Tessic Health

WA · STATE RULES

Telehealth rules in Washington

Washington regulates a telehealth brand's marketing as tightly as its clinic. The My Health My Data Act gives every patient a private right to sue over health data, any provider delivering telemedicine must sign an attestation that they finished the state's training, and a phone-only visit is off the table unless the patient has been seen inside three years. This page covers those rules, the licensing paths, opioid limits, and how Tessic Health's providers work within them.

Book a DemoAll states
First visit
Async with conditions
Physician license
IMLC member; no state permit
Controlled drugs
PMP check under opioid rules
Nurse practitioners
Full practice

Rules checked September 2026 · 21 sources cited

ONLY IN WASHINGTON

What is different about Washington

Each rule here is true of Washington and of none of the states that border it. Beside each one: what the neighbours do instead.

  1. 01 · Advertising

    Patients can sue over health data

    The My Health My Data Act, RCW 19.373, treats almost any data that identifies a health condition as consumer health data. Collecting it needs separate consent, selling it needs a signed authorization, and a violation counts as an unfair practice under the Consumer Protection Act, which means the patient can bring the claim personally.

    Source: RCW 19.373

    Across the border

    • Idaho

      Idaho has passed no comprehensive consumer data statute at all. A misuse of health data there is policed through the Idaho Consumer Protection Act by the attorney general rather than by the person whose data moved.

      Source: Idaho Code 48-603

    • Oregon

      The Oregon Consumer Privacy Act in ORS chapter 646A does class health information as sensitive data needing opt-in consent, but enforcement belongs to the Oregon Department of Justice and the statute gives consumers no right to sue.

      Source: ORS chapter 646A

  2. 02 · Practice

    Providers sign a training attestation

    RCW 43.70.495 requires a telemedicine training program built by a state collaborative, and a provider who furnishes telemedicine services must sign and keep an attestation that the training is done. The attestation is held by the provider or the employer and produced on request.

    Source: RCW 43.70.495

    Across the border

    • Idaho

      Idaho imposes documentation duties instead of training. Idaho Code 54-5708 makes a provider record the patient's informed consent and the identity checks at first contact, with no course to complete and nothing to attest to.

      Source: Idaho Code 54-5708

    • Oregon

      Oregon sets no telemedicine course for licensees. The Oregon Medical Board applies its ordinary standard of care to remote visits and reserves required education for pain management and cultural competency.

      Source: Oregon Medical Board: telemedicine

  3. 03 · First visit

    A phone-only visit needs a recent appointment

    Under RCW 48.43.735 an audio-only telemedicine visit is billable only where the provider has an established relationship: an in-person or audio-video appointment with the patient in the previous three years, at that provider or the same medical group, or a referral from someone who has one.

    Source: RCW 48.43.735

    Across the border

    • Idaho

      Idaho puts no clock on the telephone. Idaho Code 54-5705 lets a provider start the relationship through any virtual care that meets the community standard of care, so a first call can be the first contact.

      Source: Idaho Code 54-5705

    • Oregon

      Oregon runs the opposite way: ORS 743A.058 forbids an insurer from requiring an enrollee to have an established relationship, or to consent in person, before a telemedicine service is covered.

      Source: ORS 743A.058

PRACTICE RULES

How telehealth works in Washington

Washington splits its telehealth duties between the Department of Health, which owns the training attestation and the consumer health data rules, and the Washington Medical Commission, which applies the medical practice act to remote visits.

  1. 01

    One standard, wherever the patient is

    The Washington Medical Commission applies the Uniform Disciplinary Act to telemedicine the way it applies it in an exam room, and RCW 18.130.180 makes a departure from the standard of care unprofessional conduct. The commission treats the patient's location as the place of practice.

    Source: Washington Medical Commission

  2. 02

    Keep the attestation on file

    The telemedicine training in RCW 43.70.495 is developed by a collaborative for hospitals and health care providers and offered without charge. Each provider signs and retains the attestation, and an employer holding it for its clinicians has to be able to produce it.

    Source: RCW 43.70.495

  3. 03

    Health data needs its own consent

    RCW 19.373 requires a consumer health data privacy policy published separately from the general privacy policy and linked from the site's home page. Consent to collect must be separate from consent to share, and the policy names every category collected, the sources and the purposes.

