- Counselors
- Social Workers
- Marriage and Family Therapists
- Psychologists
- Psychiatrists
- Medicaid Telehealth Parity Law
- Private Pay Telehealth Parity Law
- Payment Parity
- Permission for the Temporary Practice of Clinicians Licensed Outside the State
- Response to COVID-19
- Counselors
- Social Workers
- Marriage and Family Therapists
- Psychologists
- Psychiatrists
- Medicaid Telehealth Parity Law
- Private Pay Telehealth Parity Law
- Payment Parity
- Permission for the Temporary Practice of Clinicians Licensed Outside the State
- Response to COVID-19
Counselors
Counselors
Source: Title 22 (Examining Boards) Texas Administrative Code Part 30, Chapter 681
Rules Relating to the Licensing and Regulation of Professional Counselors
Chapter C: G Technological means of communication may be used to facilitate the therapeutic counseling process.
Texas State Board Of Examiners Of Professional Counselors, Code Of Ethics
RULE §681.41, General Ethical Requirements
(g) Technological means of communication may be used to facilitate the therapeutic counseling process. Counselors engaging in interactive distance counseling must adhere to each provision of the rules and statutes of the board.
Marriage and Family Therapists
Marriage and Family Therapists
Texas Administrative Code
Title 22. Examining Boards
Part 35. Texas State Board of Examiners of Marriage and Family Therapists
Chapter 801. Licensure and Regulation of Marriage and Family Therapists
RULE §801.44, Relationships with Clients
(q) A licensee who engages in interactive therapy via the telephone or internet must provide the client with his/her license number and information on how to contact the board by telephone, electronic communication, or mail, and must adhere to all other provisions of this chapter.
§801.58. Technology-Assisted Services.
(a)Licensees who provide marriage and family therapy to clients or supervision to supervisees outside the State of Texas shall comply with the laws and rules of this board and of the out-of-state regulatory authority.
(b)Licensees who provide treatment, consultation, and supervision using technology-assisted services shall meet the same standards of appropriate practice as licensees who practice in traditional (i.e., in-person) settings.
(c)In accordance with Occupations Code, §502.251 (relating to License Required), a person may not practice as a marriage and family therapist unless the person holds a license under this chapter or is exempt under Occupations Code, §502.004 (relating to Application of Chapter).
(d)Licensees may use technology-assisted services only after receiving appropriate education, training, and/or supervised experience in using relevant technology. A therapist who uses technology-assisted services must maintain documentation of academic preparation and supervision in the use of technology-assisted services as part of the therapist's academic program or the substantial equivalent provided through at least 15 hours of continuing education and 2 hours every subsequent renewal period. Licensees must comply with this subsection by January 1, 2018.
(e)A licensee shall not render therapy using technology-assisted services without complying with the following at the onset of each session:
(1)fully verifying the location and identity of the client, to the most reasonable extent possible;
(2)disclosing the identity and applicable credentials of the licensee; and
(3)obtaining appropriate consents from clients.
(f)Before providing technology-assisted services, licensees shall determine whether a client is a minor. Upon determining that a client is a minor, and before providing technology-assisted services, licensees shall obtain required consent from a parent or guardian and shall verify the identity of the parent, guardian, or other person consenting to the minor's treatment.
(g)The licensee shall determine if technology-assisted service is an appropriate delivery of treatment or supervision, considering the professional, intellectual, or emotional needs of the client or supervisee.
(h)Informed consent shall include, at a minimum, information that defines electronic service delivery as practiced by the licensee and the potential risks and ethical considerations. The licensee shall obtain and maintain written and/or electronic evidence documenting appropriate client informed consent for the use of technology-assisted services. The licensee shall ensure that the informed consent complies with other informed consent requirements in this chapter and shall include the following:
(1)identification of the client, the therapist, and the therapist's credentials;
(2)list of services provided by the licensee using technology-assisted services;
(3)client agreement that the therapist determines on an on-going basis whether the condition being assessed and/or treated is appropriate for technology-assisted services;
(4)details on security measures taken with the use of technology-assisted services, as well as potential risks to privacy notwithstanding such measures;
(5)information regarding secure protocols and back-up plans in case of technical failure;
(6)the licensee's credentials or training to engage in technology-assisted services, physical location of practice, and contact information;
(7)risks and benefits of engaging in the use of technology;
(8)emergency procedures to follow when the therapist is not available;
(9)information collected and any passive tracking mechanisms used;
(10)third-party websites or services used by the licensee to facilitate technology-assisted services; and
(11)an explanation of how records are maintained electronically, including, but not limited to, encryption type and record security, and the archival storage period for transaction records.
