Verified October 8, 2026 against the statutes and regulations cited below. Research, not legal advice. All states
What operators miss in Washington
- Payment parity has an opt-out: hospitals, hospital systems, telemedicine companies and provider groups of 11 or more may negotiate telemedicine rates that differ from in-person rates.
- A clinician may not bill a patient directly for a telehealth service that is not a covered telemedicine service without the patient's consent before the visit (RCW 18.134.070).
Does Washington have a telehealth registration for out-of-state clinicians?
Washington has no telehealth registration. Under the Uniform Telehealth Act, an out-of-state clinician needs a Washington license or compact privilege unless a listed exception applies.
- No telehealth-specific registration: a clinician needs the full license or an exception.
Citation: RCW 18.134.040
When can an out-of-state clinician treat Washington patients without a Washington license?
Licensed out-of-state clinicians may consult with a Washington clinician who keeps responsibility, give a specialty assessment or treatment recommendation (not treatment), or give follow-up to an established patient temporarily in Washington who was treated in the clinician's state.
- Exception for follow-up care with an existing patient
- Exception for consultation with a licensed physician
Citation: RCW 18.134.040
Can a patient relationship start by telehealth in Washington?
A practitioner-patient relationship may be established through telehealth, which covers synchronous and asynchronous technology, but not through email, instant messaging, text messaging or fax. Boards may not set a different standard of care for telehealth or limit the technology used.
- Asynchronous care can establish the relationship
Citation: RCW 18.134.010, 18.134.030
Does Washington require telehealth consent?
In-person informed-consent standards apply to telehealth. Separately, a provider must get the patient's consent before billing for an audio-only visit; it lasts up to 12 months, may be verbal or written, and must be kept five years.
Citation: RCW 18.134.030, 48.43.735; WAC 284-170-433
What limits does Washington put on prescribing by telehealth?
Prescribing by telehealth follows the same professional standards as in-person care. The Medical Commission rescinded its separate telemedicine policy in December 2024 because the Uniform Telehealth Act superseded it.
Citation: RCW 18.134.030
Does Washington require its own controlled-substance registration?
Do private payers in Washington have to cover telehealth?
- Private-payer telehealth coverage law
- Parity with conditions
Citation: RCW 48.43.735; WAC 284-170-433
How does Washington treat the corporate practice of medicine?
Does Washington have a consumer health data law?
Effective March 31, 2024. Requires consent to collect or share consumer health data, a signed authorization to sell it, and bars geofencing around health facilities. Violations are enforced under the Consumer Protection Act, including private lawsuits.
- My Health My Data Act (RCW 19.373)
Adding Washington to your telehealth practice?
A State Expansion Pack applies Washington's rules to your service line and lists what changes in your workflow before the first visit.