West Virginia
Counselors and Marriage and Family Therapists "Technology-Assisted Counseling or Therapy is defined as any counseling or marriage and family therapy that is facilitated by the use of technology including, but not limited to, interactive audio, video or other telecommunications or electronic media, when the counselor or therapist and the client are not located in the same place at the time of service delivery." "For the Out-of-State Licensed Professional Counselor (LPC) or Licensed Marriage & Family Therapist (LMFT) who wishes to provide technology-assisted counseling or therapy to the client physically present in WV: All persons providing counseling or marriage and family therapy via technology-assisted delivery to persons (clients) physically present in the State of West Virginia shall be licensed in West Virginia." "For the licensee of this Board that uses technology-assisted counseling or therapy as the delivery method, the WV Board of Counseling recommends the following: 1) The licensee should be reminded of the standards of counseling and marriage and family therapy practice set forth in W. Va. Code § 30-31-1 et seq., Board rules, and professional code(s) of ethics as per W. Va. Code § 27-1-11 and §27-8-10, also apply to technology-assisted counseling and therapy. Technology-Assisted counseling or therapy shall be held to the same standards of appropriate practice as those in-person settings. 2) The licensee should be aware of the potential problems unique to technology-assisted counseling or therapy in that the counseling relationship, client identity, and other counseling related matters may be compromised. 3) The licensee should limit the practice of technology-assisted counseling or therapy to the areas of competence in which proficiency has been gained through education, training, and experience. Additionally, the licensee should continually assess both their professional and technical competence when providing technology-assisted counseling or therapy. 4) The licensee should understand and inform their clients of the limits to confidentiality and risks to the possible access or disclosure of confidential data and information that may occur during electronic service delivery. 5) The licensee shall take reasonable steps to ensure that security measures are in place for obtaining, protecting, verifying, and controlling access to client data. 6.a.) For the WV Licensed Professional Counselor (LPC) providing distance counseling to a client physically present in WV, the licensee shall adhere to "Section H - Distance Counseling, Technology, and Social Media" of the current version of the ACA Code of Ethics. In addition, the board recommends the LPC review the NBCC Policy Regarding the Provision of Distance Professional Services to provide further guidance and ethical considerations when providing technology assisted counseling. 6.b.) For the WV Licensed Marriage and Family Therapist (LMFT) providing distance therapy to a client physically present in WV, the licensee shall adhere to "Standard VI - Technology Assisted Professional Services" of the current version of the AAMFT Code of Ethics. In addition, the LMFT will also benefit from referencing the Association of Marital and Family Therapy Regulatory Boards – Teletherapy Guidelines (September 2016)." Social Workers The WV Board of Social Work has adopted, by legislative process, the National Association of Social Workers (NASW) Code of Ethics for professional social workers. Social workers who provide services via electronic media (such as computer, telephone, radio, and television) should inform recipients of the limitations and risks associated with such services. Counselors and Marriage and Family Therapists "Technology-Assisted Counseling or Therapy is defined as any counseling or marriage and family therapy that is facilitated by the use of technology including, but not limited to, interactive audio, video or other telecommunications or electronic media, when the counselor or therapist and the client are not located in the same place at the time of service delivery." "For the Out-of-State Licensed Professional Counselor (LPC) or Licensed Marriage & Family Therapist (LMFT) who wishes to provide technology-assisted counseling or therapy to the client physically present in WV: All persons providing counseling or marriage and family therapy via technology-assisted delivery to persons (clients) physically present in the State of West Virginia shall be licensed in West Virginia." "For the licensee of this Board that uses technology-assisted counseling or therapy as the delivery method, the WV Board of Counseling recommends the following: 1) The licensee should be reminded of the standards of counseling and marriage and family therapy practice set forth in W. Va. Code § 30-31-1 et seq., Board rules, and professional code(s) of ethics as per W. Va. Code § 27-1-11 and §27-8-10, also apply to technology-assisted counseling and therapy. Technology-Assisted counseling or therapy shall be held to the same standards of appropriate practice as those in-person settings. 2) The licensee should be aware of the potential problems unique to technology-assisted counseling or therapy in that the counseling relationship, client identity, and other counseling related matters may be compromised. 