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North Dakota

Counselors

Source

DISTANCE COUNSELING

“Counselors currently engaging in distance counseling are offered a DCC (Distance Counselor Credential) through NBCC. This is a focused training for those practicing distance counseling, and although it is not mandatory for ND counselors to have this training, it is highly recommended.

The NDBCE also reminds counselors involved in distance counseling to be aware of the laws and requirements of the state where the client resides, which may require licensure in that state.

Further information on distance counseling activities and practice can be found in the 2014 ACA Code of Ethics, page 17, Section H. It is extremely important to review the ACA Code of Ethics before entering into distance counseling practice. The Code of Ethics can be viewed on this website.

If you reside inside or outside of the state of North Dakota, and wish to practice counseling via Internet with clients residing in North Dakota, you must be licensed by the North Dakota Board of Counselor Examiners.”

Social Workers

Social Workers

Source

“The Board has adopted the NASW Code of Ethics 2017 version as its Code of Ethics under Administrative Code 75.5-02-06.1-01 effective April 1, 2021. These specific ethical standards are enacted to guide social workers’ practice and conduct, and to provide a basis for adjudication. A violation of the Code of Ethics adopted by the Board is grounds for disciplinary action

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

CHAPTER 43-51

PROFESSIONAL AND OCCUPATIONAL LICENSING

43-51-02. Location of practice of an occupation or profession.

"The provision of services to an individual in this state which fall within the standard of practice of a profession or occupation regulated by a board, regardless of the means by which the services are provided or the physical location of the person providing those services, constitutes the practice of that occupation or profession in this state and is subject to regulation by the appropriate board in this state."

Source

BOARD STATEMENT ON TELEPSYCHOLOGY IN NORTH DAKOTA

 ND STATE BOARD OF PSYCHOLOGIST EXAMINERS 1

"The use of technology to provide psychological services via remote means, sometimes known as telepsychology, is a bourgeoning part of our profession. While telepsychology can increase efficiencies and make mental health services more accessible, it is not without its own complexities. For example, psychologists practicing telepsychology must adhere not only to guidelines related to the utilization of new methods in the delivery of services  APA/ASPPB/APAIT Joint Telepsychology Guidelines), but must also follow the laws of multiple jurisdictions as those laws apply to their practice of telepsychology. This statement is meant to briefly orient psychologists to some of the issues they may encounter related to telepsychological practice.

First, there is no special licensure status or credential within North Dakota for the practice of telepsychology. As a result, a psychologist licensed in North Dakota may be permitted to provide telepsychology services to recipients located either inside or outside North Dakota. When doing so, the psychologist must comply with the laws and regulations of a) North Dakota, including NDCC 43-32 and 43-51, b) the jurisdiction in which the psychologist is located, and c) the jurisdiction in which the recipient is located. The psychologist should specifically be aware of whether each jurisdiction permits telepsychology and how they regulate it.

A psychologist licensed in another jurisdiction, but who is not licensed in North Dakota may also be permitted to provide telepsychology services in North Dakota. If the psychologist or the recipient is located in North Dakota, the psychologist must comply with North Dakota laws, including NDCC 43-32 and 43-51.

These laws require, in part, that the services of the psychologist be within the scope of practice and title of the license of a psychologist. In situations where the recipient is located in North Dakota, the law also requires that the services be a continuation of a professional relationship with the recipient that was formed first in the jurisdiction in which the provider is licensed, as long as the foreign jurisdiction permits remote practice. This psychologist must also comply with the laws of the jurisdictions where a) the psychologist is licensed, b) the psychologist is located, and c) the recipient is located. This psychologist should specifically be aware of whether each jurisdiction permits telepsychology and how they regulate it.

A psychologist’s failure to follow the laws of any of the jurisdictions in which they are licensed or located, or where the recipient of their services is located, may result in discipline of the psychologist by all of the relevant jurisdictions. Psychologists are strongly encouraged to regularly review the applicable laws to ensure their practices, including their provision of telepsychology, are compliant.

