Arizona
Telepractice R4-6-1106 A. Except as otherwise provided by statute, an individual who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice to a client located in Arizona shall be licensed by the Board. B. Except as otherwise provided by statute, a licensee who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice to a client located outside Arizona shall comply with not only A.R.S. Title 32, Chapter 33, and this Chapter but also the laws and rules of the jurisdiction in which the client is located. C. An individual who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice shall: 1. In addition to complying with the requirements in R4-6-1101, document the limitations and risks associated with telepractice, including but not limited to the following; a. Inherent confidentiality risks of electronic communication, b. Potential for technology failure, c. Emergency procedures when the licensee is unavailable, and d. Manner of identifying the client when using electronic communication that does not involve video; 2. In addition to complying with the requirements in R4-6-1103, include the following in the progress note required under R4-6-1103(H): a. Mode of session, whether interactive audio, video, or electronic communication; and b. Physical location of the client during the session.” Telepractice R4-6-1106 A. Except as otherwise provided by statute, an individual who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice to a client located in Arizona shall be licensed by the Board. B. Except as otherwise provided by statute, a licensee who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice to a client located outside Arizona shall comply with not only A.R.S. Title 32, Chapter 33, and this Chapter but also the laws and rules of the jurisdiction in which the client is located. C. An individual who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice shall: 1. In addition to complying with the requirements in R4-6-1101, document the limitations and risks associated with telepractice, including but not limited to the following; a. Inherent confidentiality risks of electronic communication, b. Potential for technology failure, c. Emergency procedures when the licensee is unavailable, and d. Manner of identifying the client when using electronic communication that does not involve video; 2. In addition to complying with the requirements in R4-6-1103, include the following in the progress note required under R4-6-1103(H): a. Mode of session, whether interactive audio, video, or electronic communication; and b. Physical location of the client during the session.” Telepractice R4-6-1106 A. Except as otherwise provided by statute, an individual who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice to a client located in Arizona shall be licensed by the Board. B. Except as otherwise provided by statute, a licensee who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice to a client located outside Arizona shall comply with not only A.R.S. Title 32, Chapter 33, and this Chapter but also the laws and rules of the jurisdiction in which the client is located. C. An individual who provides counseling, social work, marriage and family therapy, or substance abuse counseling via telepractice shall: 1. In addition to complying with the requirements in R4-6-1101, document the limitations and risks associated with telepractice, including but not limited to the following; a. Inherent confidentiality risks of electronic communication, b. Potential for technology failure, c. Emergency procedures when the licensee is unavailable, and d. Manner of identifying the client when using electronic communication that does not involve video; 2. In addition to complying with the requirements in R4-6-1103, include the following in the progress note required under R4-6-1103(H): a. Mode of session, whether interactive audio, video, or electronic communication; and b. Physical location of the client during the session.” A.A.C. R4-26-109. General Provisions Regarding Telepractice "A. Except as otherwise provided by law, a licensee who provides psychological service or supervision by telepractice to a client or patient or supervisee located outside Arizona shall comply with not only A.R.S. Title 32, Chapter 19.1, and this Chapter but also the laws and rules of the jurisdiction in which the client or patient or supervisee is located. B. Before providing psychological service or supervision by telepractice, a licensee shall establish competence in use of telepractice that conforms to prevailing standards of scientific and professional knowledge. C. A licensee who provides psychological service or supervision by telepractice shall maintain competence in use of telepractice through continuing education, consultation, or other procedures designed to address changing technology used in telepractice. D. A licensee who provides psychological service or supervision by telepractice shall take all reasonable steps to ensure confidential communications stored electronically cannot be recovered or accessed by an unauthorized person when the licensee disposes of electronic equipment or data." A.A.C. R4-26-110. Providing Psychological Service by Telepractice "A. Before providing psychological service by telepractice, a licensee who is in compliance with R4-26-109 shall conduct a risk analysis as clinically indicated and document in the client or patient’s record required under R4-26-106 whether use of telepractice: 1. Is consistent with the client or patient’s knowledge and skill regarding use of the technology involved in providing psychological service by telepractice or with ready access to assistance with use of the technology, and 2. Is in the best interest of the client or patient. B. A licensee shall not provide psychological service by telepractice unless both conditions of the risk analysis conducted under subsection (A) are met. C. Before providing psychological service by telepractice, a licensee shall: 1. Obtain the written informed consent of the client or patient, using language that is clear and understandable and consistent with accepted professional and legal requirements. The licensee shall ensure the written informed consent addresses the following and a copy is placed in the client or patient’s record required under R4-26-106: a. The manner in which the licensee will verify the identity of the client or patient before each psychological service if the telepractice does not involve video; b. The manner in which the licensee will ensure the client or patient’s electronic communications are received only by the licensee or supervisee; c. Limitations and innovative nature of using technology to provide psychological service; d. Inherent confidentiality risk resulting from use of technology; e. Potential risk of technology failure