Medical Assistant Frequently Asked Questions

If you don't find the answer to your question after reviewing these FAQs, email medical.assistants@doh.wa.gov.

General

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. Specifically, MA-Rs are more limited in medication administration and cannot perform phlebotomy. Registration does not require any formal training or testing and 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
Optometrist.

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.

Are there any continuing education requirements?

No, there are no continuing education requirements for renewal of any of the medical assistant credentials in Washington.

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?

A medical assistant-certified can place IVs under immediate supervision, remove IVs, and administer certain medications under direct visual supervision if the tasks meet delegation requirements. Unfortunately, starting an IV is out of scope for all other 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. 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.

What is the effect of ESHB 1073 on the medical assistant professions?

The changes to the medical assistant statute, RCW 18.360, that were implemented with the passing of Engrossed Substitute House Bill 1073 (PDF) are outlined below:

Expands the scope of practice for medical assistant-registered credential holders to include administration of medication, including intramuscular injections under direct visual supervision, if the drugs are unit or single dose and limited to legend drugs and schedule iii-v. See medical assistant-registered FAQ section for more details.
Allows a medical assistant-certified to administer start intravenous lines and administer intravenous injections for diagnostic or therapeutic agents under direct visual supervision.
Updates the supervision requirement to allow administration of vaccines or obtaining specimens for diagnostic testing without the supervisor being present (must be immediately available).
Allows medical assistant-phlebotomist and medical assistant-hemodialysis technician applicants to work on a pending credential up to 180 days after filing application.
Increases the level of anesthesia that a medical assistant-registered can assist with during minor surgeries from local anesthetic to minimal sedation.

What is the effect of ESSB 5983 on the medical assistant professions?

Engrossed Substitute Senate Bill 5983 (PDF) passed during the 2024 legislative session and allows individuals with an active medical assistant-certified or medical assistant-registered credential to administer treatment for known or suspected syphilis infections under telemedicine supervision.

When will the medical assistant-EMT credential be available for applications?

Substitute Senate Bill 5940 (PDF) passed during the 2024 legislative session and established the medical assistant-EMT credential. The bill allows those who hold an active EMT, advanced EMT, or paramedic certification to qualify for an MA-EMT credential in order to work in a hospital environment. It also directs the Department of Health to write rules for the newly established MA-EMT credential, and that work is in progress. Once rules are finalized and effective, DOH can begin accepting applications. View updates on this rule making process here.

Medical Assistant-Certified

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?

See RCW 18.360.050(1).

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?

See WAC 246-827-0240.

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.

Once I have obtained my Washington state medical assistant-certified credential, do I have to maintain my national certification?

No. While it is a requirement to have taken and passed one of the five approved national examinations within the preceding five years of submitting a medical assistant-certified application, there is no requirement to maintain national certification for renewal of your Washington state medical assistant-certified credential.

Medical Assistant-Registered

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).

Can I work as a medical assistant-registered after I complete my training and I am waiting for my credential to show as "Active" on Provider Credential Search?

Medical assistant-registered who applies to the department within seven days of their date of hire into the medical assistant-registered role may work for up to 60 days while the application is processed. The applicant must stop working on the 60th day of employment if the registration has not been granted for any reason.

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 administer legend drugs and Schedule III-V controlled substances via intramuscular injection.

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. The bill also increases the level of anesthesia that a MA-R can assist with during minor surgeries from local anesthetic to minimal sedation. 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.

Medical Assistant-Phlebotomist

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?

See RCW 18.360.050.

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?

Medical assistant-phlebotomist applicants who have completed their training program are allowed to work, under the level of supervision required for the training program, for a period of up to 180 days after filing their application. The applicant must stop working on the 180th day of employment if the credential has not been granted for any reason. 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.

What do I need to do to set up a mobile phlebotomy business?

The Department of Health does not regulate the business side of mobile phlebotomy. Individuals performing phlebotomy must be credentialed and operate within the credential’s legal scope of practice and any applicable delegation laws. We recommend consulting with a business attorney, tax specialist, the Department of Licensing, and any other applicable regulatory bodies or experts to assist with setting up the business appropriately.

Medical Assistant-Hemodialysis

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?

See RCW 18.360.050.

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.

Can I work as a medical assistant-hemodialysis technician after I complete my training and I am waiting for my credential to show as "Active" on Provider Credential Search?

Medical assistant-hemodialysis technician applicants who have completed their training program are allowed to work, under the level of supervision required for the training program, for a period of up to 180 days after filing their application. The applicant must stop working on the 180th day of employment if the credential has not been granted for any reason. Check the status of your credential on Provider Credential Search.