Permutations:

ND Licensed Psychologist/Applied Behavior Analyst providing telepsychology services:

1. Psychologist/BA in ND; Recipient in ND

a. A licensee located in ND may provide remote services to individuals in ND within their competence of the scope of practice and title of the license. Licensees doing so should be aware of regulations related to this practice, including (but not limited to): NDCC 43-32 and 43-51. There is no special licensure status or credential within ND for telepractice.

2. Psychologist/BA in ND; Recipient out of ND

a. A licensee located in ND may provide remote services to individuals in another jurisdiction if such a practice is authorized in that jurisdiction. However, if such practice would be illegal, or the licensee violates a law of that other jurisdiction, or of ND, they would be subject to disciplinary action in ND (and likely the other jurisdiction). Licensees doing so should be aware of regulations related to this practice, including (but not limited to): NDCC 43-32 and 43-51. There is no special licensure status or credential within ND for telepractice.3. Psychologist/BA out of ND; Recipient in ND

a. A ND licensee traveling in another state at the time of providing remote services to individuals located in ND, must additionally ensure compliance with the laws of the jurisdiction in which they are located at the time of practice (see number 2).

4. Psychologist/BA out of ND; Recipient out of ND

a. AND licensee traveling in another state at the time of providing remote services to individuals located outside ND, the licensee must additionally ensure compliance with ND STATE BOARD OF PSYCHOLOGIST EXAMINERS 2 the laws of the jurisdiction in which they are located at the time of service as well as the jurisdiction that the recipient is located at the time of services. 

Non-ND Psychologist/BA providing telepsychology services INTO ND:

1. Non-ND Psychologist/BA in licensed state; recipient in ND

a. A non-ND licensed provider may provide remote services to individuals within ND within their competence and scope of practice and title of the license of a psychologist, as long as this is a continuation of a professional relationship with the recipient that was formed first in the jurisdiction which the provider is licensed and as long as the foreign jurisdiction permits remote practice. Foreign licensees doing so should be aware of regulations related to this practice, including (but not limited to): NDCC 43-32 and 43-51.

2. Non-ND Psychologist/BA in ND; recipient in ND

a. A non-ND licensed provider may NOT provide remote services to individuals in ND if they are located in ND at the time of services, as they would not be licensed to practice within this jurisdiction. Foreign licensees doing so should be aware that any person who violates any of the provisions of NDCC 43-32 is guilty of a class B misdemeanor, and civil remedies may also apply.

3. Non-ND Psychologist/BA in state not licensed in; recipient in ND

a. A non-ND licensed provider may not initiate services from a jurisdiction in which they are not licensed and provide these services to a recipient in ND. Foreign licensees doing so should be aware that any person who violates any of the provisions of NDCC 43-32 is guilty of a class B misdemeanor, and civil remedies may also apply."

Refer to the source provided for all requirements and limitations.

Psychiatrists

Source

North Dakota Board of Medicine

Telemedicine Rule Effective 1-1-18

CHAPTER 50-02-15

TELEMEDICINE

50-02-15-01. Definitions.  As used in this chapter:

“1.  “Telemedicine” means the practice of medicine using electronic communication, information technologies, or other means between a licensee in one location and a patient in another location, with or without an intervening health care provider.  The term includes direct interactive patient encounters as well as asynchronous store-and-forward technologies and remote monitoring.” 

“2.  “Licensee” means a physician or physician assistant licensed to practice in North Dakota.  A physician assistant practicing telemedicine from another state is subject to the rules regarding physician supervision, except that supervision may be by a North Dakota licensed physician who is practicing telemedicine in North Dakota and need not be by a North Dakota licensed physician who is physically located in North Dakota.”

50-02-15-02. Prescribing. 

“A licensee who has performed a telemedicine examination or evaluation meeting the requirements of this chapter may prescribe medications according to the licensee’s professional discretion and judgment.  Opioids may only be prescribed through telemedicine if done so as a federal Food and Drug Administration approved medication-assisted treatment for opioid use disorder.  Opioids may not be prescribed through a telemedicine encounter for any other purpose.

Licensees who prescribe controlled substances, as defined by North Dakota law, in circumstances allowed under this rule, shall comply with all state and federal laws regarding the prescribing of controlled substances, and shall participate in the North Dakota prescription drug monitoring program.”