(i)Therapists who use technology-assisted services shall meet or exceed applicable federal and state legal requirements of health information privacy, including, but not limited to, compliance with the Health Insurance Portability and Accountability Act of 1966 (HIPAA), Public Law 104-191; The Health Information Technology for Economic and Clinical Health (HITECH) Act, 42 U.S.C. Chapter 156, Subchapter III; Health and Safety Code, Chapter 181 (relating to Medical Records Privacy); and state privacy, confidentiality, and security rules.
(j)Licensees must comply with this section by January 1, 2018.
Psychologists
Psychologists
Texas State Board of Examiners of Psychologists, Telepractice Policy Statement
Vol 12 No.2
December 1999
• Telepractice Policy Statement
• Policy on Licensees Working in Exempt Facilities
• No Duty to Warn: Says Texas Supreme Court
Telepractice Policy Statement
The delivery of psychological services by telephone, teleconferencing, and the Internet is a rapidly evolving area. Board rules do not specifically address telepractice, teletherapy, teleconferencing, or electronically providing services. No rules currently prohibit such services.
However, it is important for psychologists to be aware of a number of concerns about telecommunication-based service delivery including the following:
1. The increased potential that a therapist will have limited knowledge of a distant community’s
resources in times of crisis.
2. Problems associated with obtaining informed consent.
3. The lack of standards for training providers in the use of technology as well as the special therapeutic considerations in the use of the medium.
4. The lack of vocal, visual, and other sensory cues.
5. The potential that equipment failures may lead to undue patient anxiety particularly in crisis situations.
6. The potential inability of patients in crisis or those unfamiliar with technology to adequately access and use the technology.
7. The lack of full disclosure of provider credentials.
8. The lack of definition of professional relationships.
9. The lack of confidentiality and privacy. All of these issues are actively being explored, discussed, and debated at both state and national levels. It is important to remember that the Psychologists’ Licensing Act and all other laws affecting the delivery of psychological services apply to all psychological services delivered anywhere within the state of Texas, regardless of whether or not they are provided via electronic media.
Complaints received by the Board regarding psychological services delivered through electronic media, including telephone, teleconferencing, electronic mail and Internet, will be evaluated by the Board on a case-by-case basis. However, the following general principles apply.
An individual who is physically located in another state shall be considered to be practicing psychology in Texas and, therefore, subject to the Act, if a recipient of psychological services provided by the individual is physically located in the state of Texas. Licensees should also be aware that services they offer to consumers in other states may similarly be regulated by the laws of the state in which the consumers are located.
The Board currently considers the use of non-traditional media to deliver psychological services, including telephone, teleconferencing, e-mail, and the Internet, as “emerging areas” as set forth in Board rule 465.9(e), Competency. That rule states: “in those emerging areas in which generally recognized standards for preparatory training do not exist, psychologists nevertheless take reasonable steps to ensure the competence of their work and to protect patients, clients, students, research participants, and other affected individuals from the potential for harm.” Board rule 465.9(d) requires that licensees who provide services in new areas or involving new techniques do so only after undertaking appropriate study, training, supervision, and/or consultation from persons who are competent in those areas or techniques.
Other Board rules that licensees should also consider include:
465.1. Definitions
465.6. Listings and Advertisements
465.8. Psychological Services Are Provided within a Defined Relationship
465.10. Basis for Scientific and Professional Judgments
465.11. Informed Consent/Describing
Psychological Services
465.12. Privacy and Confidentiality
465.15. Fees and Financial Arrangements
465.16. Evaluation, Assessment, Testing, and Reports
465.17. Therapy and Counseling
465.36. Code of Ethics.
Other rules may also apply depending on the type of services involved. It is important for licensees considering such services to review the characteristics of the services, the service delivery method, and the provisions for confidentiality to ensure compliance with the rules of the Board and the acceptable standards of practice.
Policy on Licensees Working in Exempt Facilities
In compliance with Section 501.004 of the Act, persons who are licensed with this Board and who work in exempt settings are exempt from the Act if their “activities and services” are a part of the duties of their positions with the exempt agencies.
