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<chapter num="10" heading="Teletherapy" title_num="10" subtitle_num="42">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <paragraph num="A.">
      <text>This chapter governs the practice of social work using teletherapy as an adjunct to, or replacement for, in-person client visits.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Nothing in this chapter restricts or limits reimbursement requirements pursuant to the Health-General Article and Insurance Article, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Asynchronous” means not occurring in real time.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Board” means the Maryland Board of Social Work Examiners.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Client” means the individual, couple, family, group, business, agency, school, organization, or association that the licensed social worker provides, or has provided, with professional services.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“In-person” means within the physical presence of the client.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Synchronous” means occurring in real time.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Teletherapy” means telehealth as defined in Health Occupations Article, §1-901, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Teletherapy practitioner” means a Maryland licensed social worker performing teletherapy services within their respective scope of practice.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Licensure.">
    <text>Subject to the provisions of Health Occupations Article, Title 19, Subtitle 3, Annotated Code of Maryland, in order to practice teletherapy a teletherapy practitioner shall be licensed in Maryland when providing teletherapy services to a client located in the State.</text>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Standards of Practice for Teletherapy.">
    <paragraph num="A.">
      <text>Before providing teletherapy services, a teletherapy practitioner shall develop and follow a procedure to:</text>
      <paragraph num="(1)">
        <text>Verify the identification of the client receiving teletherapy services through the use of:</text>
        <paragraph num="(a)">
          <text>A government issued photograph identification;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>An insurance, Medicaid, or Medicare card; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Documentation of the client’s:</text>
          <paragraph num="(i)">
            <text>Date of birth; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Home address;</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>For an initial client-telehealth practitioner encounter, disclose the teletherapy practitioner’s:</text>
        <paragraph num="(a)">
          <text>Name;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Maryland license number and type; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Contact information;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Obtain oral or written informed consent from a client or a client’s parent or guardian if State law requires the consent of a parent or guardian, including informing clients of the risks, opportunities, and obligations associated with services available to the client;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Securely collect and transmit a client’s clinical data and self-reported medical history, as necessary, and prevent access to data by unauthorized persons through encryption, or other means;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Notify clients in the event of a data breach;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Ensure that the teletherapy practitioner provides a secure and private communication modality and complies with federal and State privacy laws; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Establish safety protocols to be used in the case of an emergency, including contact information for emergency services at the client’s location.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Except when providing asynchronous teletherapy services, a teletherapy practitioner shall:</text>
      <paragraph num="(1)">
        <text>Obtain or confirm an alternative method of contacting the client in case of a technological failure;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Confirm whether the client is in Maryland and identify the client’s specific location; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Identify all individuals present at each location and confirm they are permitted to hear the client’s health information.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A teletherapy practitioner shall be held to the same standards of practice and documentation as those applicable for in-person social work practice sessions.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Client Evaluation.">
    <paragraph num="A.">
      <text>A teletherapy practitioner shall:</text>
      <paragraph num="(1)">
        <text>Perform a synchronous or asynchronous clinical client evaluation that is appropriate for the client and the condition with which the client presents before providing treatment or services through teletherapy; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If clinically appropriate for the client, provide or refer a client to:</text>
        <paragraph num="(a)">
          <text>In-person treatment; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Another type of teletherapy service.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A teletherapy practitioner may not treat a client based solely on an online questionnaire.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Teletherapy Practitioner Discipline.">
    <paragraph num="A.">
      <text>The Board shall use the same standards in evaluating and investigating a complaint and disciplining a licensee who practices teletherapy as it would use for a licensee who does not use teletherapy technology in the licensee’s practice.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The failure of a teletherapy practitioner to comply with this chapter shall constitute unprofessional conduct and may be subject to disciplinary action by the Board.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §15-141.2; Health Occupations Article, §§1-901—1-903 and 1-1001— 1-1006; Insurance Article, §15-139, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: October 7, 2019 (46:20 Md. R. 844)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01 amended effective September 18, 2023 (50:18 Md. R. 797)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02B amended effective September 18, 2023 (50:18 Md. R. 797)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03 amended effective September 18, 2023 (50:18 Md. R. 797)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended effective September 18, 2023 (50:18 Md. R. 797)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05 amended effective September 18, 2023 (50:18 Md. R. 797)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06 amended effective September 18, 2023 (50:18 Md. R. 797)</annotation>
  </annotations>
</chapter>