3) The licensee should limit the practice of technology-assisted counseling or therapy to the areas of competence in which proficiency has been gained through education, training, and experience. Additionally, the licensee should continually assess both their professional and technical competence when providing technology-assisted counseling or therapy. 4) The licensee should understand and inform their clients of the limits to confidentiality and risks to the possible access or disclosure of confidential data and information that may occur during electronic service delivery. 5) The licensee shall take reasonable steps to ensure that security measures are in place for obtaining, protecting, verifying, and controlling access to client data. 6.a.) For the WV Licensed Professional Counselor (LPC) providing distance counseling to a client physically present in WV, the licensee shall adhere to "Section H - Distance Counseling, Technology, and Social Media" of the current version of the ACA Code of Ethics. In addition, the board recommends the LPC review the NBCC Policy Regarding the Provision of Distance Professional Services to provide further guidance and ethical considerations when providing technology assisted counseling. 6.b.) For the WV Licensed Marriage and Family Therapist (LMFT) providing distance therapy to a client physically present in WV, the licensee shall adhere to "Standard VI - Technology Assisted Professional Services" of the current version of the AAMFT Code of Ethics. In addition, the LMFT will also benefit from referencing the Association of Marital and Family Therapy Regulatory Boards – Teletherapy Guidelines (September 2016)." The West Virginia Board of Examiners of Psychologists TELE-PSYCHOLOGY – SKYPE "In July 2011, the APA Division 29 task force on tele-psychology observed that internet and cell phone communication do not have the same security as a land line phone. The task force accurately comments that "The Internet is not regulated and not currently protected by privacy laws. Skype, for example, is not an encrypted site and is, therefore, not a confidential means of communication. "The task force further comments that providing psychotherapy on unencrypted sites is ‘ill advised’". The WV Board of Examiners agrees." "Because this does not completely preclude providing such services, extreme caution is advised. For those holding a license to practice in a given jurisdiction, clinical judgment and common sense must be vigorously employed in the choice to use such venue. In such a case, based on the APA's conclusions and recommendations, the WV Board of Examiners believes the psychologist would need to: 1. Contact their malpractice insurance carrier to determine if skype work is covered. 2. Contact the patient's insurance to determine coverage. 3. Use skype with an established patient determined not to be a high risk patient. 4. Make certain the patient fully understands that skype is NOT the same as a phone conversation and is not protected by federal privacy law. It is an open/public forum and anything on skype can be published/used/broadcast/etc. Signed consent would be needed before using skype." "It is somewhat doubtful that all of the above would be approved once the full nature of skype is known, but even then skype should be used on a limited basis, not as a complete substitute for in person treatment." Refer to the source provided for all requirements and limitations. “(b) Licensure. – (1) The practice of medicine occurs where the patient is located at the time the telemedicine technologies are used. (2) A physician or podiatrist who practices telemedicine must be licensed as provided in this article. (3) This section does not apply to: (A) An informal consultation or second opinion, at the request of a physician or podiatrist who is licensed to practice medicine or podiatry in this state, provided that the physician or podiatrist requesting the opinion retains authority and responsibility for the patient’s care; and (B) Furnishing of medical assistance by a physician or podiatrist in case of an emergency or disaster, if no charge is made for the medical assistance. (c) Physician-patient or Podiatrist-patient relationship through telemedicine encounter. – (1) A physician-patient or podiatrist-patient relationship may not be established through: (A) Audio-only communication; (B) Text-based communications such as e-mail, Internet questionnaires, text-based messaging or other written forms of communication; or (C) Any combination thereof.” “(2) If an existing physician-patient or podiatrist-patient relationship does not exist prior to the utilization to telemedicine technologies, or if services are rendered solely through telemedicine technologies, a physician-patient or podiatrist-patient relationship may only be established: (A) Through the use of telemedicine technologies which incorporate interactive audio using store and forward technology, real-time videoconferencing or similar secure video services during the initial physician-patient or podiatrist-patient encounter; or (B) For the practice of pathology and radiology, a physician-patient relationship may be established through store and forward telemedicine or other similar technologies. (3) Once a physician-patient or podiatrist-patient relationship has been established, either through an in-person encounter or in accordance with subdivision (2) of this subsection, the physician or podiatrist may utilize any telemedicine technology that meets the standard of care and is appropriate for the patient presentation” Refer to the source provided for all requirements and limitations. “A “valid patient-practitioner relationship” can be established through telemedicine in a manner approved by the appropriate board.” WV Code Sec. 30-5-4.