Section 501.004 states that persons who are employed in exempt facilities as psychologists or psychological associates are not required to be licensed with this Board. However, this section does require that persons who are employed by an exempt agency and who provide services to the public for added compensation above their salary from the exempt agency have to be licensed with the Board.
Therefore, any “activities and services” regarding the practice of psychology and licensure with this Board outside the context of the exempt setting are subject to the requirements of the Act and the rules and to the discipline of the Board. For example, a licensee may work part-time in an exempt facility and part-time in private practice. The private practice would be subject to all the rules regarding supervision, record keeping, confidentiality, etc. However, the work in the exempt facility would be exempt from such rules of the Board.
Since activities such as renewal, payment of fees, submission of mandatory continuing education, etc. are not considered “activities and services” performed in the context of an exempt setting, the licensee would have to adhere to these provisions of the Act and rules to keep the license in good standing. Complaints received by the Board concerning the “activities and services” of a licensee in an exempt setting are referred to the appropriate exempt agency so that the matter can be resolved in the most expedient and proper manner. Complaints pertaining to the “activities and services” occurring outside of the exempt setting by a licensee who is employed by an exempt agency will be investigated and resolved by the Board.
No Duty to Warn: Says Texas Supreme Court
On June 24, 1999, the Supreme Court of Texas delivered its opinion concerning mental health professionals’ duty to warn third parties as to specific threats of harm made by a patient of the professional. In Thapar v. Zezulka, a psychiatrist had been treating a patient for approximately three years for post-traumatic stress disorder, alcohol abuse, and various delusional beliefs about his stepfather. After being admitted to the hospital, the patient stated to his psychiatrist that he had felt like killing his stepfather. A few weeks after being released from the hospital, the patient did, in fact, shoot and kill his stepfather.
The specific issue before the court was whether or not the psychiatrist was negligent in failing to disclose the patient’s threats to the family or to law enforcement officials. Chapter 611 of the Texas Health and Safety Code provides that mental health information is confidential and permits disclosure of mental health information only in limited circumstances.
Section 611.004 lists these exceptions and specifically states in 611.004(a)(2) that,
(a) A professional may disclose confidential information only:
(2) to medical or law enforcement personnel if the professional determines that there is a probability of imminent physical injury by the patient to the patient or others or there is a probability of immediate mental or emotional injury to the patient.” Texas Health and Safety Code Ann. 611.004(a)(2).
Because Section 611.004 does not provide an exception for disclosure to third parties threatened by the patient (such as the potential victim or their family members), the court concluded that the psychiatrist could not have legally warned the patient’s stepfather or his family without violating the confidentiality statute. As such, the doctor in Thapar was prohibited from warning the patient’s family members as to the threat and, therefore, had no duty to warn potential third party victims as a result.
However, Section 611.004 does allow disclosure of serious threats to medical or law enforcement personnel. Nevertheless, the court determined that this disclosure was permissive on the part of the professional rather than mandatory. Consequently, a mental health professional has no legal duty to warn a third party of a patient’s threat but may contact the appropriate officials in the event that the professional has determined that there is a probability of imminent injury by the patient to himself or others, or mental or emotional injury to the patient. The current law will not penalize a mental health professional for failing to disclose threats to the proper officials even if he or she truly believes that some type of harm is imminent. However, professionals who do choose to disclose threats are not immune from civil liability for improper disclosure of confidential communications. This is true even if the disclosure was made in good faith. While there are circumstances where a patient’s right to confidentiality may be legally compromised, it will be incumbent on the mental health professional to show why the disclosure was permissible and made pursuant to the exception stated in 611.004(a)(2).
Copies of the Texas Supreme Court opinion in this Thapar v. Zezulka can be obtained at the Court’s website on the June 1999 “Opinions” page.
Texas State Board Of Examiners Of Psychologists’ Rules Of Practice.
Texas Administrative Code, TITLE 22, PART 21, CHAPTER 465 , RULE §465.9
Competency
(a) Licensees provide only services for which they have the education, skills, and training to perform competently.
(b) Competency includes the ability to provide services concerning a specific individual that takes into account characteristics of that individual including age, gender, ethnicity, national origin, disability, language, and socio-economic status.
(c) Licensees maintain current knowledge of scientific and professional information that ensures competency in every area in which they provide services.
(d) Licensees provide services in an unfamiliar area or involving new techniques only after first undertaking appropriate study and training, including supervision, and/or consultation from a professional competent to provide such services.
