Last updated 01/10/2023
Consent Requirements
The parent or guardian of a student shall consent prior to the student receiving behavioral health services via telehealth under this chapter after a provider-patient relationship is established pursuant to this section. The school district shall maintain any such consent form completed by a parent or guardian.
SOURCE: IA Code Title VII Subtitle 6 Chapter 280A.3, (Accessed Jan. 2023).
Telepsychology
A licensee shall ensure informed consent for telepsychology includes a description of any limitations of services as a result of the technology utilized.
SOURCE: Iowa Admin Code, Sec. 645-243.7, (Accessed Jan. 2023).
Physician Assistants
Informed consent. A licensee who uses telemedicine shall ensure that the patient provides appropriate informed consent for the medical services provided, including consent for the use of telemedicine to diagnose and treat the patient, and that such informed consent is timely documented in the patient’s medical record.
See rule for more information about how Physician Assistants must disclose limitations about the drugs and services that can be provided via telemedicine, as well as financial interests and other important information during their meetings. A mechanism for the patient to give feedback must also be provided.
SOURCE: Iowa Admin Code, Sec. 645-327.9, (Accessed Jan. 2023).
Speech Pathology and Audiology
Prior to the first telehealth visit, a licensee shall obtain informed consent from the patient specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the patient of the following:
- The risks and limitations of the use of technology to provide speech pathology or audiology services;
- The potential for unauthorized access to protected health information; and
- The potential for disruption of technology during a telehealth visit.
SOURCE: Iowa Admin Code, Sec. 645-301.1, (Accessed Jan. 2023).
Board of Dietetics
Prior to the first telehealth visit, a licensee shall obtain informed consent from the individual or group specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the individual or group of the following:
- The risks and limitations of the use of technology to provide dietetics services;
- The potential for unauthorized access to protected health information; and
- The potential for disruption of technology during a telehealth visit.
SOURCE: Iowa Administrative Code Section 645.81.17, (Accessed Jan. 2023).
Hearing Aid Specialists
Prior to the first telehealth appointment with a client, the licensee shall obtain informed consent from the client that is specific to the service or services that will be provided in the telehealth appointment. The informed consent shall specifically inform the client of, at a minimum, the following:
- The risks and limitations of the use of technology to the specific service;
- The potential for unauthorized access to protected health information; and
- The potential for disruption of technology during a telehealth appointment.
SOURCE: Iowa Admin Code, Sec. 645-123.5, (Accessed Jan. 2023).
Nursing – APRNs
Prior to providing services via telehealth, the licensee shall obtain consent from the patient, or the patient’s legal guardian or legal representative, to receive services via telehealth.
SOURCE: IA Admin Code Sec. 655-7.9(152), (Accessed Jan. 2023).
Last updated 01/10/2023
Cross State Licensing
Psychologists
For telepsychology a psychologist must be licensed or be exempt from licensure in the jurisdiction where the patient or examinee is located.
SOURCE: Iowa Admin Code, Sec. 645-243.7, (Accessed Jan. 2023).
Physician Assistants
License Required: A physician assistant who uses telemedicine in the diagnosis and treatment of a patient located in Iowa shall hold an active Iowa physician assistant license consistent with state and federal laws.
SOURCE: Iowa Admin Code, Sec. 645-327.9, (Accessed Jan. 2023).
Hearing Aid Specialists
Conducting a telehealth appointment with a client who is physically located in Iowa during the appointment, regardless of the location of the hearing aid specialist, shall require Iowa licensure.
SOURCE: Iowa Admin Code, Sec. 645-123.5, (Accessed Jan. 2023).
Nursing
A registered nurse or licensed practical nurse who provides services through telehealth to a patient physically located in Iowa must hold an active license issued by the board or have an active privilege to practice in Iowa pursuant to the nurse licensure compact.
SOURCE: IA Admin Code Sec. 655-6.4(152), (Accessed Jan. 2023).
Board of Nursing – APRN
An advanced registered nurse practitioner who provides services through telehealth to a patient physically located in Iowa must be licensed by the board. A licensee who provides services through telehealth to a patient physically located in another state shall be subject to the laws and jurisdiction of the state where the patient is physically located.
SOURCE: IA Admin Code Sec. 655-7.9(152), (Accessed Jan. 2023).