(67) (Accessed Aug. 2020). “A physician-patient relationship cannot be established through audio only communication, text communications, or any combination thereof.” “A physician-patient relationship can be established through the use of telemedicine technologies which incorporate interactive audio using store and forward technology, real-time videoconferencing or similar secure video services during the initial physician-patient encounter; or for the practice of pathology and radiology, a physician-patient relationship may be established through store and forward telemedicine or other similar technologies.” “A physician or podiatrist may not prescribe any pain-relieving controlled substance listed in Schedules II through V of the Uniform Controlled Substance Act as part of a course of treatment for chronic nonmalignant pain solely based upon a telemedicine encounter.” “A physician or podiatrist who practices medicine to a patient solely through the utilization of telemedicine technologies may not prescribe to that patient any controlled substances listed in Schedule II of the Uniform Controlled Substances Act. Certain exceptions apply.” “A physician or health care provider may not prescribe any drug with the intent of causing an abortion.” WV Code 30-14-12d, (Accessed Aug. 2020). “Prohibits providers from issuing prescriptions, via electronic or other means, for persons without establishing an ongoing physician-patient relationship, wherein the physician has obtained information adequate to support the prescription.” “Exceptions: Refer to the source provided for all requirements and limitations. “As a party state to the Nurse Licensure Compact (NLC), West Virginia issues multistate licenses to nurses and applicants who reside in the state and recognizes multistate licenses issued by other party states, for practice in West Virginia. 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. “A “valid patient-practitioner relationship” can be established through telemedicine in a manner approved by the appropriate board.” WV Code Sec. 30-5-4.(67) (Accessed Aug. 2020). “A physician-patient relationship cannot be established through audio only communication, text communications, or any combination thereof.” “A physician-patient relationship can be established through the use of telemedicine technologies which incorporate interactive audio using store and forward technology, real-time videoconferencing or similar secure video services during the initial physician-patient encounter; or for the practice of pathology and radiology, a physician-patient relationship may be established through store and forward telemedicine or other similar technologies.” “A physician or podiatrist may not prescribe any pain-relieving controlled substance listed in Schedules II through V of the Uniform Controlled Substance Act as part of a course of treatment for chronic nonmalignant pain solely based upon a telemedicine encounter.” “A physician or podiatrist who practices medicine to a patient solely through the utilization of telemedicine technologies may not prescribe to that patient any controlled substances listed in Schedule II of the Uniform Controlled Substances Act. Certain exceptions apply.” “A physician or health care provider may not prescribe any drug with the intent of causing an abortion.” WV Code 30-14-12d, (Accessed Aug. 2020). “Prohibits providers from issuing prescriptions, via electronic or other means, for persons without establishing an ongoing physician-patient relationship, wherein the physician has obtained information adequate to support the prescription.” “Exceptions: Source: WV Code of State Rules Sec. 11-1A-12.2(k) (Accessed Aug. 2020). “A practitioner providing medication-assisted treatment may perform certain aspects of telehealth if permitted under his or her scope of practice.” Source: WV Code Sec. 16-5Y-5(r) (SB 273 - 2018). (Accessed Aug. 2020). Refer to the source provided for all requirements and limitations. Source: WV Dept. of Health and Human Svcs. Medicaid Provider Manual, Chapter–519.17 Practitioner Services: Telehealth Services. (Revised Jan. 15, 2016) "West Virginia Medicaid covers and reimburses a limited number of Telehealth services that are provided to enrolled members by enrolled practitioners via a telecommunication system. West Virginia Medicaid utilizes the Centers for Medicare and Medicaid Services (CMS) guidance for Telehealth Services." Refer to the source provided for all requirements and limitations. Originating Site Reimbursement: We are not aware of any reference of the patient's/client's home as an approved originating site for Medicaid. We are not aware of any explicit payment parity. *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. We are not aware of any permission that allows for services delivered by out-of-state providers.Counselors
Social Workers
Marriage and Family Therapists
Psychologists
Psychiatrists
West Virginia Professional Regulation/Health & Safety Online Prescribing
Nurses
West Virginia Professional Regulation/Health & Safety Online Prescribing
Medicaid Telehealth Parity Law
Payment Parity
Permission for the Temporary Practice of Clinicians Licensed Outside the State
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).
