How Should Clinicians Determine Which State's Laws Govern a Telehealth Encounter?

How should clinicians determine which state's laws govern a telehealth encounter?

A telehealth appointment is generally considered to occur wherever the patient is physically located at the time of the appointment, not where the practitioner is licensed or based. This means a practitioner must confirm, at the start of every visit, exactly where the patient is sitting, rather than merely relying on an IP address, which can be inaccurate or intentionally obscured by the patient. Once the location is established, the practitioner must verify that they hold legal authority to practice in that jurisdiction, whether through a full professional license, an interstate compact agreement, a telehealth-specific registration, a temporary practice allowance, or another recognized legal carve-out.

A common and serious mistake is over-relying on the existence of an interstate compact without confirming it is actually operational. A compact can be signed and enacted between two states yet remain ineffective for the specific service or license type in question, since compacts often include a forward-dated "effective date" that has not yet arrived. Rather than trusting a general web search, a verbal assurance, or an AI-generated summary, practitioners should verify current status directly against the state's statutes, regulations, and the compact agreement itself, ideally with input from qualified legal counsel who carries a fiduciary duty to get the answer right.