Last updated 01/10/2023
Definitions
Telecommunications and Technology Commission
“Telemedicine means use of a telecommunications system for diagnostic, clinical, consultative, data, and educational services for the delivery of health care services or related health care activities by licensed health care professionals, licensed medical professionals, and staff who function under the direction of a physician, a licensed health care professional, or hospital, for the purpose of developing a comprehensive, statewide telemedicine network or education.”
SOURCE: IA Admin. Code, 751 7.1(8D). (Accessed Jan. 2023).
Psychologists
“Telepsychology” means the provision of psychological services using telecommunication technologies.
SOURCE: Iowa Admin Code, Sec. 645-243.1 (154B), (Accessed Jan. 2023).
Physician Assistant Regulations
“Asynchronous store-and-forward transmission” – the collection of a patient’s relevant health information and the subsequent transmission of the data from an originating site to a health care provider at a distant site without the presence of the patient.
“Telemedicine” – the practice of medicine using electronic audiovisual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telemedicine includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telemedicine, for the purposes of this rule establishing standards of practice, does not include the provision of medical services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof.
SOURCE: Iowa Admin Code, Sec. 645-327.9, (Accessed Jan. 2023).
Medicine
“Telemedicine” means the practice of medicine using electronic audio-visual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telemedicine includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telemedicine shall not include the provision of medical services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof.
SOURCE: Iowa Admin Code, Sec. 653-13.11, (Accessed Jan. 2023).
Speech Pathology and Audiology
“Telehealth visit” means the provision of speech pathology or audiology services by a licensee to a patient using technology where the licensee and the patient are not at the same physical location during the appointment.
SOURCE: Iowa Admin Code, Sec. 645-301.1, (Accessed Jan. 2023).
Nutritionists
“Telehealth visit” means the provision of dietetic services by a licensee to an individual or a group using technology where the licensee and the individual or group are not at the same physical location for the therapy session.
SOURCE: Iowa Administrative Code Section 645.81.17. (Accessed Jan. 2023)
Nursing
“Telehealth” means the practice of nursing using electronic audiovisual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telehealth includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telehealth, for the purposes of this rule, shall not include the provision of nursing services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof.
SOURCE: IA Admin Code Sec. 655-6.1(152), (Accessed Jan. 2023).
Nursing – APRN
“Telehealth” means the practice of nursing using electronic audiovisual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a licensee in one location and a patient in another location with or without an intervening health care provider. Telehealth includes asynchronous store-and-forward technologies, remote monitoring, and real-time interactive services, including teleradiology and telepathology. Telehealth, for the purposes of this rule, shall not include the provision of nursing services only through an audio-only telephone, email messages, facsimile transmissions, or U.S. mail or other parcel service, or any combination thereof.
SOURCE: IA Admin Code Sec. 7.1, (Accessed Jan. 2023).
Last updated 01/10/2023
Licensure Compacts
Member of the Interstate Medical Licensure Compact.
SOURCE: Interstate Medical Licensure Compact. The IMLC. (Accessed Jan. 2023).
Member of Physical Therapy Compact.
SOURCE: Physical Therapy Compact. Compact Map. (Accessed Jan. 2023).
Member of Occupational Therapy Licensure Compact.
SOURCE: Occupational Therapy Compact, Compact Map, (Accessed Jan. 2023).
Member of Nurse Licensure Compact.
SOURCE: Current NLC States and Status. NCSBN. (Accessed Jan. 2023).
Member of the EMS Compact.
SOURCE: Interstate Commission for EMS Personnel Practice. The EMS Compact. (Accessed Jan. 2023).
Member of Audiology and Speech Language Pathology Interstate Compact.
SOURCE: ASLP-IC Compact, Compact Map, (Accessed Jan. 2023).
* See Compact websites for implementation and license issuing status and other related requirements.
