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Colorado

Counselors

For all behavioral health professionals.

Source

State Board of Psychologist Examiners: Laws, Rules and Policies

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

Social Workers

For all behavioral health professionals.

Source

State Board of Psychologist Examiners: Laws, Rules and Policies

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

Marriage and Family Therapists

For all behavioral health professionals.

Source

State Board of Psychologist Examiners: Laws, Rules and Policies

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

Psychologists

For all behavioral health professionals.

Source

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

Additionally, Colorado licensed psychologists eligible to join the Interjurisdictional Psychology Compact (PSYPACT) https://www.asppb.net/mpage/legislative

Refer to the source provided for all requirements and limitations.

Psychiatrists

For all behavioral health professionals.

Source

“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 include confidentiality and computer/cybersecurity;

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.”

Refer to the source provided for all requirements and limitations.

Colorado Professional Regulation/Health & Safety Online Prescribing

Source

“Pharmacists are prohibited from dispensing prescription drugs if they know, or should have known, that it was on the basis of an internet-based questionnaire, an Internet-based consult, or a telephone consultation, all without a valid pre-existing patient-practitioner relationship.”

Source

““Bona fide physician-patient relationship”, for purposes of the medical marijuana program, means:

A physician and a patient have a treatment or counseling relationship, in the course of which the physician has completed a full assessment of the patient's medical history, including reviewing a previous diagnosis for a debilitating or disabling medical condition, and current medical condition, including an appropriate personal physical examination. “Appropriate personal physical examination” may not be performed by remote means, including telemedicine.”

Refer to the source provided for all requirements and limitations.

Nurses

“As a party state to the Nurse Licensure Compact (NLC), Colorado issues multistate licenses to nurses and applicants who reside in the state and recognizes multistate licenses issued by other party states, for practice in Colorado. 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.

Colorado Professional Regulation/Health & Safety Online Prescribing

Source

“Pharmacists are prohibited from dispensing prescription drugs if they know, or should have known, that it was on the basis of an internet-based questionnaire, an Internet-based consult, or a telephone consultation, all without a valid pre-existing patient-practitioner relationship.”

Source

““Bona fide physician-patient relationship”, for purposes of the medical marijuana program, means:

A physician and a patient have a treatment or counseling relationship, in the course of which the physician has completed a full assessment of the patient's medical history, including reviewing a previous diagnosis for a debilitating or disabling medical condition, and current medical condition, including an appropriate personal physical examination. “Appropriate personal physical examination” may not be performed by remote means, including telemedicine.”

Refer to the source provided for all requirements and limitations.

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

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.”

SourceCMS 1500 Telemedicine Manual

Private Pay Telehealth Parity Law

Source:  CO Revised Statutes 10-16-123(2)(b)

“(b) (I) Subject to all terms and conditions of the health benefit plan, a carrier shall reimburse the treating participating provider or the consulting participating provider for the diagnosis, consultation, or treatment of the covered person delivered through telehealth on the same basis that the carrier is responsible for reimbursing that provider for the provision of the same service through in-person consultation or contact by that provider.

(II) A carrier shall not restrict or deny coverage of a health care service that is a covered benefit solely:

(A) Because the service is provided through telehealth rather than in-person consultation or contact between the participating provider or, subject to section 10-16-704, the nonparticipating provider and the covered person where the health care service is appropriately provided through telehealth; or

(B) Based on the communication technology or application used to deliver the telehealth services pursuant to this section.”

Resource

Refer to the source provided for all requirements and limitations.

Payment Parity

Source:  CO Revised Statutes 10-16-123(2)(b)

“(b) (I) Subject to all terms and conditions of the health benefit plan, a carrier shall reimburse the treating participating provider or the consulting participating provider for the diagnosis, consultation, or treatment of the covered person delivered through telehealth on the same basis that the carrier is responsible for reimbursing that provider for the provision of the same service through in-person consultation or contact by that provider.

(II) A carrier shall not restrict or deny coverage of a health care service that is a covered benefit solely:

(A) Because the service is provided through telehealth rather than in-person consultation or contact between the participating provider or, subject to section 10-16-704, the nonparticipating provider and the covered person where the health care service is appropriately provided through telehealth; or

(B) Based on the communication technology or application used to deliver the telehealth services pursuant to this section.”

Resource

Refer to the source provided for all requirements and limitations.

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 counselors, social workers or MFT's.

Colorado licensed psychologists eligible to join the Interjurisdictional Psychology Compact (PSYPACT) https://www.asppb.net/mpage/legislative

Refer to the source provided for all requirements and limitations.

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).

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