(e) In emerging areas in which generally recognized standards for preparatory training do not exist, licensees take reasonable steps to ensure the competence of their work and to protect patients, clients, research participants, and other affected individuals from the potential for harm.
(f) Licensees are responsible for ensuring that all individuals practicing under their supervision are competent to perform those services.
(g) Licensees who delegate performance of certain services such as test scoring are responsible for ensuring that the entity to whom the delegation is made is competent to perform those services.
(h) Licensees who lack the competency to provide particular psychological services to a specific individual must withdraw and refer the individual to a competent appropriate service provider.
(i) Emergency Situations. In emergencies, when licensees are asked to provide services to individuals for whom appropriate mental health services are not available and for which the licensee has not obtained the necessary competence, licensees may provide such services only to the extent necessary to ensure that services are not denied. If ongoing services are provided, licensees must comply with subsection (d) of this section as soon as practicable or refer the patient as per subsection (h) of this section.
(j) Licensees refrain from initiating or continuing to undertake an activity when they know or should know that there is a substantial likelihood that personal problems or conflicts will prevent them from performing their work-related activities or producing a psychological report in a competent and timely manner. When licensees become aware of such conflicts, they must immediately take appropriate measures, such as obtaining professional consultation or assistance in order to determine whether they should limit, suspend, or terminate the engagement in accordance with Board rule §465.21 of this title (relating to Termination of Services).
Source Note: The provisions of this §465.9 adopted to be effective June 3, 1999, 24 TexReg 4017; amended to be effective September 12, 2002, 27 TexReg 8479; amended to be effective June 5, 2005, 30 TexReg 3099; amended to be effective May 30, 2007, 32 TexReg 2864; amended to be effective September 19, 2012, 37 TexReg 7289
Psychiatrists
Texas Administrative Code Chapter 174 Subchapter A
“a) A health professional providing a health care service or procedure as a telemedicine medical service:
(1) is subject to the same standard of care that would apply to the provision of the same health care service or procedures in an in-person setting;
(2) must establish a practitioner-patient relationship; and
(3) must maintain complete and accurate medical records as set out in §165.1 of this title (relating to Medical Records).
(b) Adequate measures must be implemented to ensure that patient communications, recordings and records are protected consistent with Federal and State privacy laws.”
“Physicians who treat and prescribe through communications technology are practicing medicine and must possess a full Texas medical license when treating residents of Texas. An out-of-state physician may provide episodic consultations without a Texas medical license, as provided in Texas Occupations Code, §151.056, §172.2(g)(4) of this title (relating to Construction and Definitions), and §172.12(f) of this title (relating to Out-of-State Telemedicine License).”
CHAPTER 111. TELEMEDICINE AND TELEHEALTH
Sec. 111.001. DEFINITIONS. In this chapter:
“(1) "Health professional" and "physician" have the meanings assigned by Section 1455.001, Insurance Code.”
“(2) "Store and forward technology" means technology that stores and transmits or grants access to a person's clinical information for review by a health professional at a different physical location than the person.”
“(3) "Telehealth service" means a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional's license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.”
“(4) "Telemedicine medical service" means a health care service delivered by a physician licensed in this state, or a health professional acting under the delegation and supervision of a physician licensed in this state, and acting within the scope of the physician's or health professional's license to a patient at a different physical location than the physician or health professional using telecommunications or information technology.”
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 22, eff. April 1, 2005.
Renumbered from Occupations Code, Section 107.001 by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 23.001(69), eff. September 1, 2005.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 205 (S.B. 1107), Sec. 1, eff. May 27, 2017.
“Sec. 111.002. INFORMED CONSENT. A treating physician or health professional who provides or facilitates the use of telemedicine medical services or telehealth services shall ensure that the informed consent of the patient, or another appropriate individual authorized to make health care treatment decisions for the patient, is obtained before telemedicine medical services or telehealth services are provided.”
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 22, eff. April 1, 2005.
Renumbered from Occupations Code, Section 107.002 by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 23.001(69), eff. September 1, 2005.
“Sec. 111.003. CONFIDENTIALITY. A treating physician or health professional who provides or facilitates the use of telemedicine medical services or telehealth services shall ensure that the confidentiality of the patient's medical information is maintained as required by Chapter 159 or other applicable law.”
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 22, eff. April 1, 2005.
Renumbered from Occupations Code, Section 107.003 by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 23.001(69), eff. September 1, 2005.
