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Delaware

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

Source

3500 Board of Examiners of Psychologists18.0 Telepsychology

"18.1 “Telepsychology” means the practice of psychology by distance communication technology such as but not necessarily limited to telephone, email, Internet-based communications, and videoconferencing.

18.2 In order to practice telepsychology one must hold a current, valid license issued by the Board.

18.3 Licensees understand that this rule does not provide licensees with authority to practice telepsychology in service to clients domiciled in any jurisdiction other than Delaware, and licensees bear responsibility for complying with laws, rules, or policies for the practice of telepsychology set forth by other jurisdictional boards of psychology.

18.4 Licensees practicing telepsychology shall comply with all of these rules of professional conduct and with requirements incurred in state and federal statutes relevant to the practice of psychology.

18.5 Licensees establish and maintain current competence in the professional practice of telepsychology through continuing education, consultation, or other procedures, in conformance with prevailing standards of scientific and professional knowledge. Licensees establish and maintain competence in the appropriate use of the information technologies utilized in the practice of telepsychology.

18.6 Licensees recognize that telepsychology is not appropriate for all psychological problems and clients, and decisions regarding the appropriate use of telepsychology are made on a case-by-case basis. Licensees practicing telepsychology are aware of additional risks incurred when practicing psychology through the use of distance communication technologies and take special care to conduct their professional practice in a manner that protects the welfare of the client and ensures that the client’s welfare is paramount. Licensees practicing telepsychology shall:

18.6.1 Conduct a risk-benefit analysis and document findings specific to:

18.6.1.1 Whether the client’s presenting problems and apparent condition are consistent with the use of telepsychology to the client’s benefit; and

18.6.1.2 Whether the client has sufficient knowledge and skills in the use of the technology involved in rendering the service or can use a personal aid or assistive device to benefit from the service.

18.6.2 Not provide telepsychology services to any person or persons when the outcome of the analysis required in subsections 18.6.1.1 and 18.6.1.2 of this regulation is inconsistent with the delivery of telepsychology services, whether related to clinical or technological issues.

18.6.3 Upon initial and subsequent contacts with the client, make reasonable efforts to verify the identity of the client;

18.6.4 Obtain alternative means of contacting the client;

18.6.5 Provide to the client alternative means of contacting the licensee;

18.6.6 Establish a written agreement relative to the client’s access to in-person emergency services in the client’s geographical area, in instances such as, but not necessarily limited to, the client experiencing a suicidal or homicidal crisis;

18.6.7 Licensees, whenever feasible, use secure communications with clients, such as encrypted text messages via email or secure websites and obtain and document consent for the use of non-secure communications.

18.6.8 Prior to providing telepsychology services, obtain the written informed consent of the client, in language that is likely to be understood and consistent with accepted professional and legal requirements, relative to:

18.6.8.1 The limitations and innovative nature of using distance technology in the provision of psychological services;

18.6.8.2 Potential risks to confidentiality of information due to the use of distance technology;

18.6.8.3 Potential risks of sudden and unpredictable disruption of telepsychology services and how an alternative means of re-establishing electronic or other connection will be used under such circumstances;

18.6.8.4 When and how the licensee will respond to routine electronic messages;

18.6.8.5 Under what circumstances the licensee and service recipient will use alternative means of communications under emergency circumstances;

18.6.8.6 Who else may have access to communications between the client and the licensee;

18.6.8.7 Specific methods for ensuring that a client’s electronic communications are directed only to the licensee or supervisee;

18.6.8.8 How the licensee stores electronic communications exchanged with the client;

18.6.9 Ensure that confidential communications stored electronically cannot be recovered or accessed by unauthorized persons when the licensee disposes of electronic equipment and data."

Refer to the source provided for all requirements and limitations.

Psychiatrists

Source

1769D Telemedicine and telehealth

“(a) Physicians may practice telemedicine and telehealth. Provided that telemedicine shall not be utilized by a physician with respect to any patient in the absence of a physician-patient relationship, except for the instances in subsection (k) of this section.”

“(b) Physicians who utilize telemedicine shall, if such action would otherwise be required in the provision of the same service not delivered via telemedicine, ensure that a proper physician-patient relationship is established either in-person or through telehealth which includes but is not limited to:

(1) Fully verifying and authenticating the location and, to the extent possible, identifying the requesting patient;

(2) Disclosing and validating the provider’s identity and applicable credential or credentials;

(3) Obtaining appropriate consents from requesting patients after disclosures regarding the delivery models and treatment methods or limitations, including informed consents regarding the use of telemedicine technologies as indicated in paragraph (b)(5) of this section;

(4) Establishing a diagnosis through the use of acceptable medical practices, such as patient history, mental status examination, physical examination (unless not warranted by the patient’s mental condition), and appropriate diagnostic and laboratory testing to establish diagnoses, as well as identify underlying conditions or contraindications, or both, to treatment recommended or provided;

(5) Discussing with the patient the diagnosis and the evidence for it, the risks and benefits of various treatment options;

(6) Ensuring the availability of the distant site provider or coverage of the patient for appropriate follow-up care; and

(7) Providing a written visit summary to the patient.”

“(c) Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional (encounter in person) settings.”

“(d) The physician treating a patient through telemedicine must maintain a complete record of the patient’s care which must follow all applicable state and federal statutes and regulations for recordkeeping, confidentiality, and disclosure to the patient.”

“(e) Telemedicine shall include, at such time as feasible and when appropriate, utilizing the Delaware Health Information Network (DHIN) in connection with the practice.”

