Delaware Telepractice Requirements for Audiologists and Speech-Language Pathologists

The information below is collected from state licensure boards or regulatory agencies responsible for regulating the professions of audiology and/or speech-language pathology. The information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information.

Telepractice State Licensure Board Requirements

This state has licensure regulations for telepractice. 

Telepractice

10.1 Telepractice is the application of telecommunications technology to the delivery of speech/language pathology, audiology and hearing aid dispensing professional services at a distance by linking clinician to client or clinician to clinician for intervention and/or consultation, subject to subsection 10.2.4.5, intervention and/or consultation.

10.2 The Speech/Language Pathologist, Audiologist, or Hearing Aid Dispenser (referred to as “licensee” for the purpose of this section) who provides treatment through telepractice shall meet the following requirements:

10.2.1 Location of client during treatment through telepractice.

10.2.1.1 The licensee shall have an active Delaware license in good standing to provide services through telepractice in the state of Delaware.

10.2.1.2 During the telepractice treatment session, the client shall be located within the borders of the State of Delaware.

10.2.2 Informed consent.

10.2.2.1 Before services are provided through telepractice, the licensee shall obtain written, informed consent from the client, or other appropriate person with authority to make health care treatment decisions for the client. At minimum, the informed consent shall inform the client and document acknowledgement of the risk and limitations of:

10.2.2.1.1 The use of electronic communications in the provision of care;

10.2.2.1.2 The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of care; and

10.2.2.1.3 The potential disruption of electronic communication in the use of telepractice.

10.2.3 Confidentiality: The licensee shall ensure that the electronic communication is secure to maintain confidentiality of the client’s health and/or educational information as required by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable Federal and State laws. Confidentiality shall be maintained through appropriate processes, practices and technology, including disposal of electronic equipment and data.

10.2.4 Competence and scope of practice.

10.2.4.1 The licensee shall be responsible for determining and documenting that telepractice is an appropriate level of care for the client.

10.2.4.2 The licensee shall comply with the Board’s law and rules and regulations and all current standards of care requirements applicable to onsite care.

10.2.4.3 The licensee shall limit the practice of telepractice to the area of competence in which proficiency has been gained through education, training and experience.

10.2.4.4 Licensees who deliver telepractice services must possess specialized knowledge and skills in selecting interventions that are appropriate to the technology and that take into consideration client and disorder variables.

10.2.4.5 The licensee shall document in the file or record which services were provided by telepractice.

Citation: 24 Del. Admin. Code. § 3700.10.0 [PDF]

Telesupervision State Licensure Board Laws and Regulations 

This state has no laws or regulations for telesupervision. 

Support Personnel 

No regulations. 

Clinical Fellow 

No regulations. 

Student Intern 

No regulations. 

Telepractice Reimbursement Laws and Regulations

Telepractice Private Insurance

The law is not clearly defined indicating that any healthcare provider and service may be covered. It is left up to interpretation and/or will be determined by the payers. Clinicians will have to contact payer sources to determine if and how telepractice is covered for audiology and speech-language pathology services. 

Telemedicine

(a) As used in this section:

(1) "Distant site" means a site at which a health-care provider legally allowed to practice in the State is located while providing health-care services by means of telemedicine or telehealth.

(2) "Originating site" means a site in Delaware at which a patient is located at the time health-care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used; provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(3) "Store and forward transfer" means the transmission of a patient's medical information either to or from an originating site or to or from the provider at the distant site, but does not require the patient being present nor must it be in real time.

(4) "Telehealth" means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

(5) "Telemedicine" means a form of telehealth which is the delivery of clinical health-care services by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient's health care by a health-care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in the State, while such patient is at an originating site and the health-care provider is at a distant site.

(b) Each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each health service corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health-care plan for health-care services shall provide coverage for the cost of such health-care services provided through telemedicine.

(c) Each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each health service corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health-care plan for health-care services shall provide coverage for the cost of such health-care services provided through telehealth as directed through regulations promulgated by the Department.

(d) An insurer, health service corporation, or health maintenance organization shall not exclude a service for coverage solely because the service is provided through telemedicine services and is not provided through in-person consultation or contact between a health-care provider and a patient for services appropriately provided through telemedicine services.

(e) An insurer, health service corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis and at least at the rate that the insurer, health service corporation, or health maintenance organization is responsible for coverage for the provision of the same service through in-person consultation or contact. Payment for telemedicine interactions shall include reasonable compensation to the originating or distant site for the transmission cost incurred during the delivery of health-care services.

Citation: Del. Code tit. 18 § 3370 

Telepractice Medicaid

The laws and regulations include audiology and speech-language pathology telepractice services.

16.2 Definitions

16.2.1 For purposes of DMAP, telemedicine is the use of medical or behavioral health information exchanged from one site to another site via an electronic interactive telecommunications system to improve a patient's health.

16.2.1.1 An interactive telecommunications system is defined as multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site.

16.2.4 Distant Site refers to the site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via the interactive telecommunications system.

16.2.4.1 All distant site consulting providers must be enrolled in the Delaware Medical Assistance Program (DMAP) or in a DMAP Managed Care Organization (MCO) in order to be reimbursed for the professional services provided.

16.2.4.2 Facility fees for the distant site are not covered.

16.2.4.3 Distant Site providers include the following:

  • Practitioner
  • Inpatient/Outpatient Hospitals (including ER)
  • Physicians (or Physicians Assistants under the physician's supervision)
  • Certified Nurse Practitioners
  • Nurse Midwives
  • Licensed Psychologists
  • Licensed Clinical Social Workers
  • Licensed Professional Counselors of Mental Health
  • Speech/Language Therapists
  • Audiologists
  • Other providers as approved by the DMAP 

Citation: DE Medical Assistance Program, Practitioner Provider Specific Manual

ASHA Guidance

Telepractice State Licensure

  • Obtain a license from the state in which you reside and from the state in which the patient/client resides.
  • If a state has not established regulations on telepractice, then contact the licensure board for further guidance and ask for written verification.
  • It is the responsibility of the clinician to review the regulations on the state licensure board website in their entirety and regularly for updates or changes.

Telesupervision

If a state has not established regulations on telesupervision, then contact the licensure board for further guidance and ask for written verification.

Reimbursement for Telepractice Services

Audiologists and speech-language pathologists should keep in mind that while a state may have passed telepractice reimbursement laws and/or regulations, this does not guarantee that payers will reimburse for these services. Learn more about considerations for audiologists and speech-language pathologists.  

Resources

For further information on telepractice requirements for audiologists and speech-language pathologists, please visit these websites:

Questions regarding state advocacy issues? Call ASHA at 800-498-2071 and ask for the State Advocacy Team.

ASHA Corporate Partners