Telepsychiatry in Washington

Telepsychiatry can be used to augment behavioral health services in a variety of facilities including hospitals, federally qualified health centers, community clinics, correctional facilities, outpatient offices, primary care offices, crisis centers, schools, geriatric facilities and more. 

Parity Laws 

  • Washington’s parity law, enacted in 2015, mandates health plans to cover a service delivered through telemedicine if: 
    •  The plan covers the service when delivered in person 
    • The service is medically necessary 
    • The service is recognized as an essential health benefit under the Affordable Care Act 


  • Medicaid 
    • Washington Medicaid (Apple Health) reimburses for live video, store-and-forward, and remote patient monitoring under some circumstances 
  • Medicare  
    • Medicare only reimburses for telehealth services that are provided to a patient at one of 11 outlined originating sites and that site has to be located in a health professional shortage area (HPSA) or a county outside a metropolitan statistical area (MSA).  
  • Private Payers 
    • Insurers (including employee health plans and Medicaid Managed Care) must reimburse a provider for services delivered through telemedicine or store-and-forward under certain circumstances 

Telemedicine Prescribing 

  • Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, are to be held to the same standards of appropriate practice as those in in-person settings. 
  • Treatment, including issuing a prescription, based solely on an online questionnaire or consultation does not constitute an acceptable standard of care. 

Cross State Licensing 

  • Clinicians need to have a Washington license in order to provide telepsychiatry services to patients located in the state.  
  • Washington is a member of the Interstate Medical Licensure Compact (IMLC) 
  • Washington is not a member of the Nurse Licensure Compact (NLC) 

Helpful Resources