If you don't find the answer to your question after reviewing these FAQs, email firstname.lastname@example.org.
- Do I need a healthcare credential from the Department of Health?
If you're practicing medicine, or assisting in the practice of medicine, you must have a healthcare credential issued by the Washington State Department of Health. There are many types of licenses that grant different scopes of practice and require different levels of education.
Chapter 18.360 RCW requires people in healthcare facilities, who act as medical assistants, to have a credential. Practicing as a medical assistant includes many duties identified in RCW 18.360.050. Examples include administering vaccines and intravenous injections, assisting in certain medical procedures and withdrawing blood.
- I'm a nationally certified or registered medical assistant through my professional association. Do I still need a Washington State credential?
If you're performing the clinical duties outlined in RCW 18.360.050 or calling yourself a medical assistant-certified, medical assistant-registered, medical assistant-phlebotomist or medical assistant-hemodialysis technician in the state of Washington, you must have a Department of Health-issued medical assistant credential.
- I work in a healthcare facility and am called a medical assistant but I don't have any type of credential from the Department of Health. Will I automatically become a medical assistant?
No. If you are completing duties outlined in RCW 18.360.050, you must meet the minimum requirements for and obtain a medical assistant credential.
- What is the difference between a registration and a certification?
Registration has a narrower scope of practice and the credential is tied to the employer. RCW 18.122.030 defines registration and certification.
- Who can supervise a medical assistant?
RCW 18.360.005 directs that a healthcare practitioner will supervise medical assistants. RCW 18.360.010(3) defines a healthcare practitioner as:
- Medical physician or medical physician assistant
- Osteopathic physician or osteopathic physician assistant
- Podiatric physician
- Registered nurse
- Advanced registered nurse practitioner
- Naturopathic physician
- What does supervision mean?
Supervision is defined in RCW 18.360.010(11) as meaning the supervision of procedures permitted pursuant to this chapter by a healthcare practitioner who is physically present and is immediately available in the facility. The healthcare practitioner doesn't need to be present during procedures to withdraw blood, administer vaccines, or obtain specimens for diagnostic testing, but must be immediately available.
Supervision is further defined in WAC 246-827-0010:
- "Immediate supervision" means the supervising healthcare practitioner is on the premises and available for immediate response as needed.
- "Direct visual supervision" means the supervising healthcare practitioner is physically present and within visual range of the medical assistant.
- Will I have to renew my medical assistant certification or registration?
Yes. You must renew your certification or registration. After the initial issuance, the medical assistant credential must be renewed every two years on the credential holder's birthday. Initial credentials issued within 90 days of the practitioner's birthday don't expire until the practitioner's next birthday. A person issued a credential on July 15, 2013 with a birthday on August 6 will renew the credential on August 6, 2014, August 6, 2016, August 6, 2018, etc.
- Once my initial medical assistant credential is issued, when does it need to be renewed?
See WAC 246-12-020(3). Initial credentials issued within 90 days of the credential holder's birthday expire on the credential holder's birthday the following year. If you are issued a credential on August 1 and your birthday is September 15, you'll renew the credential on September 15 the following year. If you're issued a credential on August 1 and your birthday is December 15, your renewal will be due on that birthday. After your first renewal, you'll need to renew your credential every two years on or before your birthday.
- Do I need to renew/hold both a medical assistant-certified and a medical assistant-phlebotomist credential to perform phlebotomy?
The scope of practice of a medical assistant-phlebotomist includes capillary, venous, and arterial invasive procedures for blood withdrawal, CLIA waived, moderate and high complexity tests, and EKG. A medical assistant-certified may perform capillary and venous blood withdrawals, CLIA waived and moderated complexity tests, and EKG but may not perform arterial invasive procedures for blood withdrawal or high complexity designated CLIA tests. If you hold a medical assistant-certified credential, you need only to retain your medical assistant-phlebotomist credential if you're required to perform arterial invasive procedures for blood withdrawal or high complexity tests.
