FREQUENTLY ASKED QUESTIONS
ABOUT THE PSYPACT COMPACT
General Information
What is PSYPACT?
The Psychology Interjurisdictional Compact (AKA PSYPACT) is an interstate compact designed to facilitate the legal practice of telepsychology and temporary in-person, face-to-face psychology services across state boundaries without requiring a psychologist to be licensed in every state to practice.
What type of interjurisdictional practice does PSYPACT allow?
PSYPACT allows psychologists to provide interjurisdictional services without requiring a psychologist to become licensed in every state to practice. The two types of interjurisdictional practice are:
- temporary in-person, face-to-face practice
- telepsychology
I have heard the terms Home State, Receiving State, and Distant State. What do these terms mean?
For temporary, in-person, face to face practice:
- Home State refers to the PSYPACT member state in which the psychologist is licensed to practice psychology. If the psychologist is licensed in more than one PSYPACT member state and is providing temporary, in person, face to face services under PSYPACT, the Home State is any PSYPACT member state where the psychologist is licensed.
- Distant State is the PSYPACT member state where a psychologist is physically present (not through the use of telecommunication platforms), to provide temporary in-person, face-to-face psychological services.
For telepsychology:
- Home State means a PSYPACT member state where a psychologist is licensed to practice psychology. In order to practice telepsychology services under PSYPACT, the psychologist must be physically present and providing services from their declared Home state. If the psychologist is licensed in more than one PSYPACT member state, the Home State is the PSYPACT member state where the psychologist is physically present when the telepsychology services are delivered.
- Receiving State refers to a PSYPACT member state where the patient is physically located when the telepsychology services are delivered.
How many states are currently members of PSYPACT?
Thirty-one states have enacted PSYPACT legislation. PSYPACT is in effect in 28 of those 31 states.
How does a state become a member of PSYPACT?
To become a PSYPACT member state, each state must follow their legislative process and enact the Model PSYPACT Legislation. Specifically, a bill must first be introduced and then adopted by the state’s legislature. With one exception, bills in NY can only be introduced by legislators or by standing committees of the Senate and Assembly. The single exception is legislation introduced as part of the Executive Budget that is submitted by the Governor. The PSYPACT Model Legislation must be enacted exactly as it is written, which ensures that each state enacts identical language in their legislation. CLICK HERE to view the PSYPACT Model Legislation.
What is the cost of state membership in PSYPACT?
PSYPACT member states are charged an annual assessment of $10 per Authorization Holder who is licensed to practice in their Home State (note. Authorization Holder refers to a psychologist who is authorized to practice under PSYPACT authority). There is an annual cap of $6,000 for the assessment fee. The PSYPACT Commission, which is the PSYPACT administrative body, will provide public notice of any proposed revision to the annual assessment fee at least 90 calendar days prior to the next PSYPACT Commission meeting. The funds received from the annual state assessments are used to cover PSYPACT Commission related expenses including, but not limited to Commission staff, legal and accounting, computer and website services, and travel.
I heard that only doctoral level clinicians are eligible to practice under PSYPACT. Is there a plan to allow individuals with master’s degrees to practice under PSYPACT in the future?
The current PSYPACT Model Legislation lists “Graduate Degree” as the broader eligibility criteria. The PSYPACT Rules currently define “Graduate Degree” as a doctoral degree. PSYPACT Leadership informed the NYSPA PSYPACT Subcommittee that expanding the PSYPACT Compact to include other mental health professions has not been definitively ruled out. However, they stated there is nothing planned in the immediate future.
Can changes be made to the PSYPACT Model Legislation? What happens if a member state disagrees with changes to PSYPACT Model Legislation?
Yes, changes can be made to the PSYPACT Model Legislation. If a PSYPACT member state does not agree with the changes to the legislation and decides not to enact the changes in their state’s legislation, the PSYPACT member state has to leave the Compact because member states all must have the same exact legislation. *Of note, the PSYPACT Model Legislation is currently written using broad terms that are defined more specifically in the Commission’s Rules. These definitions as well as the Rules themselves can be changed without requiring a change to the PSYPACT Model Legislation. For example, the PSYPACT Model Legislation states that applicants must have earned a graduate degree in psychology to be eligible for an E-Passport. The Model Legislation does not specify what type of graduate degree, but the PSYPACT Commission Rules currently define graduate degree as a “doctoral degree”. This criterion could be changed to a “master’s or doctoral degree” without necessitating a change to the PSYPACT Model Legislation.
How does a PSYPACT member state leave the PSYPACT Compact?