    Source: RCW 19.373

  4. 04

    Records stay under the state act

    Washington's Uniform Health Care Information Act, RCW 70.02, governs disclosure of a patient's health care information and sets what a valid authorization must contain. It runs alongside the consumer health data rules rather than being displaced by them.

    Source: RCW 70.02

FIRST VISIT

Can a first visit happen without a live call in Washington?

Yes, with conditions

Yes, but not by telephone alone for a new patient. Washington lets a first visit happen remotely when the standard of care is met, while RCW 48.43.735 makes an audio-only encounter billable only after an in-person or video appointment in the previous three years.

Washington never wrote a questionnaire ban into statute. What it wrote instead is a modality rule: the audio-only pathway is reserved for patients the practice already knows, which pushes a first contact into video or an office.

  1. 01

    Video carries the first visit

    An audio-video telemedicine encounter counts as a covered service on the same terms as an in-person visit under RCW 48.43.735, with no prior-relationship condition attached. That makes video, not a form and not a phone call, the workable route for a new patient here.

    Source: RCW 48.43.735

  2. 02

    The three-year clock

    The established relationship that unlocks audio-only can come from the same provider, another provider in the same medical group, or a referral by a provider who has one, provided the referring notes reach the treating provider. The qualifying appointment must fall inside the previous three years.

    Source: RCW 48.43.735

  3. 03

    Consent before the bill

    A provider who intends to bill for an audio-only telemedicine service obtains the patient's consent to that service in advance. Under WAC 284-170-433 the consent may be written or verbal, and it is documented and retained for at least five years.

    Source: WAC 284-170-433

PRESCRIBING

Prescriptions and controlled drugs in Washington

Washington wrote no separate telemedicine prescribing statute. A remote prescriber is held to the same chapters as any other, which in practice means the opioid prescribing rules in WAC 246-919 and the state prescription monitoring program.

  1. 01

    Opioid rules apply by phase

    WAC 246-919-850 and the sections after it set separate duties for acute, subacute, perioperative and chronic pain, including a patient evaluation, a written treatment plan, and consultation once a dose passes the rule's morphine equivalent trigger.

    Source: WAC 246-919-850

  2. 02

    Query the monitoring program

    The opioid rules in WAC 246-919 direct a prescriber to check the prescription monitoring program before starting opioid treatment and at intervals through chronic care. The database is integrated into electronic health records so the query can run inside the visit.

    Source: WAC 246-919

  3. 03

    No state controlled-substance license

    Washington issues no separate state controlled substance registration for practitioners, so a federal DEA registration plus an active Washington professional license is the whole permission set. RCW 69.50.315 separately shields anyone who administers an opioid overdose reversal drug.

    Source: RCW 69.50.315

  4. 04

    Pharmacy side of the order

    A pharmacy outside the state that ships to a patient here needs a non-resident license from the Washington State Pharmacy Quality Assurance Commission under RCW 18.64, and the commission applies Washington dispensing standards to that shipment.

    Source: RCW 18.64

Federal rules apply on top of every state's. Prescribing controlled substances by telehealth without an in-person visit runs on DEA flexibilities currently extended through December 31, 2026, with a permanent rule still pending.

LICENSES

Who can treat patients in Washington

Physicians are licensed by the Washington Medical Commission, and the state joined the Interstate Medical Licensure Compact, which shortens the paperwork but still ends in a full state license. Nurse practitioners hold full practice authority.

  1. 01

    The compact still issues a state license

    Compact participation gives a qualifying physician an expedited path to a Washington license through a letter of qualification from their state of principal licensure. It is a faster application, not a license that travels on its own into the state.

    Source: Interstate Medical Licensure Compact

  2. 02

    No telehealth-only registration

    There is no telehealth permit or registration that would let a physician licensed elsewhere treat a patient located here without the state's own license. Every clinician seeing a Washington patient holds the ordinary credential for their profession.

    Source: Washington Medical Commission

  3. 03

    Nurse practitioners practice on their own

    The American Association of Nurse Practitioners lists this as a full practice authority state. An advanced registered nurse practitioner evaluates, diagnoses, orders tests and prescribes under the Nursing Care Quality Assurance Commission with no physician agreement.

