Marriage and Family Therapists

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State Board of Psychologist Examiners: Laws, Rules and Policies

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30-1 TELETHERAPY POLICY – GUIDANCE REGARDING PSYCHOTHERAPY THROUGH ELECTRONIC MEANS WITHIN THE STATE OF COLORADO

When listed, certified, registered, or licensed and treating clients within the State of Colorado, it is at the discretion of the mental health professional as to the type of modality of treatment format that is appropriate for the client. Regardless of the modality chosen, the mental health professional must comply with all provisions as outlined in the Mental Health Practice Act, Title 12 Article 43.

It is recommended that the initial therapeutic contact be in person and adequate to provide a conclusive diagnosis and therapeutic treatment plan prior to implementing any psychotherapy through electronic means. The mental health professional is expected to establish an ongoing therapeutic relationship including face-to-face visits on a periodic basis thereafter.

Once a mental health professional chooses to provide psychotherapy via electronic means, the mental health professional is expected to carefully identify and address issues that involve:

1) The agreed upon therapeutic means of communication between the client and the mental health professional. (i.e. when will face-to-face contact be appropriate, what method(s) of electronic communication will be utilized, what is the structure of the contractual relationship);

2) Implementing written consent form(s) and proper disclosure(s) including, but not limited to the client’s knowledge regarding security issues, confidentiality, structure, etc.; 

3) Ensuring that the therapeutic means of communication includes confidentiality and computer/cyber security;

4) Determining the basis and ability for the mental health professional to support the rationale for the decision to choose a particular therapeutic method;

5) Ensuring that the mental health professional is practicing within his/her scope of practice;

6) Ensuring that the therapeutic means of communication that is chosen does not cause any potential harm to the client.

The mental health professional may encounter specific challenges while providing psychotherapy through electronic means. The mental health professional must realize that these challenges may include, but are not limited to:

1) Verifying the identity of the client and determining if they are a minor;

2) Providing the client with procedures for alternative modes of communication when there is possible technology failure;

3) Assessing how to cope with potential misunderstandings when the visual cues that would normally occur during face-to-face visits do not exist;

4) Assessing how to address crisis intervention when necessary;

5) Ensuring that clients are knowledgeable with regard to encryption methods, firewall, and backup systems to help secure communication and educate clients on the risk of unsecured communications;

6) Establishing a means to retain and preserve data;

7) Upon request, have the ability to capture and provide client treatment notes, summaries or other information that is received via the electronic technology;

8) Disclosing that health insurance coverage may not exist for psychotherapy service that is provided through technological means.

Disclaimer

This policy applies only to mental health professionals who are certified, registered, or licensed, and treating clients within the State of Colorado.

Date Adopted by Program:

12/13/11 – State Board of Addiction Counselor Examiners 04/22/2011 – State Grievance Board

03/18/2011 – State Board of Licensed Professional Counselor Examiners

02/25/11 State Board of Marriage & Family Therapist Examiners 04/8/2011 – State Board of Psychologist Examiners

01/28/11 State Board of Social Work Examiners

Date Revised by Program:

02/02/18 - State Board of Psychologist Examiners

01/26/18 - State Board of Social Work Examiners

01/19/18 - State Board of Marriage and Family Therapist Examiners

01/05/18 - State Board of Licensed Professional Counselor Examiners

12/15/17 - State Board of Registered Psychotherapists

11/28/17 - State Board of Addiction Counselor Examiners

Medicaid Telehealth Parity Law

“(1) On or after July 1, 2006, in-person contact between a health care or mental health care provider and a patient shall not be required under the state's medical assistance program for health care or mental health care services delivered through telemedicine that are otherwise eligible for reimbursement under the program. The services shall be subject to reimbursement policies developed pursuant to the medical assistance program. This section also applies to managed care organizations that contract with the state department pursuant to the statewide managed care system only to the extent that:

(a) Health care or mental health care services delivered through telemedicine are covered by and reimbursed under the medicaid per diem payment program”

Source: CO Revised Statutes 25.5-5-320

Link: https://law.justia.com/codes/colorado/2017/title-25.5/colorado-medical-assistance-act/article-5/part-3/section-25.5-5-320/

Refer to the source provided for all requirements and limitations.

Originating Site Reimbursement: 

“If no originating provider is present during a Telemedicine Services appointment, then the location of the originating site is at the member’s discretion and can include the member’s home. However, members can be required to choose a location suitable to delivery of telemedicine services that may include adequate lighting and environmental noise levels suitable for easy conversation with a provider.”

Source: CMS 1500 Telemedicine Manual 

Link: https://www.colorado.gov/pacific/sites/default/files/CMS1500%20Telemedicine%20Billing%20Manual%20061919.pdf