that disrupts provision of psychological service and how to reestablish communication if disruption occurs; f. When and how the licensee will respond to routine electronic communications; g. The circumstances under which the licensee and client or patient will use an alternative means of communication; h. Who is authorized to access the electronic communication between the licensee and client or patient; i. The manner in which the licensee stores the electronic communication between the licensee and the client or patient; and j. The type of secure electronic technology the licensee will use to communicate with the client or patient; 2. Establish a written agreement with the client or patient that specifies contact information for sources of face-to-face emergency services in the client or patient’s geographical area and requires the client or patient to contact a source of face-to-face emergency services when the client or patient experiences a suicidal or homicidal crisis or other emergency. If the licensee has knowledge the client or patient is experiencing a suicidal or homicidal crisis or other emergency, the licensee shall assist the client or patient to contact a source of face-to-face emergency services. The licensee shall place a copy of the written agreement required under this subsection in the client or patient’s record required under R4-26-106. 3. Obtain the name and contact information for an emergency contact; 4. Obtain information about an alternative means of contacting the client or patient; and 5. Provide the client or patient with information about an alternative means of contacting the licensee. D. A licensee who provides psychological service by telepractice shall repeat the risk analysis required under subsection (A) as clinically indicated. E. If a licensee does not provide psychological service by telepractice to a client or patient, the provisions of this Section do not apply to electronic communications with the client or patient regarding: 1. Scheduling an appointment, billing, establishing benefits, or determining eligibility for services; and 2. Checking the welfare of the client or patient in accord with reasonable professional judgment." Refer to the source provided for all requirements and limitations. 36-3601. Definitions For the purposes of this chapter: “1. "Health care decision maker" has the same meaning prescribed in section 12-2801. 2. "Health care provider" means a person licensed pursuant to title 32, chapter 7, 13, 14, 15, 17, 18, 19.1, 25, 28, 29 or 33. 3. "Telemedicine" means the practice of health care delivery, diagnosis, consultation and treatment and the transfer of medical data through interactive audio, video or data communications that occur in the physical presence of the patient, including audio or video communications sent to a health care provider for diagnostic or treatment consultation.” 36-3602. Delivery of health care through telemedicine; requirements; exceptions “A. Except as provided in subsection E of this section, before a health care provider delivers health care through telemedicine, the treating health care provider shall obtain verbal or written informed consent from the patient or the patient's health care decision maker. If the informed consent is obtained verbally, the health care provider shall document the consent on the patient's medical record. B. The patient is entitled to all existing confidentiality protections pursuant to section 12-2292. C. All medical reports resulting from a telemedicine consultation are part of a patient's medical record as defined in section 12-2291. D. Dissemination of any images or information identifiable to a specific patient for research or educational purposes shall not occur without the patient's consent, unless authorized by state or federal law. E. The consent requirements of this section do not apply: 1. If the telemedicine interaction does not take place in the physical presence of the patient. 2. In an emergency situation in which the patient or the patient's health care decision maker is unable to give informed consent. 3. To the transmission of diagnostic images to a health care provider serving as a consultant or the reporting of diagnostic test results by that consultant.” Refer to the source provided for all requirements and limitations. “(tt) Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section 32-1901 to a person unless the licensee first conducts a physical or mental health status examination of that person or has previously established a doctor-patient relationship. The physical or mental health status examination may be conducted during a real-time telemedicine encounter with audio and video capability, unless the examination is for the purpose of obtaining a written certification from the physician for the purposes of title 36, chapter 28.1.” Refer to the source provided for all requirements and limitations. “Arizona is a member of the Nurse Licensure Compact (NLC). The Nurse Licensure Compact allows for nurses to have one multistate license with the ability to practice in all compact states.” 32-1660. Nurse licensure compact “A. A multistate license to practice registered or licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a nurse to practice as a registered nurse or as a licensed practical/vocational nurse, under a multistate licensure privilege, in each party state.” “B. A state must implement procedures for considering the criminal history records of applicants for initial multistate license or licensure by endorsement. Such procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant's criminal history record information from the federal bureau of investigation and the agency responsible for retaining that state's criminal records.” “C. Each party state shall require that, in order for an applicant to obtain or retain a multistate license in the home state, the applicant meets all of the following criteria: 1. Meets the home state's qualifications for licensure or renewal of licensure as well as all other applicable state laws. 2. either: (a) Has graduated or is eligible to graduate from a licensing board-approved registered nurse or licensed practical/vocational nurse prelicensure education program. (b) Has graduated from a foreign registered nurse or licensed practical/vocational nurse prelicensure education program that both: (i) Has been approved by the authorized accrediting body in the applicable country. (ii) has been verified by an independent credentials review agency to be comparable to a licensing board-approved prelicensure education program. 3. If a graduate of a foreign prelicensure education program not taught in English or if English is not the individual's native language, Has successfully passed an English proficiency examination that includes the components of reading, speaking, writing, and listening. 