Telehealth Rules by State for Therapists

Telehealth regulations for mental health professionals vary significantly from state to state. Before providing therapy via telehealth, you need to know three things about the state where your client is located: whether it participates in PSYPACT (the Psychology Interjurisdictional Compact), whether it requires separate informed consent for telehealth, and which statute and licensing board govern your practice there.

The table below compares all 50 states and the District of Columbia. 42 jurisdictions currently participate in PSYPACT, which allows psychologists holding an E.Passport to provide telehealth services across member states without obtaining a separate license in each one. Non-member states generally require full licensure before you can treat clients located there.

How to Use This Table

Telehealth jurisdiction follows the client's locationat the time of the session, not yours. If your client is physically located in a state where you are not licensed (and PSYPACT does not apply), you generally may not provide services — even for an established client who is traveling. Document the client's city and state at the start of every telehealth session.

Consent Requirements

Most states require or expect informed consent specific to telehealth, covering the platform and its security, privacy limitations of electronic communication, emergency procedures when therapist and client are in different locations, and a backup plan for technology failure. Even where a separate telehealth consent is not explicitly mandated, obtaining and documenting one is the standard of care.