Key Takeaways
- HIPAA compliance starts with a risk assessment.
A risk assessment identifies vulnerabilities in how your practice collects, stores, uses, and protects patient information.
- Written policies are only one part of compliance.
Private practices must also train staff, manage vendor relationships, and implement procedures that work in daily operations.
- HIPAA compliance requires ongoing maintenance.
Regular reviews, workforce training, vendor oversight, and incident response planning help practices remain compliant as they grow and change.
What Psychologists Should Review Before Expanding a Practice Under PSYPACT
Expanding a psychology practice across state lines can create opportunities to serve more clients, maintain continuity of care when clients relocate, and reach new markets through telepsychology. The Psychology Interjurisdictional Compact (PSYPACT) can make this expansion easier for eligible psychologists, but it does not eliminate the legal and operational questions that come with practicing across state lines.
Before accepting clients in additional states, psychologists should review their professional authorization, state-specific obligations, and existing business arrangements. Addressing these issues before expansion can help prevent compliance problems and reduce disruptions to client care.
1. Confirm PSYPACT Eligibility and Authorization
PSYPACT is an interstate compact that facilitates telepsychology and temporary in-person practice across participating jurisdictions. It applies to licensed psychologists who meet the compact’s eligibility requirements, not all mental health professionals.
Psychologists seeking to provide telepsychology under PSYPACT must obtain an Authority to Practice Interjurisdictional Telepsychology (APIT) from the PSYPACT Commission. This requires an E.Passport credential from the Association of State and Provincial Psychology Boards (ASPPB).
For temporary in-person practice in another participating jurisdiction, psychologists generally need a Temporary Authorization to Practice (TAP), which requires an Interjurisdictional Practice Certificate (IPC).
An ASPPB credential alone does not authorize interstate practice under PSYPACT. Psychologists must obtain the applicable authorization from the Commission and maintain it in accordance with the relevant requirements. The two authorizations also cover different types of practice.
Before expanding, verify that your authorization is active and that the jurisdiction where you intend to practice participates in PSYPACT. Check the official PSYPACT website for current participation, eligibility, application, and renewal information.
2. Review the Laws in Each State Where You Practice
PSYPACT does not create a single set of laws that governs every aspect of psychological practice. State requirements can still affect how psychologists provide services, maintain records, handle client information, and meet professional obligations.
Before providing services in a new state, review the laws and rules that apply to the services you intend to offer. Depending on the state and your practice model, this may include requirements involving:
- Informed consent and telepsychology disclosures
- Recordkeeping, access, and retention
- Confidentiality and reporting obligations
- Assessment, testing, and documentation
- Professional conduct and complaint procedures
- Continuing education and other applicable professional requirements
Also consider whether the services you plan to offer are permitted under the relevant state’s laws. PSYPACT does not automatically resolve every question about particular assessments, evaluations, or specialized services.
Location matters, too. When practicing under an APIT, a psychologist must be physically located in their declared PSYPACT home state while providing telepsychology services. The client must also be in a participating state or jurisdiction. A psychologist who travels outside their declared home state cannot assume their APIT continues to authorize telepsychology from that location.
3. Check Your Business Structure and Practice Agreements
Professional authorization and business authorization are separate issues. Even when a psychologist can legally provide services to a client in another state under PSYPACT, the practice’s existing business structure and agreements still need review.
Consider whether your current entity and operations are appropriate for the expansion. Depending on the states involved, questions may include:
- Whether your professional entity can operate as structured in the new state
- Whether foreign registration or other business filings may be required
- Whether ownership, management, or professional-entity rules affect the planned expansion
- Whether your client agreements and informed consent documents accurately describe your services
- Whether contracts with referral sources, platforms, or other businesses need revision
PSYPACT authorization does not automatically satisfy state requirements for forming or registering a business. Professional licensing rules, entity laws, and general business requirements address different issues.
Before committing to a new state, review the proposed arrangement with a healthcare attorney familiar with the relevant states. That review can identify structural problems before they become costly to fix.
4. Confirm Malpractice Insurance and Other Coverage
An expansion can change the geographic scope of your practice, even if you continue to work from the same office. Your malpractice policy may have specific terms governing telepsychology, temporary in-person services, or clients located in other jurisdictions.
Contact your insurer before beginning interstate services. Confirm that the policy covers your intended services and the locations involved, and ask whether any endorsements or other changes are needed.