- Can a medical assistant place or start an IV line? What if they take extra training?
Unfortunately, starting an IV is out of scope for all the medical assistant professions. This is true even if the medical assistant has taken additional training to be certified in IV placement. Regardless of an individual’s training or skills, they must operate within the legal scope of practice of any healthcare credential they hold. A medical assistant-certified can remove IVs or administer certain medications if the tasks meet delegation requirements per WAC 246-827-0240, but medical assistants cannot place IVs. See RCW 18.360.050 for the full scope of practice for all medical assistant professions.
- How much is the application and renewal fee?
Fees for the medical assistant credentials are on the Medical Assistant licensing webpage.
- What are medical assistants allowed to do related to calling in prescriptions and prescription refills?
The medical assistant statute doesn't address the medical assistant's role related to calling in and refilling prescriptions. RCW 18.360.060 lists the determinations that a healthcare practitioner must make before delegating a task to a medical assistant. This section says that protocols may be used provided that they don't involve clinical judgment and don't involve the administration of medications, other than vaccines. Medical assistants need to consult with their supervising healthcare practitioners to determine what their duties should be relating to calling in and refilling prescriptions.
- Does the dispensing optician licensing exemption in RCW 18.34.010(1) substitute for the requirement for optometric assistants to get one of the new medical assistant credentials?
This exemption allows supervised employees to practice opticianry without dispensing optician credentials.
This exemption doesn't allow supervised employees to practice as medical assistants without credentials.
Supervised employees practicing opticianry shouldn't perform optician duties that might also be considered the practice of medical assisting.
Licensed dispensing opticians or registered dispensing optician apprentices wouldn't be required to get medical assistant credentials provided their practice is limited to that of opticians. An optometric assistant will need one of the medical assistant credentials to work under the supervising physician or optometrist when performing duties listed in RCW 18.360.050 that are outside, or overlap with, the scope of opticianry defined in RCW 18.34.060.
A licensed dispensing optician or registered dispensing optician apprentice will need one of the medical assistant credentials to work under the supervising physician or optometrist when performing duties listed in RCW 18.360.050 that are outside the scope of opticianry.
- How do I obtain a medical assistant-certified credential?
- Provide proof of completion of the required medical assistant training identified WAC 246-827-0200(1).
- Pass an examination within five years before submission of an initial application identified in WAC 246-827-0200(2). Applicants may receive an interim certification if they have met all of the qualifications required for certification except for passage of the examination. The interim permit will expire upon passage of the examination or after one year, whichever occurs first, and is not renewable.
- Complete a Department of Health application and pay a fee.
- Fulfill any additional requirements in the application.
- What duties can a medical assistant-certified perform?
- Is the medical assistant-certified credential transferable or tied to the facility?
A person who holds an active medical assistant-certified credential can work at different facilities throughout Washington State without needing multiple credentials. The credential isn't tied to a particular facility or supervisor.
- Where can I find the regulations related to medication administration for medical assistant-certified?
- What is the medical assistant interim certification?
According to RCW 18.360.040(1)(b), a person may obtain an interim certification if he or she has met all of the qualifications for medical assistant-certified, except for passing the examination. A person holding an interim permit possesses the full scope of practice of a medical assistant-certified. The interim permit expires upon passing of the examination or after one year, whichever occurs first, and may not be renewed.
- Can I work as a medical assistant-certified before my credential shows as ""Active"" on the Provider Credential Search website?
Unless you meet one of the exemptions in RCW 18.360.090, you may not practice clinically as a medical assistant-certified until your credential is active. See WAC 246-827-0100 for some tasks that may be performed in a healthcare setting that don't require a medical assistant credential. Check the status of your credential on Provider Credential Search.
- How do I obtain a medical assistant-registered credential?
- Complete and submit a Department of Health application and pay the fee.
- Submit the Healthcare Practitioner Endorsement.