Full details at: Chapter 50-02-15 TELEMEDICINE

Source

Refer to the source provided for all requirements and limitations.

North Dakota Professional Regulation/Health & Safety Online Prescribing

Source

ND Centennial Code, Sec. 19-02.1-15.1.(c) & (f) (Accessed Mar. 2020).

“c. "In-person medical evaluation" means a medical evaluation that is conducted with the patient in the physical presence of the practitioner, without regard to whether portions of the evaluation are conducted by other practitioners, and must include one of the following actions: (1) The prescribing practitioner examines the patient at the time the prescription or drug order is issued; (2) The prescribing practitioner has performed a prior examination of the patient within twelve months; (3) Another prescribing practitioner practicing within the same health system, group, or clinic as the prescribing practitioner has examined the patient within twelve months; (4) A consulting practitioner to whom the prescribing practitioner has referred the patient has examined the patient within twelve months; or (5) The referring practitioner has performed an examination in the case of a consultant practitioner issuing a prescription or drug order when providing services by means of telemedicine. d. "Internet" and "practice of telemedicine" have the meanings set forth in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Pub. L. 110-425; 21 U.S.C. 802-803].”

“f. "Valid prescription" means a prescription that is issued for a legitimate medical purpose in the usual course of professional practice by a practitioner who has conducted an in-person medical evaluation of the patient.”

Refer to the source provided for all requirements and limitations.

Nurses

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

North Dakota Professional Regulation/Health & Safety Online Prescribing

Source

ND Centennial Code, Sec. 19-02.1-15.1.(c) & (f) (Accessed Mar. 2020).

“c. "In-person medical evaluation" means a medical evaluation that is conducted with the patient in the physical presence of the practitioner, without regard to whether portions of the evaluation are conducted by other practitioners, and must include one of the following actions: (1) The prescribing practitioner examines the patient at the time the prescription or drug order is issued; (2) The prescribing practitioner has performed a prior examination of the patient within twelve months; (3) Another prescribing practitioner practicing within the same health system, group, or clinic as the prescribing practitioner has examined the patient within twelve months; (4) A consulting practitioner to whom the prescribing practitioner has referred the patient has examined the patient within twelve months; or (5) The referring practitioner has performed an examination in the case of a consultant practitioner issuing a prescription or drug order when providing services by means of telemedicine. d. "Internet" and "practice of telemedicine" have the meanings set forth in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Pub. L. 110-425; 21 U.S.C. 802-803].”

“f. "Valid prescription" means a prescription that is issued for a legitimate medical purpose in the usual course of professional practice by a practitioner who has conducted an in-person medical evaluation of the patient.”

Refer to the source provided for all requirements and limitations.

Medicaid Telehealth Parity Law

Source: http://www.nd.gov/dhs/services/medicalserv/medicaid/docs/general-information-medicaid-provider-manual.pdf

COVERED SERVICES
Qualified services for telemedicine must:
• Maintain actual visual contact (face-to-face) between the practitioner and patient.
• Be medically appropriate and necessary with supporting documentation included in the patient’s clinical medical record.
• Be provided via secure and appropriate equipment to ensure confidentiality and quality in the delivery of the service. The service must be provided using a HIPAA compliant platform.

Refer to the source provided for all requirements and limitations.

Originating Site Reimbursement: No reference found

Private Pay Telehealth Parity Law

Source:  ND Century Code Sec. 26.1-36-09.15(2)

"An insurer may not deliver, issue, execute, or renew a policy that provides health benefits coverage unless that policy provides coverage for health services delivered by means of telehealth which is the same as the coverage for health services delivered by in-person means."

Refer to the source provided for all requirements and limitations.

 

Payment Parity

Source: ND Century Code Sec. 26.1-36-09.15(3)

"Payment or reimbursement of expenses for covered health services delivered by means of telehealth under this section may be established through negotiations conducted by the insurer with the health services providers in the same manner as the insurer with the health services providers in the same manner as the insurer establishes payment or reimbursement of expenses for covered health services that are delivered by in-person means."

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 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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