Review other coverage as appropriate, including cyber liability insurance and protection for employees or contractors who may support the expanded practice.
PSYPACT authorization does not guarantee insurance coverage. The compact’s authorization requirements and your insurer’s policy terms are separate matters.
Planning to expand your psychology practice across state lines? Jackson LLP advises independent healthcare practices on business structure, contracts, and regulatory issues. Contact Jackson LLP to discuss the legal questions involved in your expansion.
5. Review Billing, Privacy, and Technology Practices
Adding clients in new states can affect how your practice handles billing, electronic records, and third-party technology. These issues deserve attention before you begin offering services across state lines.
Billing and Reimbursement
PSYPACT does not determine whether an insurer will reimburse services delivered under the compact. Review payor contracts, network participation requirements, and applicable reimbursement policies before relying on insurance revenue from a new market. Confirm how each payor treats telepsychology services and whether your current agreements cover the planned arrangement.
Privacy and Records
Review how your practice collects, stores, transmits, and releases client information. Check whether your privacy notices, consent forms, recordkeeping procedures, and vendor agreements reflect your expanded operations. Federal requirements, including HIPAA where applicable, may interact with state confidentiality and mental health record laws.
Technology and Staffing
Confirm that your telehealth platform supports your planned services and that staff understand the procedures for verifying client locations, documenting sessions, and responding to emergencies. If you use contractors or outside administrative support, review their roles, access to client information, and contractual obligations.
These steps can reveal operational gaps before they affect client care or create compliance concerns.
6. Plan for Changes to Your Practice
A multistate practice needs processes for keeping authorizations, policies, and business arrangements current. Expansion is not a one-time compliance task.
Establish a process for monitoring changes to PSYPACT requirements and the laws of the states where you practice. Track authorization renewals, insurance requirements, and any state-specific obligations relevant to your services.
Your practice should also have a procedure for determining where a client is physically located before each telepsychology session. If a client moves, travels, or plans to receive services outside a participating jurisdiction, your existing authorization may not cover it. Staff should know when to pause and verify the applicable requirements rather than assume the session can proceed.
Review your business arrangements periodically, particularly when you add new services, hire clinicians, change ownership, or enter another state. A structure that worked for a single-state practice may not suit a growing multistate operation.
What Legal Review Should Come Before a PSYPACT Expansion?
PSYPACT can reduce licensing barriers for eligible psychologists, but it does not eliminate the need to review state laws, business requirements, insurance, and practice operations. The questions to address will depend on where your practice is based, which states you plan to serve, and how your business is structured.
Before expanding, identify the states involved and the services you intend to provide. Then review the professional, business, and contractual requirements that apply to your plans.
Connect With Our Team for a Free Consultation
Jackson LLP works with independent healthcare practices on business formation, contracts, and regulatory matters. If you plan to expand a psychology practice into additional states, contact Jackson LLP to discuss the legal considerations before you commit. We serve practices in Illinois, Wisconsin, New York, Texas, and California.
Our healthcare attorneys offer free 15-minute phone consultations and handle most services on a flat-fee basis.
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Frequently Asked Questions About PSYPACT and Multistate Psychology Practices
Can I practice psychology in another state with PSYPACT without obtaining a separate license?
Eligible psychologists may provide telepsychology or temporary in-person services in participating jurisdictions after obtaining the applicable PSYPACT authorization. The compact does not authorize practice in every state or eliminate all state-specific requirements.
What is the difference between APIT and TAP under PSYPACT?
APIT authorizes eligible psychologists to provide interjurisdictional telepsychology, while TAP authorizes temporary in-person practice in another participating jurisdiction. Each has separate eligibility and credentialing requirements.
Do psychologists have to follow the laws of the state where their client is located?
Yes. Psychologists must understand and comply with the applicable laws, rules, and regulations of the jurisdictions into or out of which they practice, subject to the compact’s specific provisions. PSYPACT does not replace state-specific professional obligations.
Can I provide PSYPACT telepsychology services while traveling outside my home state?
No. Under PSYPACT’s APIT requirements, psychologists must be physically located in their declared home state when providing authorized telepsychology services. Psychologists should verify their authorization and applicable requirements before providing services from another location.
Does PSYPACT authorization allow me to open a psychology practice in another state?
Not automatically. PSYPACT addresses qualifying interstate psychology services, not every business formation, entity registration, or operational requirement. Depending on your plans and the state involved, additional legal review or business filings may be necessary.
