Chiropractor, Chiropractic X-Ray Technician FAQs

Frequently Asked Questions (FAQs)

Cannabis Health and Beauty Aids (CHABA) FAQs

1. What is a cannabis health and beauty aid (CHABA)?

As defined in RCW 69.50.575 a CHABA is a product containing parts of the cannabis plant which:

a. Is intended for use only as a topical application to provide therapeutic benefit or to enhance appearance;
b. Contains a THC concentration of not more than 0.3 percent;
c. Does not cross the blood-brain barrier; and
d. Is not intended for ingestion by humans or animals.

2. What is a hemp consumable?

As defined by RCW 15.140.020 a hemp consumable means a product that is sold or provided to another person that is:

(a) Made of hemp;
(b) Not a cannabis product, as defined in RCW 69.50.101; and
(c) Intended to be consumed or absorbed inside the body by any means, including inhalation, ingestion, or insertion.

3. May chiropractors use cannabis health and beauty aids or hemp consumables in their practice?

The Chiropractic Quality Assurance Commission (CQAC) has determined that items defined in statute as CHABA or hemp consumable are legal for chiropractors to use in their practice. While CQAC has made this determination, chiropractors should ensure that other relevant state and federal agencies permit the use of CHABA and hemp consumables.

4. May chiropractors use cannabis-infused oils or lotions in their practice?

CQAC has determined that topical products, such as oils and lotions, that meet the definition of a CHABA in RCW 69.50.575 (see Question 1) and those that meet the definition of a hemp consumable (see Question 2) are legal for chiropractors to use in their practice.

While CQAC has made this determination, chiropractors should ensure that other relevant state and federal agencies permit the use of CHABA and hemp consumables.

CQAC has also determined it is not within the scope of practice of chiropractors to use any products, including topical lotions and oils, that contain more than 0.3% THC on their patients even if the product is the subject of a medical marijuana authorization or the patient requests and provides the product for the chiropractor to use.
 
5. May chiropractors use cannabidiol (CBD) products in their practice?

CQAC has determined that chiropractors may use items defined as a CHABA or a hemp consumable in their practice. A CBD product may or may not meet the statutory definition of a CHABA or a hemp consumable. It is the responsibility of the licensed chiropractor to ensure any product they use meets the definition of a CHABA product as defined in RCW 69.50.575 (See Question 1) or hemp consumable defined in RCW 15.140.020 (see question 2) While CQAC has made this determination, chiropractors should ensure that other relevant state and federal agencies permit the use of a CHABA or a hemp consumable.

6. May a chiropractor sell cannabis health and beauty aids (CHABA) and hemp consumables as part of their practice?

CQAC has determined that chiropractors may sell items defined in statute as CHABA or hemp consumables. While CQAC has made this determination, chiropractors should ensure that other relevant state and federal agencies permit the sale of CHABA and hemp consumables.

Is a “remediation plan” under WAC 246-808-060 and WAC 246-808-070 a disciplinary action that is reportable?

CQAC does not consider a “remediation plan” to be disciplinary action under the Uniform Disciplinary Act (RCW 18.130). A remediation plan does not place any restriction or limitation on a chiropractor's license.

CQAC does not consider a “remediation plan” reportable to the National Practitioner Data Bank (NPDB) or Federation of Chiropractic Licensing Board's Chiropractic Information Network – Board Action Databank (CIN-BAD). The “remediation plan” does not contain findings of fact, or a finding of unprofessional conduct.

Finally, a “remediation plan” is not placed on the Department of Health's Provider Credential Search but would be provided as part of a request under the Public Records Act (RCW 42.56), unless an exemption to disclosure applies.

How much is the application fee?

Please see our fee page for information about fees. The application is on our website.

How long does the application process take?

The average application processing time is four to six weeks. The most current application processing times are on our Application Status webpage. Applications requiring commission review are considered during commission panel calls on the first and third Thursday of every month.

How do I get an inactive chiropractic license?

You must have an active chiropractic license to go inactive.

To go inactive, you must submit a request in writing and submit the inactive renewal fee. See our fee page for more information.

If you recently renewed your credential and you would like to go to inactive status, you may do so by submitting a written request. You may choose to keep your credential active until your next renewal cycle. Renewal fees cannot be refunded, but you can be moved to inactive status for the remainder of your renewal period. 

Is continuing education (CE) required to renew my inactive chiropractic license?

No, CE is not required to renew an inactive chiropractic license. 

If I'm licensed in another state, may I begin practicing once you have my license application?

