Telemedicine Services to Patients
- Telehealth Overview
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A health care practitioner may provide telehealth services to a patient in Washington if the services are consistent with:
- The health care practitioner's scope of practice in Washington
- Applicable professional practice standards in Washington
- Requirements and limitations of federal and Washington state law
A practitioner-patient relationship may be established through telehealth. Email, instant messaging, text messaging, and fax are not considered telehealth unless otherwise authorized by statute. More information on telehealth for health providers is available on our Telehealth webpage.
Definitions (Engrossed Substitute Senate Bill 5481 (2024))
Telehealth is the use of synchronous or asynchronous telecommunications technology by a health care provider to deliver health care services, including assessment, diagnosis, consultation, treatment, and monitoring of a patient.
Telemedicine is the delivery of clinical health care services through real-time interactive audio and video technology. It is a subset of telehealth.
- Telemedicine Training Requirements
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Beginning January 1, 2021, health care professionals who offer telemedicine services must complete telemedicine training (PDF). See the Department of Health's policy statement (PDF) for more information. Allopathic physicians (MDs) and osteopathic physicians (DOs) are exempt from this requirement.
You can learn more about training options and access additional resources on the Washington State Telehealth Collaborative Training page. Training is free and publicly available. Select "enroll" and create a Canvas account to Washington State Medical Professional Telemedicine Training.
More resources are available at:
- Substitute House Bill 1196
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Substitute House Bill 1196 was passed during the 2021 legislative session. It requires:
- Beginning July 25, 2021, providers must receive patient consent for billing either the patient or their health plan prior to providing audio-only telemedicine services. The patient consent requirement applies to:
- Commercial health plans regulated by the state
- Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) plans
- Behavioral health administrative services organizations and managed care organizations contracted with the Health Care Authority
- Medicaid managed care plans contracted with the Health Care Authority
- Beginning, January 1, 2023, the provider must have an established relationship with a patient for an audio-only telemedicine service in order to be compensated at the same rate as an in-person visit. An established relationship includes a prior in-person or real-time interactive (audio-only) visit within the timeframe specified in current statute.
- Under Senate Bill 5821 (2024), the timeframe was extended from 2 years to 3 years.
- Beginning July 25, 2021, providers must receive patient consent for billing either the patient or their health plan prior to providing audio-only telemedicine services. The patient consent requirement applies to:
- Substitute Senate Bill 5423
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Substitute Senate Bill 5423 (PDF) passed in the 2021 legislative session. This bill allows Washington state Allopathic Physicians (MDs) and Osteopathic Physicians (DOs) to consult with practitioners licensed in another state, via telemedicine, to diagnose and treat a Washington provider's established patient.
- Engrossed Substitute Senate Bill 5481
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Engrossed Substitute Senate Bill 5481 (PDF) passed in the 2024 legislative session. It establishes uniform standards for telehealth services across regulated professions, including updated statutory definitions, authorization requirements, and practice parameters. The Revised Code of Washington (RCW) has been updated to reflect these changes. Providers should review current statutory language to ensure compliance.
- Senate Bill 5821
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Senate Bill 5821 passed in the 2024 legislative session. Senate Bill 5821:
- Establishes uniform standards for audio-only telehealth services
- Clarifies authorization conditions
- Identifies eligible regulated professionals
- Extends the required in-person or real-time interactive visit interval from 2 years to 3 years
Providers should review the updated Revised Code of Washington (RCW) provisions for full statutory requirements.
For more questions, please contact the Board of Osteopathic Medicine and Surgery, the Washington Medical Commission, or the program manager for your profession.