Last updated 01/10/2023
Miscellaneous
The following persons and entities may use or access the network for data and video services including access to the Internet if the use is for telemedicine or educational purposes:
- Licensed health care professionals or licensed health care professionals who function under the direction of or in collaboration with a physician or a hospital, or both, for example, other doctors, students, nurses, physician’s assistants, therapists, clinical social workers, psychologists;
- Hospital or physician clinic staff members;
- Professional boards on which health professionals serve, for example, a nurse serving on the board of the American Cancer Society;
- Patients acting under the direction of a licensed health care professional;
- Health care employees of facilities that have a contractual agreement with the hospital or physician;
- Health care employees of facilities that do not have a contractual agreement with the hospital or physician clinic;
- Employees of health care associations for various health care employees, for example, Association of Iowa Hospitals and Health Systems, Iowa Medical Society, Iowa Osteopathic Medical Association, Iowa Chiropractic Society, Iowa Nurses Association;
- Professional board members where a health care professional serves as a member of a board, for example, a physician serving on the board of the American Cancer Society
SOURCE: IA Admin. Code, 751 7.11(8D). (Accessed Jan. 2023).
A licensee under the purview of the board who provides treatment for the correction of malpositions of human teeth or the initial use of orthodontic appliances shall not begin orthodontic treatment on a new patient unless one of the following conditions is met:
- The licensee performs an initial in-person or teledentistry examination of the teeth and supporting structures of the new patient prior to beginning orthodontic treatment.
- The new patient provides the licensee with the portion of the dental record taken within the prior six months of an in-person or teledentistry examination of the teeth and supporting structures of the new patient prior to the licensee beginning orthodontic treatment.
SOURCE: Iowa Annotated Statute Sec. 153.24, (Accessed Jan. 2023).
Last updated 01/10/2023
Online Prescribing
Pharmacists are prohibited from dispensing prescription drugs if the pharmacist knows or should have known that the prescription was issued solely on the basis of an Internet-based questionnaire, an Internet-based consult, or a telephone consult.
SOURCE: IA Admin. Code, 657 8.19(5). (Accessed Jan. 2023).
A physician must be physically present with a woman at the time an abortion-inducing drug is provided.
SOURCE: IA Admin. Code, 653 13.10(3) (Accessed Jan. 2023).
Generally, a licensee shall perform an in-person medical interview and physical examination for each patient. However, the medical interview and physical examination may not be in-person if the technology utilized in a telemedicine encounter is sufficient to establish an informed diagnosis as though the medical interview and physical examination had been performed in-person. Prior to providing treatment, including issuing prescriptions, electronically or otherwise, a licensee who uses telemedicine shall interview the patient to collect the relevant medical history and perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. An Internet questionnaire that is a static set of questions provided to the patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview, does not constitute an acceptable medical interview and physical examination for the provision of treatment, including issuance of prescriptions, electronically or otherwise, by a licensee.
Under certain circumstances, whether or not such circumstances involve the use of telemedicine, a licensee may treat a patient who has not been personally interviewed, examined and diagnosed by the licensee. See rule.
SOURCE: Iowa Admin Code, Sec. 653-13.11, (Accessed Jan. 2023).
Specific requirements apply for mental health professionals establishing a provider-patient relationship in a school-based setting. See full law text for details.
A mental health professional with prescribing authority who provides telehealth services in accordance with this section shall not prescribe any new medication to a student during a telehealth session. However, a mental health professional with prescribing authority may initiate new prescriptions, alter the dosage of an existing medication, or discontinue an existing medication for the treatment of the student’s behavioral health condition after consultation with the student’s parent or guardian.
SOURCE: IA Code Chapter 280A.4 (Accessed Jan. 2023).
A mental health professional with prescribing authority who provides telehealth services shall not alter the dosage of an existing medication or prescribe any new medication during a telehealth session without prior consultation with the student’s parent or guardian.
SOURCE: IA Code 281.14.24, (Accessed Jan. 2023).
Physician Assistant-Patient Relationship
A licensee who uses telemedicine shall establish a valid physician assistant-patient relationship with the person who receives telemedicine services. The physician assistant-patient relationship begins when:
- The person with a health-related matter seeks assistance from a licensee;
- The licensee agrees to undertake diagnosis and treatment of the person; and
- The person agrees to be treated by the licensee whether or not there has been an in-person encounter between the physician assistant and the person.
A valid physician assistant-patient relationship may be established by:
- In-person encounter. Through an in-person medical interview and physical examination where the standard of care would require an in-person encounter;
- Consultation with another licensee. Through consultation with another licensee (or other health care provider) who has an established relationship with the patient and who agrees to participate in, or supervise, the patient’s care; or
- Telemedicine encounter. Through telemedicine, if the standard of care does not require an in-person encounter, and in accordance with evidence-based standards of practice and telemedicine practice guidelines that address the clinical and technological aspects of telemedicine.