- The medical assistant-registered who applies to the department within seven days of employment by the endorsing healthcare practitioner, clinic or group practice may work as a medical assistant-registered for up to 60 days while the application is being processed.
- What duties can a medical assistant-registered perform?
- A medical assistant-registered may perform only the duties attested to in the Healthcare Practitioner Endorsement form completed and returned to the department.
- For a full list of duties a medical assistant-registered may be trained to perform, see RCW 18.360.050(4).
- Is the medical assistant-registered credential transferable or tied to the facility?
- The medical assistant-registered credential terminates when the medical assistant-registered separates employment with the endorsing health care practitioner, clinic or group practice.
- The medical assistant-registered must notify the department within 30 days of separation of employment.
- What medications may a medical assistant-registered administer?
- A medical assistant-registered may administer eye drops, topical ointments, and vaccines, including combination or multidose vaccines.
- A medical assistant-registered may not administer injections other than vaccines.
- May a medical assistant-registered collect blood specimens?
- A medical assistant-registered may collect a blood specimen only by performing a finger or heel stick. A medical assistant-registered may not perform phlebotomy unless credentialed as a medical assistant-phlebotomist.
- What is the effect of ESHB 1073 on the medical assistant-registered scope of practice? Is it in effect?
Engrossed Substitute House Bill 1073 (PDF) expanded the medical assistant-registered (MA-R) scope of practice to include medication administration, including legend and schedule III-V drugs. This bill included a provision that rendered it effective immediately, so the expanded scope is in place now. We will open rules to update all impacted medical assistant rule sections, as well as adding a new section to establish guidelines for MA-R medication administration.
MA-Rs could previously administer vaccines, topical ointments and eye drops, which has not changed. The effect of the recent legislation is that the supervision level required for administration of vaccines or obtaining specimens for diagnostic testing has been lowered to “immediately available,” meaning that the supervising/delegating healthcare practitioner (limited to a physician, physicians’ assistant, RN, ARNP or optometrist per RCW 18.360.010) does not have to be present on the same premises for these tasks, but must be immediately available. The bill also expands the scope of practice for MA-Rs to include administration of legend drugs and schedule III-V narcotics, via intramuscular injection only. The bill does not permit any other route of administration of legend drugs or schedule III-V narcotics. As with any task, all delegation laws must be followed and the delegating healthcare practitioner is responsible for ensuring the MA-R is sufficiently trained and skilled to perform the task prior to delegation.
- How do I obtain a medical assistant-phlebotomist credential?
- Complete one of the required phlebotomy training options identified WAC 246-827-0400.
- Complete a Department of Health application and pay a fee.
- Fulfill any additional requirements in the application.
- What duties can a medical assistant-phlebotomist perform?
- Is the medical assistant-phlebotomist credential transferable or tied to the facility?
A person who holds an active medical assistant-phlebotomist credential can work at different facilities throughout Washington State without needing multiple credentials. The credential isn't tied to a particular facility or supervisor.
- Can I apply for my credential before the transcripts from my phlebotomy program are available?
Yes. However, we won't issue the credential until the Department of Health receives official transcripts. We'll enter your application and begin the review process once we receive the application and fee. Once we receive your transcripts, we can complete the review and issue the credential to applicants who meet the requirements.
- Can I work as a medical assistant-phlebotomist after I complete my training and I am waiting for my credential to show as "Active" on Provider Credential Search?
There is no provision in law that allows you to perform phlebotomy procedures during the period where your training is complete and your credential is not yet active. A trainee may complete the phlebotomy-specific training required in WAC 246-827-0400, complete and submit the application, then continue to train in other job duties while the Department of Health processes the application. Check the status of your credential on Provider Credential Search.
- I have a national phlebotomy certificate but didn't complete a phlebotomy program through a post-secondary school or college that has accreditation recognized by the U.S. Department of Education. Do I qualify for the medical assistant-phlebotomist credential?