    Source: AANP: full practice authority brief

  4. 04

    Physician assistants work to a plan

    A physician assistant here practices under a collaboration agreement filed with the commission, and RCW 18.71A sets what that agreement covers. The agreement, not a separate telehealth rule, defines which remote services the physician assistant may deliver.

    Source: RCW 18.71A

How Tessic Health's providers are licensed in Washington

ADVERTISING

Marketing to patients in Washington

Two statutes shape a telehealth brand's marketing here: the Consumer Protection Act, which the consumer health data law plugs into, and the state's commercial email and telephone solicitation rules.

  1. 01

    A private claim, not just a fine

    RCW 19.86 lets a person injured by an unfair or deceptive act sue for damages, which a court may treble up to a statutory cap, plus fees. Because RCW 19.373 declares a health data violation an unfair practice, an ad pixel that leaks a condition is a claim a patient can file.

    Source: RCW 19.86

  2. 02

    The health data policy is a page

    The consumer health data privacy policy is its own document with its own home page link. It cannot be folded into the general privacy notice, and it has to state how a consumer withdraws consent and how a deletion request is handled.

    Source: RCW 19.373

  3. 03

    Selling data needs an authorization

    A sale of consumer health data requires a signed authorization separate from consent, listing the data sold, the purchaser, and an expiry no more than one year out. Seller and purchaser each keep a copy of that authorization for six years.

    Source: RCW 19.373

  4. 04

    Email and calls have their own act

    The Commercial Electronic Mail Act, RCW 19.190, bars a misleading subject line or sender in email sent to an address in the state, and RCW 80.36.390 governs telephone solicitation, including the duty to identify the caller and end the call on request.

    Source: RCW 19.190

TESSIC HEALTH IN WASHINGTON

How Tessic Health's providers cover Washington

A brand's Washington patients are seen by Tessic Health's clinicians trading under the brand's own name, with the management company held clear of the clinical side. Each step below follows from a statute or commission rule cited above.

  1. 01

    State-licensed clinicians only

    Every clinician who sees a patient located in the state holds a current license from the relevant commission, whether it came through the compact route or a direct application. Nurse practitioners practice to the full scope the state allows.

  2. 02

    Attestations collected at onboarding

    Telemedicine training is finished and the signed attestation collected before a clinician takes a first visit here, and the file sits with the credentialing record so it can be produced without notice.

  3. 03

    Video first, phone later

    A first visit in this state runs on audio and video. Audio-only follow-ups open only for patients with a qualifying appointment inside the three-year window, and consent to an audio-only service is captured before the encounter is billed.

  4. 04

    Health data handled as its own class

    Brands operating here publish a consumer health data privacy policy at its own link, capture separate consent before any health data is collected for marketing, and sell no category of that data.

  5. 05

    In-state pharmacy compliance

    Prescriptions ship at 0% markup from pharmacies holding the non-resident license this state requires, with cold-chain packing where the drug needs it.

COMMON QUESTIONS

Questions about telehealth in Washington

  • Not for a new patient in practice. RCW 48.43.735 makes an audio-only telemedicine service billable only when the patient has had an in-person or audio-video appointment within the previous three years, or arrives by referral from a provider who has one.

  • Yes. RCW 43.70.495 requires providers delivering telemedicine to complete the state's telemedicine training and to sign and retain an attestation that they did. The training is offered at no cost and the attestation is kept by the provider or the employer.

  • Consent to collect has to be separate from consent to share, a sale needs a signed authorization, and the consumer health data privacy policy is its own document linked from the home page. A breach of those duties is an unfair practice a patient can sue over.

  • Only with this state's license. It is an Interstate Medical Licensure Compact member, so the application can be expedited through a letter of qualification, but no telehealth-only registration skips the license itself.

  • Yes. This is a full practice authority state, so an advanced registered nurse practitioner can evaluate, diagnose, order tests and prescribe under the nursing commission's license with no physician collaboration agreement required.

  • No. A federal DEA registration and an active state professional license are enough. The controls that matter sit in the opioid prescribing rules in WAC 246-919 and in the monitoring program queries those rules require.

SOURCES

Rules checked September 2026 · 21 sources cited. A planning summary, not legal advice. Statutes, board rules and enforcement priorities change; a brand's own counsel should review its model and marketing before launch.

OTHER STATES

Rules in other states

Each state page is researched from that state's own statutes and board rules.

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