Out of State Providers

In order to bill an encounter for services provider via telemedicine or telehealth, you must be licensed as a provider in Washington State, or a part of an interstate compact that Washington participates in such as RCW 18.225.090. Service(s) must be rendered consistent with the scope of professional licensure or certification. This answer does not pertain to providers in a Direct IHS Clinic, Tribal Clinic, or Tribal FQHC as those providers may be licensed in any state per federal law.

If you are a participating interstate compact provider, the same expectations apply for billing and encountering as outlined in the answer above, meaning if the client is temporarily in a state that is not a participating compact provider, then it would not be billable or encounterable to provide services to the WA Medicaid client. Note: If the Washington (WA) Apple Health (Medicaid) client is receiving services outside of Washington State by a Washington State provider, the provider must follow the applicable laws of the state in which the client is located.

SOURCE: WA State Health Care Authority Behavioral Health Policy and Billing FAQ (Jan. 2025). (Accessed May 2025).

A distant site must be located within the continental United States, Hawaii, District of Columbia, or any United States territory (e.g., Puerto Rico). A distant site is where a physician or other licensed provider, delivering a professional service, is physically located at the time the service is provided through telemedicine.

To bill for services provided via telemedicine to a client located in Washington State, the practitioner must either:

• Be licensed as a provider in Washington State OR
• Have an interstate compact license that is recognized by Washington State. Active Washington State compacts include the following:
  • Psychology Interjurisdictional Compact
  • Physical Therapy Licensure Compact
  • Nurse Licensure Compact
  • Occupational Therapy Licensure Compact
  • DOH Note: Some compacts are still in the implementation process. See the Department of Health’s (DOH) website for details specific to Washington State.

SOURCE: WA State Health Care Authority Telemedicine Policy and Billing Manual (Jan. 2025), p. 18-20. (Accessed May 2025).