“Sec. 111.004. RULES. The Texas Medical Board, in consultation with the commissioner of insurance, as appropriate, may adopt rules necessary to:
(1) ensure that patients using telemedicine medical services receive appropriate, quality care;
(2) prevent abuse and fraud in the use of telemedicine medical services, including rules relating to the filing of claims and records required to be maintained in connection with telemedicine medical services;
(3) ensure adequate supervision of health professionals who are not physicians and who provide telemedicine medical services; and
(4) establish the maximum number of health professionals who are not physicians that a physician may supervise through a telemedicine medical service.”
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 22, eff. April 1, 2005.
Renumbered from Occupations Code, Section 107.004 by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 23.001(69), eff. September 1, 2005.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 205 (S.B. 1107), Sec. 2, eff. May 27, 2017.
“Sec. 111.005. PRACTITIONER-PATIENT RELATIONSHIP FOR TELEMEDICINE MEDICAL SERVICES. (a) For purposes of Section 562.056, a valid practitioner-patient relationship is present between a practitioner providing a telemedicine medical service and a patient receiving the telemedicine medical service as long as the practitioner complies with the standard of care described in Section 111.007 and the practitioner:
(1) has a preexisting practitioner-patient relationship with the patient established in accordance with rules adopted under Section 111.006;
(2) communicates, regardless of the method of communication, with the patient pursuant to a call coverage agreement established in accordance with Texas Medical Board rules with a physician requesting coverage of medical care for the patient; or
(3) provides the telemedicine medical services through the use of one of the following methods, as long as the practitioner complies with the follow-up requirements in Subsection (b), and the method allows the practitioner to have access to, and the practitioner uses, the relevant clinical information that would be required in accordance with the standard of care described in Section 111.007:
(A) synchronous audiovisual interaction between the practitioner and the patient in another location;
(B) asynchronous store and forward technology, including asynchronous store and forward technology in conjunction with synchronous audio interaction between the practitioner and the patient in another location, as long as the practitioner uses clinical information from:
(i) clinically relevant photographic or video images, including diagnostic images; or
(ii) the patient's relevant medical records, such as the relevant medical history, laboratory and pathology results, and prescriptive histories; or
(C) another form of audiovisual telecommunication technology that allows the practitioner to comply with the standard of care described in Section 111.007.
(b) A practitioner who provides telemedicine medical services to a patient as described in Subsection (a)(3) shall:
(1) provide the patient with guidance on appropriate follow-up care; and
(2) if the patient consents and the patient has a primary care physician, provide to the patient's primary care physician within 72 hours after the practitioner provides the services to the patient a medical record or other report containing an explanation of the treatment provided by the practitioner to the patient and the practitioner's evaluation, analysis, or diagnosis, as appropriate, of the patient's condition.
(c) Notwithstanding any other provision of this section, a practitioner-patient relationship is not present if a practitioner prescribes an abortifacient or any other drug or device that terminates a pregnancy.”
Added by Acts 2017, 85th Leg., R.S., Ch. 205 (S.B. 1107), Sec. 3, eff. May 27, 2017.
“Sec. 111.006. COORDINATION TO ADOPT RULES THAT DETERMINE VALID PRESCRIPTION. (a) The Texas Medical Board, the Texas Board of Nursing, the Texas Physician Assistant Board, and the Texas State Board of Pharmacy shall jointly adopt rules that establish the determination of a valid prescription in accordance with Section 111.005. Rules adopted under this section must allow for the establishment of a practitioner-patient relationship by a telemedicine medical service provided by a practitioner to a patient in a manner that complies with Section 111.005(a)(3).
(b) The Texas Medical Board, the Texas Board of Nursing, the Texas Physician Assistant Board, and the Texas State Board of Pharmacy shall jointly develop and publish on each respective board's Internet website responses to frequently asked questions relating to the determination of a valid prescription issued in the course of the provision of telemedicine medical services.”
Added by Acts 2017, 85th Leg., R.S., Ch. 205 (S.B. 1107), Sec. 3, eff. May 27, 2017.
“Sec. 111.007. STANDARD OF CARE FOR TELEMEDICINE MEDICAL SERVICES AND TELEHEALTH SERVICES. (a) A health professional providing a health care service or procedure as a telemedicine medical service or a telehealth service is subject to the standard of care that would apply to the provision of the same health care service or procedure in an in-person setting.
(b) An agency with regulatory authority over a health professional may not adopt rules pertaining to telemedicine medical services or telehealth services that would impose a higher standard of care than the standard described in Subsection (a).”