Medical history and physical examination may be done through telemedicine if the technology utilized in a telemedicine encounter is sufficient to establish an informed diagnosis as though the medical interview and physical examination had been performed in person.
An Internet questionnaire that is a static set of questions provided to the patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview, does not constitute an acceptable medical interview and physical examination for the provision of treatment, including issuance of prescriptions, electronically or otherwise, by a licensee.
See rule for circumstances where the standard of care may not require a licensee to personally interview or examine a patient.
Prescribing to a patient based solely on an Internet request or Internet questionnaire (i.e., a static questionnaire provided to a patient, to which the patient responds with a static set of answers, in contrast to an adaptive, interactive and responsive online interview) is prohibited. Absent a valid physician assistant-patient relationship, a licensee’s prescribing to a patient based solely on a telephonic evaluation is prohibited, with the exception of the circumstances described in subrule 327.9(21).
SOURCE: Iowa Admin Code, Sec. 645-327.9, (Accessed Jan. 2023).
Nursing – APRNs
Prior to providing services through telehealth, the licensee shall first establish a practitioner-patient relationship. A practitioner-patient relationship is established when:
- The person with a health-related matter seeks assistance from the licensee;
- The licensee agrees to provide services; and
- The person agrees to be treated, or the person’s legal guardian or legal representative agrees to the person’s being treated, by the licensee regardless of whether there has been a previous in-person
encounter between the licensee and the person.
A practitioner-patient relationship can be established through an in-person encounter, consultation with another licensee or health care provider, or telehealth encounter.
Notwithstanding paragraphs 7.9(5)“a” and “b,” services may be provided through telehealth without first establishing a practitioner-patient relationship in the following settings or circumstances:
- Institutional settings;
- Licensed or certified nursing facilities, residential care facilities, intermediate care facilities, assisted living facilities, and hospice settings;
- In response to an emergency or disaster;
- Informal consultations with another health care provider performed by a licensee outside of the context of a contractual relationship, or on an irregular or infrequent basis, without the expectation or exchange of direct or indirect compensation;
- Episodic consultations by a specialist located in another jurisdiction who provides consultation services upon request to a licensee;
- A substitute licensee acting on behalf and at the designation of an absent licensee or other health care provider in the same specialty on an on-call or cross-coverage basis; or
- When a sexually transmitted disease has been diagnosed in a patient, a licensee prescribes or dispenses antibiotics to the patient’s named sexual partner(s) for the treatment of the sexually transmitted disease as recommended by the U.S. Centers for Disease Control and Prevention.
A licensee providing services through telehealth may issue a prescription to a patient as long as the issuance of such prescription is consistent with the standard of care applicable to the in-person setting.
SOURCE: IA Admin Code Sec. 655-7.9(152), (Accessed Jan. 2023).
Last updated 01/10/2023
Professional Boards Standards
IA Board of Dentistry
SOURCE: IA Admin Code 650-27.12(153) (Accessed Jan. 2023).
IA Board of Medicine
SOURCE: IA Admin Code Sec. 653.13.11 (Accessed Jan. 2023).
IA Board of Physical and Occupational Therapists
SOURCE: IA Admin Code Sec. 645-201.3 & 645-208.3. (Accessed Jan. 2023).
IA Board of Nursing
SOURCE: IA Admin Code Sec. 655-6.4(152), (Accessed Jan. 2023).
IA Board of Dietetics
SOURCE: Iowa Administrative Code Section 645.81.17. (Accessed Jan. 2023)
Education Department Standards
SOURCE: IA Code 281.14.23, (Accessed Jan. 2023).
Board of Psychology
SOURCE: Iowa Admin Code, Sec. 645-243.7, (Accessed Jan. 2023).
Board of Physician Assistants
SOURCE: Iowa Admin Code, Sec. 645-327.9, (Accessed Jan. 2023).
Board of Speech Pathology and Audiology
SOURCE: Iowa Admin Code, Sec. 645-301.1, (Accessed Jan. 2023).
Hearing Aid Specialists
SOURCE: Iowa Admin Code, Sec. 645-123.5, (Accessed Jan. 2023).
Board of Nursing – APRN
SOURCE: IA Admin Code Sec. 655-7.9(152), (Accessed Jan. 2023).
