64 Monitor on Psychology • December 2015
Practice PERSPECTIVE ON
By Dr. Katherine C. Nordal • Executive Director for Professional Practice
An aging population, rising health-care costs, increased prevalence of chronic
diseases and lack of providers in some areas are among the issues driving the
momentum for increasing patient access to care through telehealth services
— real-time, face-to-face audio/visual communication with a health-care
provider. A new report from Transparency Market Research estimates the
global telemedicine market could reach $36.3 billion by
2020. However, the future of telehealth and telepsychology is
dependent on reimbursement and regulatory policies at both
the federal and state levels.
An increasing number of states are enacting mandates that call
for insurance companies to cover services provided by telehealth
if those same services would be covered when provided in person.
Currently, 29 states plus Washington, D.C., have such requirements, and three other states prohibit insurers from imposing restrictions on telehealth services that are covered. Similarly, bills
have been introduced in Congress that would increase the use of
telehealth in federal systems, including Medicare.
A growing number of states have also instituted telepractice
policies — either through statutes that govern the delivery of
health-care services or through state laws that include remote
services within the scope of practice. Psychology licensing
boards have issued advisory opinions on telepractice, indicating
that those who provide services via electronic means to
consumers within the state must be licensed in that state.
APA has been actively involved in developing guidelines
on telepsychological practice and supporting other related
initiatives that promote lawful, ethical telepractice. Our first
step was creating a task force to evaluate the need for guidelines
on telepsychological practice and to develop guidance with
representatives from APA, the Association of State and Provincial
Psychology Boards (ASPPB) and The Trust. This is the first time
APA has jointly developed professional practice guidelines with
At its meeting during APA’s 2013 Annual Convention,
APA’s Council of Representatives approved the Guidelines
for the Practice of Telepsychology ( www.apa.org/practice/
guidelines/ telepsychology.aspx). The guidelines are intended
to both educate and inform practicing psychologists in
applying current standards of professional practice when using
telecommunication technologies. The new guidelines are not
intended to change or define psychologists’ scope of practice.
Rather, they are intended to guide psychologists on issues to
consider before they provide telepsychology services.
Step two involves the development of regulatory guidance
for psychology licensing boards to oversee telepractice — both
intrastate and interstate. ASPPB developed standards and
principles consistent with the Telepsychology Guidelines to
assist licensing boards in appropriate telepractice.
At the same time, ASPPB began working on a regulatory
mechanism to facilitate interjurisdictional telepractice while
maintaining the licensing board’s mission to protect consumers.
PSYPACT is a multistate compact that would allow for
telepsychological practice and temporary in-person practice
across state lines up to 30 days in participating states. For more
information on PSYPACT, go to www.psypact.org.
APA Practice has been involved in this development, with
APA Director of Legal and Regulatory Policy Deborah Baker,
JD, participating in ASPPB’s ongoing workgroup. Because
implementation of the PSYPACT will require a minimum of
seven states to enact the legislation, collaboration between
the licensing boards and state, provincial and territorial
psychological associations will be important. The APA Board
of Directors has endorsed PSYPACT, and it is also supported by
the Committee for the Advancement of Professional Practice,
the governing body of the APA Practice Organization (which
reports to the APAPO Board of Directors). APA and the
Practice Organization are supporting efforts at the state level to
operationalize PSYPACT to standardize requirements among
licensing boards and protect psychologists and consumers. n
For more information, contact Deborah Baker at dbaker@apa.
org. The APAPO, a companion organization to APA, advocates on
behalf of practicing psychologists.