California Telehealth Laws for Mental Health Providers: 2026 Compliance Guide

Overview

California Telehealth Laws for Mental Health Providers: 2026 Compliance Guide

Telehealth has transformed mental health care delivery in California. What began as a pandemic necessity has become a permanent fixture, with California enacting some of the nation's strongest telehealth protections.

Key takeaways

• California Telehealth Laws for Mental Health Providers: 2026 Compliance Guide Telehealth has transformed mental health care delivery in California.
• What began as a pandemic necessity has become a permanent fixture, with California enacting some of the nation's strongest telehealth protections.
• For general telehealth compliance across all states, see our national telehealth guide.
• This guide focuses specifically on California regulations.
• California Telehealth Regulatory Framework Key Legislation AB 32 (2021) - Made pandemic-era telehealth flexibilities permanent: Payment parity required for telehealth services No geographic restrictions on patient location within California Audio-only services permitted with conditions SB 1448 (2022) - Enhanced telehealth consumer protections: Informed consent requirements Right to in-person care Privacy protections Licensure Requirements for Telehealth The Fundamental Rule You must be licensed in the state where the patient is physically located at the time of service.

Details

For general telehealth compliance across all states, see our national telehealth guide. This guide focuses specifically on California regulations.

California Telehealth Regulatory Framework

Key Legislation

AB 32 (2021) - Made pandemic-era telehealth flexibilities permanent:

• Payment parity required for telehealth services
• No geographic restrictions on patient location within California
• Audio-only services permitted with conditions

SB 1448 (2022) - Enhanced telehealth consumer protections:

• Informed consent requirements
• Right to in-person care
• Privacy protections

Licensure Requirements for Telehealth

The Fundamental Rule

You must be licensed in the state where the patient is physically located at the time of service.

This means:

• California license required for patients in California
• Cannot treat California patients with only an out-of-state license
• Patient's billing address doesn't matter—physical location does

Interstate Compact & Out-of-State Patients

California has joined two major interstate compacts, expanding practice opportunities:

Psychology Interjurisdictional Compact (PSYPACT)

California Status: MEMBER (joined 2023)

PSYPACT allows licensed psychologists to practice telepsychology across member states without obtaining additional licenses.

To participate:

1. Hold valid California psychology license
2. Apply for E.Passport through PSYPACT
3. Practice in any PSYPACT member state

Counseling Compact

California Status: MEMBER (joined 2024)

The Counseling Compact allows LPCs/LPCCs to practice across member states.

Note: California's LPCC license is recognized under the Compact, allowing practice in other member states once the Compact is fully operational.

For credentialing across states, see our insurance credentialing guide.

Informed Consent Requirements

California requires specific informed consent for telehealth. Per Business and Professions Code Section 2290.5:

Required Consent Elements

1. Explanation of telehealth: What it is and how it works
2. Limitations: Technical issues, emergencies, privacy risks
3. Alternatives: In-person services are available
4. Right to withdraw: Patient can stop telehealth at any time
5. Emergency protocols: What happens if patient is in crisis
6. Privacy information: How their information is protected

Documentation Requirements

• Verbal consent acceptable, but written preferred
• Document consent in patient record
• Re-consent annually or when significant changes occur

Technology & Platform Requirements

HIPAA Compliance

All telehealth platforms must be HIPAA-compliant. This requires:

• Signed Business Associate Agreement (BAA)
• End-to-end encryption
• Access controls and audit logs
• Secure data storage

HIPAA-compliant platforms:

• Doxy.me
• SimplePractice Telehealth
• Zoom for Healthcare
• Google Meet (with BAA)
• Microsoft Teams (with BAA)

NOT compliant:

• Regular Zoom (non-healthcare version)
• FaceTime
• Skype
• Standard Google Meet

For comprehensive HIPAA guidance, see our HIPAA compliance checklist.

Audio-Only (Telephone) Sessions

California permits audio-only mental health services with conditions:

Requirements for Audio-Only

1. Patient must consent to audio-only format
2. Video must be offered if clinically appropriate
3. Audio-only clinically appropriate for the service
4. Document rationale for audio-only in record

Billing Audio-Only Services

• Use same CPT codes as video/in-person
• Modifier 93 indicates audio-only
• Payment parity required (same rate as video)

Telehealth Billing & Reimbursement

Payment Parity (AB 32)

California requires payment parity—telehealth reimbursement must equal in-person rates:

• Medi-Cal: Must pay same as in-person
• Commercial insurance: Must pay same as in-person
• Medicare: Follows federal rules (generally parity)

For detailed rate information, see our California reimbursement rates guide.

Billing Codes and Modifiers

For complete CPT code guidance, see our Mental Health CPT Codes guide.

Medi-Cal Telehealth Billing

Medi-Cal covers telehealth services for mental health. See our Medi-Cal billing guide for specific requirements.

Prescribing via Telehealth

For prescribers (psychiatrists, NPs):

Controlled Substances

• DEA registration in California required
• Ryan Haight Act provisions apply
• Initial in-person exam NOT required for most mental health prescribing (ongoing flexibilities)
• Maintain relationship with local emergency resources

Standard Medications

• No in-person requirement
• Standard prescribing protocols apply
• E-prescribing encouraged

Emergency Protocols

Every telehealth practice needs emergency protocols:

Required Elements

1. Client location verification: Confirm physical address at start of each session
2. Emergency contacts: Collect local emergency contacts
3. Local resources: Know emergency resources in client's location
4. Crisis plan: Written plan for managing crises remotely
5. Documentation: Document emergency protocols in client record

When to Transition to Higher Care

• Active suicidal/homicidal ideation with plan
• Severe psychiatric decompensation
• Unable to maintain safety via telehealth
• Client preference for in-person care

Frequently Asked Questions

Can I provide telehealth to patients in other states?

Generally, you must be licensed where the patient is located. However, California has joined PSYPACT (psychologists) and the Counseling Compact (LPCs), allowing practice in member states without additional licensure.

Is audio-only therapy covered by insurance in California?

Yes. California law requires coverage of audio-only mental health services when clinically appropriate. Bill with modifier 93. For billing details, see our CPT codes guide.

What platform should I use for telehealth therapy?

Use any HIPAA-compliant platform with a signed Business Associate Agreement. Popular options include Doxy.me, SimplePractice, and Zoom for Healthcare. See our HIPAA compliance guide for requirements.

Do I need separate malpractice coverage for telehealth?

Most malpractice policies cover telehealth within your licensed state(s). Review your policy and confirm telehealth is included. For interstate practice via compacts, verify multi-state coverage.

Can I see California clients if I'm licensed elsewhere?

Only if you also hold a California license, or if your license type is covered by an interstate compact California has joined (PSYPACT for psychologists, Counseling Compact for LPCs).

Managing telehealth compliance? Ease Health's platform includes built-in telehealth documentation and consent tracking. Schedule a demo to see how we simplify telehealth for California providers.

Next steps

• Review the key takeaways and adapt them to your practice workflow.
• Use the details section as a checklist when you implement or troubleshoot.
• Share this with your billing or admin team to align on process and terminology.