Telehealth in Oregon: rules and setup

This lesson covers what governs a video session in Oregon: whose rules apply when the client is somewhere else, why no licensure compact helps you yet, the ethics code the OBLPCT enforces online, the Oregon Health Plan telemedicine rule, and the codes and setup a first telehealth practice needs. It is written for a clinician about to run a first telehealth practice in Oregon. It pairs with the HIPAA and records lesson, which covers the vendor agreements this one takes for granted.

No special certificate, and the client's location decides

The OBLPCT's practice FAQ answers the first question directly: the Board does not require any additional certification to practice teletherapy. An Oregon license already authorizes work in person or by electronic means with clients who are inside Oregon.

The harder question is the client who leaves. The same FAQ says that when a client will be physically in another state for a while, it is up to that state to decide if you may keep treating them, because Oregon "cannot authorize practice within another state." The answer runs the same way in reverse when you travel: the state you are sitting in decides. For a clinician licensed elsewhere whose client is staying in Oregon, the Board points to its limited permit page. The working rule, then, is that licensure follows the client's physical location at the time of the session, and with an out-of-state client, check that state's board before the session.

Oregon is in neither compact

The Counseling Compact would let a counselor licensed in one member state practice in the others under a single privilege. Oregon has not joined. The Board's FAQ, asked whether Oregon will, answers "The short answer: no." The Board asked for a bill in the 2025 session, its concept was not approved to move forward, and the Compact was introduced anyway as House Bill 3351 by Representative Diehl. The Board's page says that bill "was not successful," and the Legislature's record shows it never left the House committee. The Board's stated concerns include conflicts between the Compact's language and Oregon's constitution, statutes, and rules, and the regulatory power it would hand to an outside commission.

House Bill 3339, which would have enacted PSYPACT for psychologists, ended the 2025 session in committee the same way. I found no 2026 enactment of either as of September 2026. My post on the Counseling Compact and Oregon goes into the history; for this lesson, the point is that a compact privilege is not available to you.

The rule that governs your conduct online

OAR 833-100-0011 adopts the 2014 ACA Code of Ethics as the OBLPCT's code of professional conduct for licensees, registered associates, permit holders, and applicants, and says a violation is unprofessional conduct sufficient for discipline. The 2014 Code, which the rule adopts, has a Section H on distance counseling, technology and social media. There is no separate Oregon teletherapy rule. Section H is the standard you will be measured against, so read it in full once; it is short, and it is the document a Board investigator would have open next to your consent form.

Clinical social workers and psychologists are held to their own boards' codes, so check the Board of Licensed Social Workers or the Board of Psychology for the equivalent.

The OHP telemedicine rule

For Oregon Health Plan clients the operative rule is OAR 410-172-0850, Telemedicine for Behavioral Health, last changed in 2018. Its definition of video is strict: a synchronous, live, two-way video transmission between a provider at a distant site and a client at an originating site. Telephone and email consultations are covered only under the Health Evidence Review Commission's guidelines and HERC-approved codes, and the services allowed by phone are the ones listed on the Behavioral Health Fee Schedule that OHA publishes. Fax and email images are not covered outside narrow exceptions.

Section (4) is the operating checklist. A provider billing OHP for telemedicine must comply with HIPAA and OHA's own privacy rules (OAR 943, division 14), use technology that meets both, have policies in place to prevent a breach of client information, follow HERC guidelines for phone and email consultation, and keep the clinical and financial documentation that OAR 410-120-1360 requires.

Section (5) is the parity clause: OHA covers behavioral health telemedicine "to the same extent that the services would be covered" in person. That is a coverage rule; it sets no payment rate. Fee-for-service rates live on the OHP fee schedule page, which also says that rates for CCO members come from the CCO, so check the schedule or the CCO rather than a coding guide. One warning from my research: a 2020 OHA telehealth billing PDF still turns up in search results, and its own header says it has been superseded. Do not bill from it.

Place of service codes and modifiers

A telehealth claim carries a place of service code that tells the payer where the client was. CMS's place of service code set defines POS 02 as telehealth provided other than in the patient's home and POS 10 as telehealth provided in the patient's home; POS 11 is the office. Some payers also ask for a modifier such as 95 on the service line. Which modifier, and whether they want one at all, varies by payer, so check each payer's telehealth policy before the first claim. The superbills and CPT lesson covers the rest of the claim.

Setting up the platform and the session

1. Choose a video platform that will sign a business associate agreement. The requirement is 45 CFR 164.504(e), and an encryption claim without a signed BAA does not meet it; consumer tiers of well-known products often do not include one.
2. Write a telehealth informed consent that covers the distance counseling items in Section H of the 2014 ACA Code of Ethics, which is adopted by OAR 833-100-0011. The checklist attached to this lesson lists them.
3. Open each session by confirming where the client is sitting, which is the fact that decides whose rules apply under the OBLPCT's FAQ, and record it in the note. I treat a current address and a local emergency contact as part of the same check; that is standard practice for remote work, not a regulation.
4. Write a short breach-prevention policy for the telehealth setup, which OAR 410-172-0850(4)(c) requires of OHP providers and which costs nothing for everyone else.
5. Document each session as OAR 410-120-1360 requires for OHP and as your board's records rule requires for everyone; the progress notes lesson has the templates.
6. Decide the fallback when video fails. For OHP, only the services on the Behavioral Health Fee Schedule are billable by phone; for other payers, check the telehealth policy.

One sentence for prescribers

If you share clients with a psychiatric prescriber, the DEA and HHS have extended the flexibility that allows controlled substances to be prescribed by telemedicine without a prior in-person exam through December 31, 2026, a fourth temporary extension rather than a permanent rule, and it concerns prescribers only.

These are the rules as I read them from the primary texts, linked above and listed below, as an LPC who sees clients by video; none of it is legal or billing advice, and the board, the payer, or an attorney has the last word on your situation.

Real example from my own filing

The document attached below is my telehealth consent, rebuilt and redacted. The first two parts are the stock consent most EHRs ship; the third part is the care-coordination paragraph a telehealth-only provider needs under the OHP telemedicine rule, promising a referral to an in-person provider within ten business days when in-person care is indicated or requested, and notice to the CCO. A CCO panel application asked for that paragraph as an attachment, and the Medicaid validation form's 24-hour coverage question was answered by pointing at the emergency instructions in it.

Further reading

• CMS: Telehealth (video). A short plain-language explainer from the federal payer, useful for seeing telehealth the way a client's insurer describes it.