee (or other health

care provider) who has an established relationship with the patient and who agrees to participate in, or

supervise, the patient’s care; or

(3) Telemedicine encounter. Through telemedicine, if the standard of care does not require an

in-person encounter, and in accordance with evidence-based standards of practice and telemedicine

practice guidelines that address the clinical and technological aspects of telemedicine.”

Refer to the source provided for all requirements and limitations.

Iowa Professional Regulation/Health & Safety Online Prescribing

Source

“Pharmacists are prohibited from dispensing prescription drugs if the pharmacist knows or should have known that the prescription was issued solely on the basis of an Internet-based questionnaire, an Internet-based consult, or a telephone consult, and was completed without a pre-existing patient-provider relationship.”

Source

“A physician must be physically present with a woman at the time an abortion-inducing drug is provided.”

Source

“Prior to providing treatment, including issuing prescriptions, electronically or otherwise, a licensee who uses telemedicine shall interview the patient to collect the relevant medical history and perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. An Internet questionnaire that is a static set of questions provided to the patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview, does not constitute an acceptable medical interview and physical examination for the provision of treatment, including issuance of prescriptions, electronically or otherwise, by a licensee.”

Source

Recently Passed Legislation

“Specific requirements apply for mental health professionals establishing a provider-patient relationship in a school-based setting. See full law text for details.

A mental health professional with prescribing authority who provides telehealth services in accordance with this section shall not prescribe any new medication to a student during a telehealth session. However, a mental health professional with prescribing authority may initiate new prescriptions, alter the dosage of an existing medication, or discontinue an existing medication for the treatment of the student’s behavioral health condition after consultation with the student’s parent or guardian.”

Refer to the source provided for all requirements and limitations.

Nurses

“As a party state to the Nurse Licensure Compact (NLC), Iowa issues multistate licenses to nurses and applicants who reside in the state and recognizes multistate licenses issued by other party states, for practice in Iowa. A nurse holding a multistate license is entitled to practice in any NLC party state, but must comply at all times with the laws of the state where he or she is currently practicing.”

“It should be noted that not every state in the US is an NLC party state; a map of participating states, as well as further resources related to the NLC, are available on the Nurse Licensure Compact website.”

Refer to the source provided for all requirements and limitations.

Iowa Professional Regulation/Health & Safety Online Prescribing

Source

“Pharmacists are prohibited from dispensing prescription drugs if the pharmacist knows or should have known that the prescription was issued solely on the basis of an Internet-based questionnaire, an Internet-based consult, or a telephone consult, and was completed without a pre-existing patient-provider relationship.”

Source

“A physician must be physically present with a woman at the time an abortion-inducing drug is provided.”

Source

“Prior to providing treatment, including issuing prescriptions, electronically or otherwise, a licensee who uses telemedicine shall interview the patient to collect the relevant medical history and perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. An Internet questionnaire that is a static set of questions provided to the patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview, does not constitute an acceptable medical interview and physical examination for the provision of treatment, including issuance of prescriptions, electronically or otherwise, by a licensee.”

Source

Recently Passed Legislation

“Specific requirements apply for mental health professionals establishing a provider-patient relationship in a school-based setting. See full law text for details.

A mental health professional with prescribing authority who provides telehealth services in accordance with this section shall not prescribe any new medication to a student during a telehealth session. However, a mental health professional with prescribing authority may initiate new prescriptions, alter the dosage of an existing medication, or discontinue an existing medication for the treatment of the student’s behavioral health condition after consultation with the student’s parent or guardian.”

Refer to the source provided for all requirements and limitations.

Medicaid Telehealth Parity Law

Refer to the source provided for all requirements and limitations.

1 SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES, §514C.34

https://www.legis.iowa.gov/docs/code/514C.34.pdf

Private Pay Telehealth Parity Law

Source: IA Code 514C.34(3)

“Health care services that are delivered by telehealth must be appropriate and delivered in accordance with applicable law and generally accepted health care practices and standards prevailing at the time the health care services are provided, including all rules adopted by the appropriate professional licensing board, pursuant to chapter 147, having oversight of the health care professional providing the health care services.”

Refer to the source provided for all requirements and limitations.

Payment Parity

We are not aware of any explicit payment parity.

Permission for the Temporary Practice of Clinicians Licensed Outside the State

We are not aware of any permission that allows for services delivered by out-of-state providers.

Note: As this is a free resource and Rules and Regulations regarding Telehealth are always changing, we appreciate any updates or corrections. They can be emailed to us at This email address is being protected from spambots. You need JavaScript enabled to view it. with a link to the source or a citation of the rule or regulation.

THTC Program Button

Telemental health is not a separate service from mental health services. All state licensing boards require that licensed clinicians follow all the regulations for practicing under their license no matter what medium of communication is used. All licensing boards also require that clinicians only practice within the boundaries of their competence. This usually requires education, continuing education, and/or supervision in telemental health. Complete our telehealth training program to cover all the essential competencies of providing telemental health services and earn the THTC (Telemental Health Training Certificate).

1 comment

  • Comment Link Deborra M Smith Thursday, 07 February 2019 17:36 posted by Deborra M Smith

    Can you direct me to the rules and regulations of providing mental health therapy and psychiatric services in Iowa via telehealth

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