The requirements under WAC 246-827-0400 state that an applicant must either:
- Successfully complete a phlebotomy program through a post-secondary school or college accredited by a regional or national accrediting organization recognized by the U.S. Department of Education; or
- Successfully complete a phlebotomy training program. The phlebotomy training program must be approved by a healthcare practitioner who is responsible for determining the content of the training and for ascertaining the proficiency of the trainee. The training programs have specific requirements found in the section of rule cited above.
To satisfy requirement 1, your transcripts or other official school documents must show that you have taken a course that teaches phlebotomy concepts (i.e., introduction to phlebotomy) and at least one class or externship that teaches the practice of phlebotomy (i.e., advanced phlebotomy or an externship with credit).
- Before the medical assistant law took effect, our organization trained personnel to do phlebotomy who would obtain a health care assistant credential when they completed training. This would allow them to work as phlebotomists. If we continue to train our personnel in-house, will they qualify for the medical assistant-phlebotomist credential?
Yes, organizations may continue to train personnel in-house or develop in-house programs that will satisfy the training requirement for the medial assistant-phlebotomist credential. The medical assistant rules set requirements for these training programs. These requirements are found in WAC 246-827-0400(2)(a). Additional training is necessary if the trainee is to perform arterial invasive procedures or line draws. These requirements are found in WAC 246-827-0420.
- How do I obtain a medical assistant-hemodialysis technician credential?
- Complete the required training identified WAC 246-827-0500.
- Complete a Department of Health application and pay a fee.
- Any additional requirements required in the application.
- What duties can a medical assistant-hemodialysis technician perform?
- Is the medical assistant-hemodialysis technician credential transferable or tied to the facility?
A person who holds an active medical assistant-hemodialysis technician credential can work at different facilities throughout Washington State without needing multiple credentials. The credential isn't tied to a particular facility or supervisor.
Forensic Blood Draws
- What is a "forensic" or "law enforcement" blood draw?
A forensic or law enforcement blood draw is when a person's blood is drawn at the direction of a law enforcement officer in order to test the person for alcohol, cannabis, or any drug, pursuant to a search warrant, a valid waiver of the warrant requirement, when exigent circumstances exist, or under any other authority of law.
- May a medical assistant-phlebotomist or medical assistant-certified perform a blood draw for forensic, rather than clinical purposes?
Yes. RCW 46.61.506 (5) clearly lists medical assistants-phlebotomist and medical assistants-certified as healthcare professionals who may draw blood for law enforcement, or forensic purposes, under the implied consent act, RCW 46.20.308.
- What categories of medical assistant may draw blood for forensic purposes?
It's within the scope of practice of a properly trained medical assistant-phlebotomist or medical assistant-certified to draw blood for forensic purposes.
- What level of supervision is required for a medical assistant-phlebotomist or medical assistant-certified to draw blood for forensic purposes?
A supervising healthcare practitioner, as defined under RCW 18.360.010 (3), doesn't need to be physically present with the medical assistant-phlebotomist or medical assistant-certified for the blood draw, but must be immediately available for consultation, in person or by phone, within a reasonable period of time.
- Must a supervising healthcare practitioner issue an order for each forensic blood draw performed by a medical assistant-phlebotomist or medical assistant-certified?
Medical assistants perform clinical functions under orders from their supervising healthcare practitioner(s). RCW 18.360.060(2) authorizes medical assistants to work under protocols that don't involve clinical judgment or the administration of medications. The delegating healthcare practitioner must determine that blood draws don't require the exercise of clinical judgment if a protocol is used. Therefore, a medical assistant-phlebotomist or medical assistant-certified may perform a blood draw at the direction of a law enforcement officer if either:
a. The medical assistant's supervising healthcare practitioner has issued an order for the blood draw, or
b. The blood draw is performed under a protocol.
- May a medical assistant-phlebotomist or medical assistant-certified perform a blood draw outside of a clinic, hospital, or other "traditional" healthcare setting?
Yes. A medical assistant's operation is not limited by location.