“(f) Without a prior and proper patient-provider relationship, as provided in subsection (b) of this section, providers are prohibited from issuing prescriptions solely in response to an Internet questionnaire, an Internet consult, or a telephone consult.”

“(g) Prescriptions made through telemedicine and under a physician-patient relationship may include controlled substances, subject to limitations as set by the Board.”

“(h) Physicians using telemedicine technologies to provide medical care to patients located in Delaware must, prior to a diagnosis and treatment, either provide:

(1) An appropriate examination in-person;

(2) Have another Delaware-licensed practitioner at the originating site with the patient at the time of the diagnosis;

(3) The diagnosis must be based using both audio and visual communication; or

(4) The service meets standards of establishing a patient-physician relationship included as part of evidence-based clinical practice guidelines in telemedicine developed by major medical specialty societies.”

“(i) After a physician-patient relationship is properly established in accordance with this section, subsequent treatment of the same patient with the same physician need not satisfy the limitations of this section.”

“(j) Nothing in this section shall be construed to limit the practice of radiology or pathology.”

“(k) Telemedicine may be practiced without a physician-patient relationship during:

(1) Informal consultation performed by a physician outside the context of a contractual relationship and on an irregular or infrequent basis without the expectation or exchange of direct or indirect compensation;

(2) Furnishing of medical assistance by a physician in case of an emergency or disaster if no charge is made for the medical assistance; or

(3) Episodic consultation by a medical specialist located in another jurisdiction who provides such consultation services on request to a licensed health-care professional.”

Refer to the source provided for all requirements and limitations.

Delaware Professional Regulation/Health & Safety Online Prescribing

Source

1769D(f)(g)(h)

(f) Without a prior and proper patient-provider relationship, as provided in subsection (b) of this section, providers are prohibited from issuing prescriptions solely in response to an Internet questionnaire, an Internet consult, or a telephone consult.

(g) Prescriptions made through telemedicine and under a physician-patient relationship may include controlled substances, subject to limitations as set by the Board.

(h) Physicians using telemedicine technologies to provide medical care to patients located in Delaware must, prior to a diagnosis and treatment, either provide:

(1) An appropriate examination in-person;

(2) Have another Delaware-licensed practitioner at the originating site with the patient at the time of the diagnosis;

(3) The diagnosis must be based using both audio and visual communication; or

(4) The service meets standards of establishing a patient-physician relationship included as part of evidenced-based clinical practice guidelines in telemedicine developed by major medical specialty societies.

Refer to the source provided for all requirements and limitations.

Nurses

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

Delaware Professional Regulation/Health & Safety Online Prescribing

Source

1769D(f)(g)(h)

“(f) Without a prior and proper patient-provider relationship, as provided in subsection (b) of this section, providers are prohibited from issuing prescriptions solely in response to an Internet questionnaire, an Internet consult, or a telephone consult.

(g) Prescriptions made through telemedicine and under a physician-patient relationship may include controlled substances, subject to limitations as set by the Board.

(h) Physicians using telemedicine technologies to provide medical care to patients located in Delaware must, prior to a diagnosis and treatment, either provide:

(1) An appropriate examination in-person;

(2) Have another Delaware-licensed practitioner at the originating site with the patient at the time of the diagnosis;

(3) The diagnosis must be based using both audio and visual communication; or

(4) The service meets standards of establishing a patient-physician relationship included as part of evidenced-based clinical practice guidelines in telemedicine developed by major medical specialty societies.”

Refer to the source provided for all requirements and limitations.

Medicaid Telehealth Parity Law

There is a Law for Payment Parity of Medicaid services provided through telehealth 

Source: DE Medical Assistance Program. Practitioner Provider Specific Manual, 2/1/2019. Ch. 16 Telemedicine

“16.4.1.5 The same procedure codes and rates apply as for services delivered in person (enrolled providers will bill Usual and Customary).”

Originating Site Reimbursement: 

“An approved originating site may include the DMAP member’s place of residence, day program, or alternate location in which the member is physically present and telemedicine can be effectively utilized.”

Link: https://medicaidpublications.dhss.delaware.gov/dotnetnuke/DesktopModules/Bring2mind/DMX/API/Entries/Download?Command=Core_Download&EntryId=887&language=en-US&PortalId=0&TabId=94

Refer to the source provided for all requirements and limitations. 

Private Pay Telehealth Parity Law

There is a Law for Private Pay Parity for services provided through telehealth.

Source: Delaware Code Title 18, Sec. 3370

“(e) An insurer, health service corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis and at least at the rate that the insurer, health service corporation, or health maintenance organization is responsible for coverage for the provision of the same service through in-person consultation or contact. Payment for telemedicine interactions shall include reasonable compensation to the originating or distant site for the transmission cost incurred during the delivery of health-care services.”

Link: https://delcode.delaware.gov/title18/c033/sc01/index.shtml

Refer to the source provided for all requirements and limitations. 

Payment Parity

There is a Law for Private Pay Parity for services provided through telehealth.

Source: Delaware Code Title 18, Sec. 3370

“(e) An insurer, health service corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis and at least at the rate that the insurer, health service corporation, or health maintenance organization is responsible for coverage for the provision of the same service through in-person consultation or contact. Payment for telemedicine interactions shall include reasonable compensation to the originating or distant site for the transmission cost incurred during the delivery of health-care services.”

Link: https://delcode.delaware.gov/title18/c033/sc01/index.shtml

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 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).

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