No. You must have an active Washington State chiropractic license to practice as a chiropractor. You may check the status of your license through the Department of Health (DOH) Provider Credential Search website. Exceptions include temporary practice permits as identified in WAC 246-808-130, WAC 246-808-133, and WAC 246-808-140. People licensed to practice chiropractic in any other state, territory of the United States, the District of Columbia, Puerto Rico, or province of Canada, having qualifications substantially equivalent to Washington's requirements may apply for licensure by endorsement as provided in RCW 18.25.040 and WAC 246-808-135.

How many hours of continuing education (CE) am I required to report and when?

To renew a chiropractic license, you must have 25 hours of CE each year. No more than 12 of the 25 CE hours can be multimedia CE hours. To renew a chiropractic X-ray technician registration, you must have six hours of CE each year.

To renew a chiropractic X-ray technician registration, you must have six hours of CE each year.

When do I have to report my continuing education (CE) hours for renewal of my chiropractic or X-ray technician credential?

License renewal occurs on the licensee's birthdate. The CE hours must be acquired during the period from the licensee's birthdate one year earlier, to the renewal date. CE hours don't carry over into another renewal period, as per WAC 246-12-230.

Attesting to completion of the CE requirement is due upon renewal. If the first renewal period is less than one full year from the date of initial licensure, no CE will be due for the first renewal period.

What continuing education (CE) courses qualify for license renewal?

Licensed chiropractors may report only CE courses that are specifically related to the chiropractic scope of practice in RCW 18.25.005. The commission has a list of chiropractic pre-approved CE categories in WAC 246-808-150 and chiropractic X-ray technician CE in WAC 246-808-209. The CE must have a signed certificate of course completion.

Does the commission pre-approve continuing education (CE) courses?

No pre-approval is required in WAC 246-808-150.

May I get an extension of time to complete my continuing education (CE)?

Extensions may be granted as described in WAC 246-808-150. Don't wait until the CE is due to request the extension. If you have exhausted all possibilities for fulfilling your CE requirements and are contemplating requesting an extension, keep in mind that responses to requests for extensions can take two weeks or longer. If your license expires before your request for extension is granted, you cannot practice. If your request for an extension is denied, you must complete the CE hours prior to your expiration date before you can renew your license. If an extension is granted, you must complete all past due requirements within the timeframe granted for the extension. Additionally, you will also have to complete the 25 CE hour requirement for chiropractors, or six CE hours for chiropractic X-ray technicians, for the next renewal cycle.

What happens if I'm audited?

The Department of Health randomly audits a percentage of all currently licensed chiropractors and chiropractic X-ray technicians to ensure compliance with the continuing education requirement. If audited, you must provide certificates of course completion received from the course sponsor. Acceptable documentation is set forth in WAC 246-808-150.

How do I make a public records request?

Anyone can ask to see written records produced by Washington state government agencies including the Department of Health.

For more information on public records, see the agency's Public Records webpage.

How do I request a verification of my Washington chiropractic license to be sent to another jurisdiction?

Our online system provides the official Washington verification for professions regulated by the Department of Health and is updated in real time. 
 
The verification system is available to the public, at no charge, and can be accessed by visiting Provider Credential Search and choosing “Healthcare Provider.” 
 
The system allows for individual verification searches, as well as the ability to download lists of professionals in specific fields. You can enter as much, or as little, information as you have available to search. 
 
If you require wet signature, please submit the verification fee of $30 and the mailing address to the regulatory agency to our office at the following address:
 
Chiropractic Quality Assurance Commission
P.O. Box 1099
Olympia, WA 98507-1099
Email: CQAC@doh.wa.gov
 
Upon receipt of the requested information, the verification will be sent directly to the regulatory agency.

How much is my license renewal fee?

The chiropractic license renewal and the chiropractic X-ray technician license fees are located on license renewal fee webpage. Late license renewal penalty fees cannot be waived, as provided in WAC 246-12-340. Chiropractic and chiropractic X-ray technician licensing fees are listed in WAC 246-808-990.

How long does the license renewal process take?

Renewal notices are mailed 90 days before the license expiration date to allow enough processing time. Send payment immediately to ensure that your license will be delivered on or before the expiration date. It's against the law to practice without a current license.

You may renew your license online.

How do I become a preceptor/direct supervisory doctor?

The process to be a preceptor/direct supervisory doctor is set forth in WAC 246-808-190.

What billing code should I use for providing services?

The Chiropractic Quality Assurance Commission doesn't provide coding and billing advice. You'll need to seek professional guidance, or other assistance, regarding these types of questions.

How long do I keep patient records?

WAC 246-808-650, requires all patient records to be maintained for at least five years. However, other entities (i.e., Department of Labor and Industries and insurance companies) may require that records be maintained longer than what is required in WAC 246-808-650. Inquire with those entities to determine what their record retention requirements are. There is also a record retention requirement in the Health Care Information Act at RCW 70.02.160.

How long do I have to respond to a patient records request?