Added by Acts 2017, 85th Leg., R.S., Ch. 205 (S.B. 1107), Sec. 3, eff. May 27, 2017.
Refer to the source provided for all requirements and limitations.
Medicaid Telehealth Parity Law
Source: TTX Admin. Code, Title 1, Sec. 354.1432(2)(A & E)
(A) The telehealth services must be designated for reimbursement by HHSC. Designated telehealth services will be listed in the Texas Medicaid Provider Procedures Manual.
(E) Before receiving a telehealth service, the patient must receive an initial evaluation for the same diagnosis or condition by a physician or other qualified healthcare professional licensed in Texas.
(i) A required initial evaluation must be performed in-person or as a telemedicine visit that conforms to 22 TAC Chapter 174 (relating to Telemedicine).
(ii) If the patient is receiving the telehealth services to treat a mental health diagnosis or condition, the patient is not required to receive an initial evaluation.
Refer to the source provided for all requirements and limitations.
Originating Site Reimbursement: According to TX Medicaid Telecommunication Services Handbook, pg. 8 & 10 (Sept. 2019). (Accessed Sept. 2019). & TX Admin. Code,
Title 1, Sec. 354.1432(1)(C): A client's home can be an originating site for service.
Private Pay Telehealth Parity Law
Source: TX Insurance Code 1455.004(a)
(a) A health benefit plan:
(1) must provide coverage for a covered health care service or procedure delivered by a preferred or contracted health professional to a covered patient as a telemedicine medical service or telehealth service on the same basis and to the same extent that the plan provides coverage for the service or procedure in an in-person setting; and
(2) may not:
(A) exclude from coverage a covered health care service or procedure delivered by a preferred or contracted health professional to a covered patient as a telemedicine medical service or a telehealth service solely because the covered health care service or procedure is not provided through an in-person consultation; and
(B) subject to Subsection (c), limit, deny, or reduce coverage for a covered health care service or procedure delivered as a telemedicine medical service or telehealth service based on the health professional's choice of platform for delivering the service or procedure.
Refer to the source provided for all requirements and limitations.
Payment Parity
Source: TX Insurance Code 1455.004(b)
(b) A health benefit plan may require a deductible, a copayment, or coinsurance for a covered health care service or procedure delivered by a preferred or contracted health professional to a covered patient as a telemedicine medical service or a telehealth service. The amount of the deductible, copayment, or coinsurance may not exceed the amount of the deductible, copayment, or coinsurance required for the covered health care service or procedure provided through an in-person consultation.
(b-1) Subsection (b) does not authorize a health benefit plan to charge a separate deductible that applies only to a covered health care service or procedure delivered as a telemedicine medical service or telehealth service.
Refer to the source provided for all requirements and limitations.
*Clinicians who have had an experience with telehealth reimbursement in this state are invited to share their experiences in the comments section below: a) type of service provided; b) insurance provider; c) payment parity, payment issues, or insurance requirements.
Permission for the Temporary Practice of Clinicians Licensed Outside the State
We are not aware of any permission that allows for services delivered by Counselors, Social Workers, or MFT's.
Psychologists: Texas is Member of the Psychology Interjurisdictional Compact of the Association of State and Provincial
Psychology Boards (PSYPACT)
Refer to the source provided for all requirements and limitations.
Response to COVID-19
Click here to view the state’s response to COVID-19 in regard to Counselors.
Click here to view the state’s response to COVID-19 in regard to Social Workers.
Click here to view the state’s response to COVID-19 in regard to Marriage and Family Therapists.
Click here to view the state’s response to COVID-19 in regard to Psychologists
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.
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).
Social Workers
Social Workers
Texas State Board Of Social Worker Examiners
Code Of Conduct And Professional Standards Of Practice
Texas Administrative Code, TITLE 22, PART 34, CHAPTER 781, SUBCHAPTER B, RULE §781.204
Relationships with Clients
(k) Electronic practice may be used judiciously as part of the social work process and the supervision process. Social workers engaging in electronic practice must be licensed in Texas and adhere to provisions of this chapter.
LICENSES AND LICENSING PROCESS
RULE §781.414
Issuance of License Certificates
(e) A licensee who offers social work services on the Internet must include a statement that the licensee is licensed by the State of Texas and provide a copy of the Code of Conduct with the information on how to contact this board by mail or telephone.