4. Has successfully passed an NCLEX-RN® or NCLEX-PN® examination or recognized predecessor, as applicable. 5. Is eligible for or holds an active, unencumbered license. 6. Has submitted, in connection with an application for initial licensure or licensure by endorsement, fingerprints, or other biometric data for the purpose of obtaining criminal history record information from the federal bureau of investigation and the agency responsible for retaining that state's criminal records. 7. Has not been convicted or found guilty or has entered into an agreed disposition, of a felony offense under applicable state or federal criminal law. 8. Has not been convicted or found guilty or has entered into an agreed disposition, of a misdemeanor offense related to the practice of nursing as determined on a case-by-case basis. 9. Is not currently enrolled in an alternative program. 10. Is subject to self-disclosure requirements regarding current participation in an alternative program. 11. Has a valid United States social security number.” “D. All party states shall be authorized, in accordance with existing state due process law, to take adverse action against a nurse's multistate licensure privilege such as revocation, suspension or probation or any other action that affects a nurse's authorization to practice under a multistate licensure privilege, including cease and desist actions. If a party state takes such an action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states.” “E. A nurse practicing in a party state must comply with the state practice laws of the state in which the client is located at the time service is provided. The practice of nursing is not limited to patient care but shall include all nursing practice as defined by the state practice laws of the party-state in which the client is located. The practice of nursing in a party state under a multistate licensure privilege will subject a nurse to the jurisdiction of the licensing board, the courts, and the laws of the party-state in which the client is located at the time service is provided.” “F. Individuals not residing in a party state shall continue to be able to apply for a party state's single-state license as provided under the laws of each party state. However, the single-state license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state. This compact does not affect the requirements established by a party state for the issuance of a single-state license.” “G. Any nurse holding a home state multistate license on the effective date of this compact may retain and renew the multistate license issued by the nurse's then-current home state, provided that: 1. A nurse who changes the nurse's primary state of residence after this Compact's effective date must meet all applicable requirements in subsection C of this article to obtain a multistate license from a new home state. 2. A nurse who fails to satisfy the multistate licensure requirements in subsection C of this article due to a disqualifying event occurring after this compact's effective date shall be ineligible to retain or renew a multistate license, and the nurse's multistate license shall be revoked or deactivated in accordance with applicable rules adopted by the interstate commission of nurse licensure compact administrators.” Refer to the source provided for all requirements and limitations. “(tt) Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section 32-1901 to a person unless the licensee first conducts a physical or mental health status examination of that person or has previously established a doctor-patient relationship. The physical or mental health status examination may be conducted during a real-time telemedicine encounter with audio and video capability, unless the examination is for the purpose of obtaining a written certification from the physician for the purposes of title 36, chapter 28.1.” Refer to the source provided for all requirements and limitations. There is currently no explicit mention of payment parity Medicaid Reimbursement: In their fee for service program, Medicaid will reimburse for medically necessary services provided via live video. Eligible Services (include): ….. Behavioral health services 1. Diagnostic consultation and evaluation; 2. Psychotropic medication adjustment and monitoring; 3. Individual and family counseling; 4. Case management “The same services are covered for store-and-forward, as for real-time, except for the field of Behavioral Health Services.” (Source: Center for Connected Health Policy, State Telehealth Laws, Fall 2019 p. 32 [accessed Nov. 2019]) There is currently no explicit mention of payment parity Effective January 1, 2021: “All contracts issued, delivered or renewed on or after January 1, 2018, must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in‑person consultation between the subscriber and a health care provider and provided to a subscriber receiving the service in this state.” Refer to the source provided for all requirements and limitations. There is currently no explicit mention of payment parity Effective January 1, 2021: “All contracts issued, delivered or renewed on or after January 1, 2018, must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in‑person consultation between the subscriber and a health care provider and provided to a subscriber receiving the service in this state.” Refer to the source provided for all requirements and limitations. For LPC, LCSW, LMFT and LISACs A.R.S. 32-3271(A)(2) "2. A person who is not a resident of this state if the person: For LPC, LCSW, LMFT and LISACs Arizona has a process for getting Licensed by Endorsement and a Temporary License. ResourceCounselors
Social Workers
Marriage and Family Therapists
Psychologists
Psychiatrists
Arizona Professional Regulation/Health & Safety Online Prescribing
Nurses
Arizona Professional Regulation/Health & Safety Online Prescribing
Medicaid Telehealth Parity Law
Private Pay Telehealth Parity Law
Payment Parity
Permission for the Temporary Practice of Clinicians Licensed Outside the State
Arizona Revised Statutes effective August 3, 2018 Page 9
(a) Performs behavioral health services in this state for not more than ninety days in any one
calendar year as prescribed by board rule.
(b) Is authorized to perform these services pursuant to the laws of the state or country in which the
person resides or pursuant to the laws of a federally recognized tribe.
(c) Informs the client of the limited nature of these services and that the person is not licensed in
this 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
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).
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 [email protected] 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).