Guide to the Rules on Telehealth Therapy for Clinical Psychologists, LMFTs, LCSWs, and LPCCs

Who can provide telehealth therapy in California?

All California-licensed mental health professionals are authorized to provide mental health services via telehealth (aka telemedicine). This page will discuss the rules for telehealth for:

• Licensed Marriage and Family Therapists (LMFTs)
• Licensed Clinical Social Workers (LCSWs)
• Licensed Professional Clinical Counselors (LPCCs)
• Licensed Clinical Psychologists

Licensed psychiatrists are also authorized to provide mental health services via telehealth, which is governed by the Medical Board of California. See our What Healthcare Providers Need to Know About Telehealth Laws in California.

Pre-licensed associates (psychological associates, AMFTs, ASWs, and APCCs) may also provide telehealth services under supervision, as long as they meet supervision and practice requirements.¹Cal. Bus. & Prof. Code § 2290.5; 16 Cal. Code Regs. §§ 1815.5, 1815.6 (BBS); 16 Cal. Code Regs. § 1396.8 (BoP)

What are the requirements for the first telehealth therapy session?

1. Inform the client of the potential risks and limitations, and benefits
   of receiving treatment via telehealth.
2. Obtain and document verbal or written consent from the
   client that they accept the use of telehealth for therapy.
3. Provide the client with your license or registration number.
4. Document your efforts to obtain the contact information
   of relevant resources, including emergency services, in
   the client’s geographic area.

See BBS Telehealth FAQ; and BoP regulations at CCR, Title 16, Section 1396.8

What are the requirements for ongoing telehealth therapy sessions?

1. Verbally obtain and document the client’s full name
   and address of present location at the beginning of each
   telehealth session.
2. Assess whether the client and the session are appropriate
   for telehealth, including, but not limited to, consideration
   of the client’s psychosocial situation.
3. Utilize industry best practices for telehealth to ensure
   both client confidentiality, the security of the
   communication medium, and client safety

See BBS Telehealth FAQ; and BoP regulations at CCR, Title 16, Section 1396.8

What technology can be used for telehealth sessions?

Mental health providers must use technology that allows for real-time, two-way audio and/or video communication.

Providers must use platforms that comply with HIPAA and California’s Confidentiality of Medical Information Act (CMIA). Common secure platforms include Zoom for Healthcare, Doxy.me, and SimplePractice.²45 C.F.R. Parts 160 & 164 (HIPAA); Cal. Civ. Code §§ 56–56.37 (CMIA)

Is informed consent required for telehealth?

Yes. Therapists must obtain informed consent from clients before beginning telehealth services. While written consent is ideal, verbal consent is legally sufficient as long as it is documented in the clinical record.

Clients should be informed of:

• The nature, purpose, and limitations of telehealth
• Potential risks (e.g., technology disruptions, privacy breaches)
• Their right to stop using telehealth at any time
• How confidentiality will be protected

See Cal. Bus. & Prof. Code § 2290.5(b); Board of Psychology – Telehealth; Board of Behavioral Sciences – Telehealth

What documentation is required for telehealth sessions?

Telehealth sessions must be documented in the same way as in-person therapy, with additional details including:

• The location of the provider and client during the session
• The type of technology used (e.g., video platform)
• Confirmation of informed consent for telehealth

Therapists must also maintain secure records and comply with legal requirements for record retention.³Cal. Bus. & Prof. Code § 2290.5(b); Cal. Health & Safety Code §§ 123100–123149.5

Do insurance plans cover telehealth therapy?

Yes. California law requires most health plans to reimburse telehealth services at parity with in-person services. This includes video and phone-based therapy if clinically appropriate. Medi-Cal also reimburses for many mental health services delivered via telehealth.⁴Cal. Health & Safety Code § 1374.13; Cal. Ins. Code § 10123.85; DHCS – Telehealth

Can California therapists provide telehealth while located outside California?

California-licensed therapists may provide telehealth services to clients located in California even if the provider is physically outside of California at the time of the session. There is no legal requirement that the provider be in California, so long as:

• The provider holds an active California license
• The client is located in California during the session
• The service complies with California laws and ethical standards

That said, providers should check the laws of the jurisdiction they are located in to ensure they are not inadvertently violating local practice rules.

See 16 Cal. Code Regs. § 1396.8(a)(3) (BoP) and Board of Psychology – Telehealth; Board of Behavioral Sciences – Telehealth

Can California therapists offer telehealth to clients located outside the state?

California therapists may not provide telehealth services to clients who are physically located outside the state unless the therapist is also licensed in the state where the client is physically located at the time of the session, or the outside state allows for exceptions.

Most U.S. states consider the location of the client to determine jurisdiction for licensure. Practicing therapy with a client in a particular state without that state’s licensure may be considered “practice without a license,” which is generally a criminal offense.

This applies even if:

• The client is a California resident who is temporarily traveling
• The provider is following up with a former client who has moved

Some states provide short windows of time for online practice by out-of-state licensees. As of 2024: AZ, CO, FL, WY, KS, NJ. Utah allows temporary practice by out of state licensees only when the client is moving to UT.

If the state does not have a carve-out for temporary practice, a therapist may be able to contact the state’s licensing board to get authorization. Otherwise, for a crisis or emergency, a therapist would likely not be penalized for providing crisis management for a client out of state.

Psychologists may participate in the PSYPACT compact, which allows telepsychology across state lines—but California is not currently a member.⁵Association of State and Provincial Psychology Boards – PSYPACT

Note that California law and regulation do not prohibit California licensed therapists from providing telehealth services to clients located out of state.⁶California Code of Regulations § 1815.5(e) (BBS); 16 Cal. Code Regs. § 1396.8(a)(2) (BoP)

Can therapists who are only licensed outside California practice telehealth therapy with clients in California?

Therapists who are licensed in another U.S. state may provide temporary therapy with California clients up to 30 days per calendar year.⁷California BPC Sec 2912 There is no reporting requirement for clinical psychologists; for other therapists, you must apply for a Temporary 30 Day Practice Allowance with the BBS.

Further Resources

Therapists can consult the following sources for current laws, best practices, and regulatory updates on telehealth:

Board of Psychology – Telehealth

Board of Behavioral Sciences – Telehealth

Also see our pages on:

Guide to California Law Related to Mental Health Professionals

Guide to California Law on Healthcare

Guide to California Law on Mental Health

Image credit: Image by redgreystock on Freepik