Medical Assistant-Emergency Medical Technician (MA-EMT)

Is this credential tied to a specific facility?

No. The MA-EMT certification can be used in hospitals licensed under RCW 70.41 and is transferable. However, the underlying EMS certification may have jurisdictional restrictions.

What are the qualifications for an MA-EMT certification?

An individual holding an active Washington state EMT, advanced EMT, or paramedic certification may qualify for the MA-EMT certification with no additional training or testing.

What types of medical facilities can I work at if I hold an MA-EMT certification?

The MA-EMT certification may only be used in hospitals licensed under RCW 70.41 per RCW 18.360.040(7). It may not be used in other health care settings such as clinics, urgent care facilities, free standing emergency departments, or any other health care facility.

Who can supervise and/or delegate medical tasks to the MA-EMT?

The MA-EMT certification is not a type of EMS certification. It is a type of medical assistant certification, therefore the certification is bound to the supervision and delegation requirements for medical assistants. Supervision and delegation is limited to a physician, physicians’ assistant, RN, ARNP, or optometrist per RCW 18.360.010(5) and bound to the tasks within the MA-EMT scope of practice outlined in RCW 18.360.050(5). Supervision and/or delegation to an MA-EMT is not provided by the physician EMS county medical program director or medical program director delegate who provides oversight to providers holding an EMS certification.

Will holding an active medical assistant-certified or other medical assistant credential qualify me for the MA-EMT certification?

No. In order to qualify for the MA-EMT certification, an individual must hold and maintain an active Washington state EMT, advanced EMT, or paramedic certification in good standing.

If an EMT, advanced EMT or paramedic certification transfers jurisdiction, no longer holds an EMS endorsement such as IV therapy or supraglottic airway endorsement, or no is no longer affiliated with a licensed EMS service, will the MA-EMT certification become inoperable?

Yes. In order to qualify for and maintain an MA-EMT certification, an individual must hold and maintain an active Washington state EMT, advanced EMT, or paramedic certification in good standing, and maintain affiliation with a licensed EMS service so the underlying EMS certification will be maintained and remain operable. If an individual no longer holds an IV Therapy endorsement on their EMS certification, they will be unable to perform venipuncture or IV therapy skills as n MA-EMT.

Can an MA-EMT work up to the scope of practice of their EMT, advanced EMT, or paramedic scope of practice in a hospital setting?

No. When working under an MA-EMT credential, an individual is bound to the MA-EMT scope of practice outlined in RCW 18.360.050(5).

Does the MA-EMT scope of practice include phlebotomy?

Yes, the MA-EMT scope of practice includes venipuncture and capillary puncture, as long as the underlying EMS certification and scope of practice includes these tasks, and the individual has been appropriately trained and delegated. See RCW 18.360.050(5)(a)(iii)(A).

All levels of EMS certification can perform capillary puncture to check glucose levels. EMS certifications that qualify for venipuncture include EMT with IV endorsement, advanced EMT, or paramedic. EMT without the IV endorsement may not perform venipuncture.

Does the MA-EMT scope of practice include starting IVs?

Yes, the MA-EMT scope of practice includes starting intravenous lines, as long as the underlying EMS certification/endorsement and scope of practice includes these tasks, and the individual has been appropriately trained and delegated. See RCW 18.360.050(5)(a)(vii).

EMS certifications that qualify for starting intravenous lines include EMT with IV endorsement, advanced EMT, or paramedic. An EMT certification that does not have an IV endorsement may not start intravenous lines.

EMTs are eligible to apply for an IV endorsement if they completed a Department of Health and county medical program director (MPD) approved EMS EMT IV endorsement course. They must meet education and clinical/field requirements and have department and MPD approved county protocols in place.

Does the MA-EMT scope of practice include medication administration?

Yes, the MA-EMT scope of practice includes administration of vaccines, opioid antagonists and oral glucose. No other medication administration is permitted under the MA-EMT certification. The underlying EMT, advanced EMT, or paramedic scope of practice must include these tasks and the individual must be appropriately trained and delegated. See RCW 18.360.050(5)(a)(vi).

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, forensic phlebotomist, or medical assistant-certified to draw blood for forensic purposes. See WAC 246-827A for rules governing forensic phlebotomists.

What level of supervision is required for a medical assistant-phlebotomist, forensic 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, forensic 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, forensic 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, forensic phlebotomist, or medical assistant-certified may perform a blood draw at the direction of a law enforcement officer if either:

the medical assistant's supervising healthcare practitioner has issued an order for the blood draw, or
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.