A Social Work Guide to Telehealth in North Carolina - National Association of Social Workers NC Chapter

A Social Work Guide to Telehealth in North Carolina

In North Carolina, telehealth practice (the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration) is subject to the same standards as traditional practice. The social worker must comply with guidelines for the locations of the social worker and the client. The social worker must accurately represent themselves and practice within their competencies. Informed consent must be expanded to address additional risks of using technology.

If you are looking for telehealth polices that were put into place due to the COVID-19 pandemic, see Updated Telehealth Policy and Advocacy Information. The North Carolina Public Health Emergency was lifted on August 15th, 2022 and this impacts social workers licensed and located in another state. See page 5 of this FAQ from the North Carolina Social Work Certification and Licensure Board for more information if you are not licensed in North Carolina.

NASW Telehealth Resources

Please review the following:

The North Carolina Social Work Certification and Licensure Board Statement on Technology Facilitated Services: https://ncswboard.gov/position-statements/

You MUST be licensed in the state of North Carolina in order to provide telehealth services to clients who are physically in North Carolina.
If your client is in another jurisdiction/state, you must be in compliance with regulatory/licensure requirements of that jurisdiction.
If you are physically located in North Carolina, but your client is in another jurisdiction/state, you need to be licensed in North Carolina.
Association of Social Work Board list of state-level information on teletherapy: https://www.aswb.org/wp-content/uploads/2021/02/State-and-Provincial-teletherapy-provisions-4.1.20.xlsx

NASW Code of Ethics: In 2017, changes were made regarding the use of technology in the provision of professional services: https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Highlighted-Revisions-to-the-Code-of-Ethics

Telemental Health: Legal Considerations for Social Workers

https://www.socialworkers.org/About/Legal/HIPAA-Help-For-Social-Workers/Telemental-Health

NASW’s Standards for Technology in Social Work Practice: https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf

NASW Assurance Services
In-Person Services During COVID-19 Crisis
Considering Teletherapy? What you need to know before you start

NASW and NASW-NC Advocacy

NASW and NASW-NC have been advocating for telehealth flexibilities for several years. Both the National office and state chapter have been advocating with the Governor, Department of Insurance, Department of Health and Human Services, insurance companies and legislators in Congress, the U.S. Senate, and the North Carolina Legislature. These efforts are ongoing.

In December 2021, NASW signed onto letters to 21 commercial insurance payors urging them to support continued coverage for tele-mental health services in line with the PHE declaration for all ambulatory levels of care—partial hospitalization program, intensive outpatient program and outpatient program. This included a letter to Blue Cross Blue Shield North Carolina. Click here to view this letter.

Below is a list of a few other letters regarding telehealth sustainability:

What Telehealth Platform to Use

NASW-NC does not endorse any telehealth platform. We highly recommend the use of a HIPAA compliant platform. HIPAA compliance has been mirroring technological change. Ensuring that your platform is HIPAA compliant is critical so as to reduce your risk and to maintain patient privacy.

Insurance Coverage for Telehealth Services

Insurance coverage for teletherapy services is impacted by federal and state laws, as well as individual insurance company policies. Providers should check with their liability insurance and their patient’s insurance plan regarding how telehealth services are covered.

Medicaid & North Carolina Health Choice

North Carolina providers of telepsychiatry services are reimbursed as long as certain conditions are met. Licensed Clinical Social Workers (LCSW) are eligible telepsychiatry providers for certain services. Exceptions to reimbursement include: the recipient is located in a jail, detention center, prison; the provider is not an enrolled provider, or the provider does not follow established criteria for the service provided.

Medicaid Telehealth Coverage and COVID-19 Resources and Information.

Medicare

Medicare Part B (Medical Insurance) covers certain telehealth services. The Medicare enrollee will pay 20% of the Medicare-approved amount for the healthcare provider’s services, and the Part B deductible applies. For most telehealth services, the Medicare enrollee will pay the same amount that they would if they got the services in person. Part B covers mental health services provided by LCSWs.

Medicare and COVID-19 Telehealth Resources.

Private Insurance

North Carolina does not have a telehealth parity law, meaning that the state does not legally require private insurance companies to cover telehealth services. Many still do, but it depends on the company and policy. Polices vary from insurance company to insurance company so be sure to check each patient's plan for allowable telehealth coverage during the public health emergency.

Useful Resources

Updated September 2022

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