Montana 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 laws and/or regulations for telepractice. 

Speech-Language Pathologists and Audiologists - Definitions

(5) "Facilitator" means a trained individual who is physically present with the patient and facilitates telepractice at the direction of an audiologist or speech-language pathologist. A facilitator may be but is not limited to an audiology or speech-language pathology aide or assistant.

(6) "Patient" means a consumer of services from an audiologist or speech-language pathologist, including a consumer of those services provided through telepractice.

(11) "Telepractice" means the practice of audiology or speech-language pathology by an audiologist or speech-language pathologist at a distance through any means, method, device, or instrumentality for the purposes of assessment, intervention, and consultation.

Citation: Mont. Code Ann. § 37-15-102

Telepractice Standards

Definitions

(1) "Asynchronous" means a method of exchanging information that does not require the patient and the provider to be available at the same time. Examples of such communication, also known as "store-and-forward" transmission, include e-mails, faxes, recorded video clips, audio files and virtual technologies and e-learning programs.

(2) "Synchronous" means interactive transmission of data occurring bi-directionally in real time and requiring the patient and the provider be available at the same time.

Provision of Telepractice Services

(1) The provision of speech-language pathology or audiology services in this state through telepractice, regardless of the physical location of the speech-language pathologist or audiologist, constitutes the practice of speech-language pathology or audiology and is subject to state licensure requirements and regulation by the board.

Limits on Telepractice

1. No person licensed as a speech-language pathologist or audiologist in another state may engage in the practice of speech-language pathology or audiology in Montana, including telepractice services, unless a license to practice has been issued in Montana.

2. All telepractitioners must abide by any statute or rule of this state governing the maintenance of patient records and patient confidentiality, regardless of the state where the records are maintained.

Delivery of Telepractice Services

(1) Telepractice services may be delivered in a variety of ways, including:

(a) Asynchronous transmission:
     (i) store-and-forward model/electronic transmission of stored clinical data from one location to another usually by the Internet via e-mail or fax; and
     (ii) video and audio transmission through regular mail service delivery and express delivery services; and

(b) Synchronous transmission:
     (i) clinician interactive model is a real time interaction between provider and patient that may occur via audio or audio/video transmission over telecommunication links such as telephone, Internet, or other methods for distance communication, including:
        (A) videoconferencing;
        (B) remote control software applications;
        (C) computer applications;
        (D) e-mail correspondence, including attachments; or
        (E) self-monitoring/testing model, which refers to the patient who receives the services and provides data to the provider without a facilitator present at the site of the patient.

(2) Live versus stored data refers to the actual data transmitted during the telepractice. Live, real time, and stored clinical data may be included during the telepractice.

Quality of Telepractice Services

(1) Elements of quality assurance include the competency of licensees, selection of patients, appropriateness of technology to the service being delivered, identification of appropriate outcome measures, collection of data, and satisfaction of the patient, caregiver, and provider.

(2) Telepractice services must conform to professional standards, including all appropriate and applicable codes of ethics.

(3) Licensees shall not engage in false, misleading, or deceptive advertising of telepractice services.

(4) Telepractice services may not be provided solely by correspondence, e.g., mail, e-mail, and faxes, although such may be adjuncts to telepractice.

(5) Licensees shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience.

(6) Telepractice services must be in compliance with safety and infection control policies and procedures.

Establishing the Practitioner-Patient Relationship

(1)(a) need for services; and

(b) candidacy for telepractice, including behavioral, physical, and cognitive abilities to participate in telepractice services. Telepractice services may be provided by the patient's evaluator or another qualified speech-language pathologist or audiologist by the board.

(2) Prior to initiating services, a speech-language pathologist or audiologist shall:

(a) make reasonable attempts to verify the identity of the patient;

(b) obtain alternative means of contacting the patient other than electronically;

(c) provide to the patient alternative means of contacting the licensee other than electronically

(d) document whether the patient has the necessary knowledge and skills to benefit from the type of telepractice provided by the licensee

(e) determine the availability of a facilitator, if needed, with the necessary level of training to assist at the patient's location

(f) provide orientation and training to the patient in the use of telepractice equipment and the telepractice protocol at an appropriate level   for the patient; an

(g) inform the patient in writing of the following:

(i) the limitations of using technology in the provision of telepractice;
(ii) the potential risks to the confidentiality of information due to technology used in telepractice;
(iii) the potential risks of disruption in the use of telepractice;
(iv) when and how the licensee will respond to routine electronic messages
(v)  in what circumstances the licensee will use alternative communications for emergency purposes;
(vi) who else may have access to patient communications with the licensee;
(vii)  how communications can be directed to a specific licensee;
(viii)  how the licensee stores electronic communications from the patient; and
(ix) that the licensee may elect to discontinue the provision of telepractice services.

(3) The written document required by (2)(g) shall be signed by both the licensee and the patient and maintained in the clinical record. If the patient is a minor, the document shall be signed by the patient's parent or guardian.

Competence-Practice Limits-Maintenance and Retention of Records

(1)  A licensee using telepractice to deliver services shall:
     (a) complete four hours of board-approved telepractice training prior to engaging in telepractice in Montana;
     (b) limit telepractice services to the licensee's scope of practice;
     (c) maintain continuing competency or associate with a group who has experience in telepractice delivery of care;
     (d) use methods for protecting health information that include authentication and encryption technology;
     (e) limit access to protected health information to only those necessary for the provision of services or those required by law; and
     (f) ensure that confidential communications obtained and stored electronically cannot be recovered and accessed by unauthorized persons when the licensee disposes of electronic equipment and data.

(2)  A speech-language pathology or audiology aide or assistant may function as a facilitator, but may not provide telepractice services.

Citation: Mont. Admin. R. 24.222.9

Telesupervision State Licensure Board Laws and Regulations

This state has no laws or regulations for telesupervision of support personnel, clinical fellows or student interns. Contact licensure board for clarification.

Support Personnel

No regulations.

Clinical Fellow

No regulations.

Student Intern

No regulations.

Telepractice Reimbursement Laws and Regulations

Telepractice Private Insurance

The law includes audiology and speech-language pathology services.

Audiologists and speech-language pathologists are classified as "health care providers."

Coverage for telemedicine services. 

(1) Each group or individual policy, certificate of disability insurance, subscriber contract, membership contract, or health care services agreement that provides coverage for health care services must provide coverage for health care services provided by a health care provider or health care facility by means of telemedicine if the services are otherwise covered by the policy, certificate, contract, or agreement.

 (6)(b) "Health care provider" means an individual:
    (i) licensed pursuant to Title 37, chapter 3, 6, 7, 10, 11, 15, 17, 20, 22, 23, 24, 25, or 35;

Citation: Mont. Code Ann. 33-22-138

Telepractice Medicaid

No laws or regulations identified that include audiology or speech-language pathology.  

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.  

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