RCW 70.02.080(1) and WAC 246-808-650 require chiropractors to respond to a written patient records request within 15 days.

RCW 70.02.030(2) indicates a healthcare provider or healthcare facility may charge a reasonable fee for providing the healthcare information, and isn't required to honor an authorization until the fee is paid. Furthermore, RCW 70.02.010(37) defines a "reasonable fee" as charging for duplicating or searching the record.

May I charge for patient records?

Yes, chiropractors may charge a "reasonable fee" as defined in RCW 70.02.010 and established in WAC 246-08-400.

How do I know if an instrument or procedure is acceptable or prohibited?

The Chiropractic Quality Assurance Commission has created the Classification of Chiropractic Instrumentation and Procedures (PDF) list using the criteria set forth in WAC 246-808-505.

If you want the commission to review a request for additions or changes to the list, you must do so in accordance with these guidelines:

• Considering Requests for Additions or Changes to the Classification of Chiropractic Procedures and Instrumentation List (PDF)
• Submission Requirements and Deadline for Items to be Considered for Inclusion on a Commission Meeting Agenda (PDF)

Acupuncture Services

Acupuncture isn't within the chiropractic scope of practice as described in RCW 18.25.005 and WAC 246-808-580. You must be a licensed East Asian medical practitioner to provide acupuncture treatment.

Do I have to be a chiropractor to own a chiropractic office or business?

The commission doesn't have jurisdiction over business models. Chiropractors should seek legal counsel about corporate practice of medicine prohibitions and the Professional Services Corporation Act (PSCA) in RCW 18.100. However, if an unlicensed person interferes with a chiropractor's practice of the profession, it may constitute unlicensed practice under RCW 18.130.190. The secretary of health has jurisdiction over the unlicensed practice of chiropractic.

Can I employ a physical therapist, acupuncturist, or other healthcare professional in my office?

As stated above, you should seek legal counsel concerning the PSCA and professions that may set up professional service corporations together.

Why do I have to take continuing education in suicide screening and referral?

Certain healthcare professionals, including chiropractors, are required to complete training in suicide prevention. This requirement is listed in RCW 43.70.442. It is the result of several pieces of legislation aimed at helping healthcare providers identify, manage, and refer patients at risk for suicide. The law also requires the Department of Health to develop minimum standards for suicide prevention training and a model list of training programs. The current model list is available on the department's website.

By January 1, 2017, the department must create a model list of training programs that meet the minimum standards. Beginning July 1, 2017, chiropractors will be required to take a training program from the model list. If you took the training prior to July 1, 2017, and that training met the minimum training requirements in the statute, then it meets the requirements of RCW 43.70.442.

How many hours of continuing education do I need to take in suicide screening and referral?

Under WAC 246-808-150, chiropractors are required to take at least three hours of continuing education in suicide screening and referral one time only.

If I take more than three hours of continuing education in suicide screening and referral, will all the hours count toward my license renewal?

Yes, all the continuing education hours in suicide screening and referral will count toward your license renewal.

Where do I find the Department of Health's suicide screening and referral training program model list, and how do I become an approved continuing education provider?

You may view the training program model list, and read information about how to become a recognized suicide screening and referral trainer and offer courses, as well as other information about the requirement at:

Suicide Prevention Training Home | Suicide Prevention Plan | Rules in Progress | Training Programs | Training Requirements

Can chiropractors obtain credit towards meeting continuing education (CE) requirements for attending the Chiropractic Quality Assurance Commission's (CQAC) business meetings and participating in activities of the National Board of Chiropractic Examiners (NBCE)?

Yes, chiropractors can obtain credit towards meeting CE requirements for attending CQAC's business meetings and participating in activities of the NBCE.

For example, participation in NBCE examination development workshops or examination administrations that relate to a subject or subjects in WAC 246-808-150(5)(a)-(p) qualify for CE credit.

Chiropractors are reminded that CE credit for hours falling under WAC 246-808-150(5)(p) may not exceed a total of twelve hours for each reporting period.

What is the HEAL-WA fee?

HEAL-WA is Health Evidence Resource for Washington State. You may have noticed a HEAL-WA fee ($16.00 per year) as part of your chiropractic license renewal. HEAL-WA is a collection of health information resources funded by license fees from selected healthcare providers in Washington State. Its mission is to provide evidence-based information to support patient care.

The HEAL-WA portal provides access to full text journals and peer reviewed resources.

Your active or inactive status chiropractic license number provides you with access to the HEAL-WA portal, but you will need to create a UW ID to log in. If you do not know your chiropractic license number and would like to look it up, you may use Provider Credential Search.

If you have further questions regarding HEAL-WA, see the HEAL-WA frequently asked questions page. If there are further questions, contact the HEAL-WA program at the University of Washington library directly: 206-221-2452.