NCMHCE

Counselors providing services by video, phone, or text must be licensed (or hold a compact privilege) in the state where the client is physically located at the time of service. At the start of each session the counselor verifies the client's identity and current location, confirms the client is in a private space, and has an emergency plan that names local crisis resources and an emergency contact near the client. Platforms must be HIPAA-compliant, with a business associate agreement. Informed consent for telehealth covers the benefits and risks of technology, privacy limits, what happens if the connection fails, and when in-person care is recommended instead.

The Counseling Compact is an interstate agreement that allows a licensed professional counselor whose home state is a member to obtain a privilege to practice in other member states. The counselor must follow the laws and rules of the remote state where the client is located. Until a privilege is issued, a counselor needs a license in each state where clients are located.

Insurance reimbursement requires a diagnosis that is clinically accurate and supported by documentation. Assigning a more severe diagnosis to obtain payment, or a less stigmatizing one that is not accurate, is insurance fraud. Counselors bill only for services actually provided, under their own credentials, and disclose fee and billing policies at the outset. Bartering is ethically acceptable only when it is not exploitative, the client requests it, and it is a customary practice in the community. Collection agencies may be used after the client has been informed of this policy and given an opportunity to pay.

Electronic health records require access controls, audit trails, encryption, and secure backup. When counselors use artificial intelligence tools (for example, note-drafting or scheduling software), they remain responsible for the accuracy of the record, must protect client information as required by HIPAA, obtain informed consent when client data are processed by the tool, and must not let software replace clinical judgment in diagnosis or risk decisions.

A subpoena compels a response but does not by itself authorize release of confidential records. The counselor contacts the client, asserts privilege on the client's behalf, and consults an attorney or the licensing board. Records are released only with the client's written authorization or a court order. Counselors avoid serving as both therapist and custody evaluator for the same family because the roles conflict.

• The Americans with Disabilities Act requires reasonable accommodations, such as accessible offices, sign language interpreters, or adjusted materials.
• Advertising must be accurate: no exaggerated claims, no testimonials solicited from current clients, and no misrepresentation of credentials.
• Professional liability insurance, timely license renewal, required continuing education, and an emergency preparedness plan for the practice are routine compliance duties.