A PSYPACT member state can withdraw from PSYPACT at any time by enacting legislation in their state that repeals the PSYPACT Compact language. The withdrawal will not take effect until six (6) months after the enactment of the legislation repealing the PSYPACT Compact language. The 6-month time frame allows for psychologists to facilitate transfer of care to other providers who are authorized to provide services to each patient.
Who oversees PSYPACT?
The Psychology Interjurisdictional Compact Commission (AKA the PSYPACT Commission) provides oversight of PSYPACT and creates and enforces the rules and policies governing PSYPACT. The PSYPACT Commission also serves to provide a mechanism to solve interstate matters when they arise.
What are the specific duties of the PSYPACT Commission?
The PSYPACT Commission is charged with the following duties and responsibilities:
- Adopt changes to the Rules or Bylaws
- Adopt changes to the fees/dues to be paid by PSYPACT member states
- Adopt the budget based on the recommendation from the Executive Board
- Enter into contracts for the provision of personnel and other administrative services
- Enforce PSYPACT member state compliance with the terms of the PSYPACT Compact, including Bylaws and Rules adopted by the PSYPACT Commission
- Perform any other necessary or appropriate duties authorized by the PSYPACT Compact
Who serves on the PSYPACT Commission?
The PSYPACT Commission is composed of one representative from each PSYPACT member state and ex-officio, non-voting member from the Association for State and Provincial Psychology Boards (ASPPB). Representatives are selected by the psychology state regulatory body for each PSYPACT member state. The representative must be one of the following:
- Executive Director, Executive Secretary or similar executive of the psychology state regulatory body;
- Current member of the State Psychology Regulatory Authority of a PSYPACT member state; OR
- Designee empowered with the appropriate delegate authority to act on behalf of the PSYPACT member state.
What role and influence can PSYPACT member states have relative to decisions impacting PSYPACT’s policies, practices, and procedures?
Representatives from each PSYPACT member state vote on enacting the Rules and creating Bylaws. A majority vote of the PSYPACT Commission constitutes a quorum.
What is the relationship between the PSYPACT Commission and ASPPB?
ASPPB, which is the alliance of psychology licensing boards in the United States and Canada, partnered with its member psychology boards to develop PSYPACT as a means to regulate the practice of telepsychology and practice across state lines. The PSYPACT Commission is a governing body of PSYPACT. ASPPB has one ex‐officio, non-voting member who serves on the Executive Board of the PSYPACT Commission.
Do the licensure requirements in other PSYPACT member states reflect the requirements for licensure in NY such that NY residents would receive services from individuals with equivalent training and education as NY licensed psychologists?
The PSYPACT Commission sets the eligibility requirements for psychologists to practice under PSYPACT and each PSYPACT member state agrees to these requirements when they adopt the PSYPACT Model Legislation. As such, the specific licensure requirements in individual states apply only to the PSYPACT Home State in which the psychologist is located.
Temporary, in-person practice
What are the requirements to conduct temporary in-person, face-to-face practice under the authority of PSYPACT?
In order to conduct temporary in-person, face-to-face practice in another PSYPACT member state under PSYPACT, a psychologist must obtain a Temporary Authorization to Practice (TAP) from PSYPACT.
What do I need to obtain a TAP so I can conduct temporary, in-person practice in another state under PSYPACT?
To obtain a TAP, you must:
- Hold a full, unrestricted license to practice psychology in a PSYPACT state
- Possess an active ASPPB Interjurisdictional Practice Certificate (IPC).
- Complete attestations
- Pay a $40 fee
What do I need to obtain the ASPPB Interjurisdictional Practice Certificate (IPC)?
To obtain the IPC, you must:
- Possess a current, active psychology license based on a doctoral degree in at least one PSYPACT member state
- Have no disciplinary action listed on any psychology license
- Possess a doctoral degree in psychology from a program that was APA/CPA accredited or designated as a psychology program by the ASPPB/National Register Joint Designation Committee at time of conferral; or deemed to be equivalent by a recognized foreign credential evaluation service.
NOTE. Applicants who have been continuously licensed (active or inactive) to practice psychology at the independent level in one or more ASPPB member jurisdictions since January 1, 1985, based on a doctoral degree in psychology from a regionally accredited institution, are deemed to have met the educational requirements for the Interjurisdictional Practice Certificate (IPC).
- Have your degree-granting institution send official transcripts to ASPPB.
- Complete annual renewals.
- Pay an initial application fee of $200 and an annual renewal fee of $50.
How long can I practice under the TAP?
The TAP allows you to practice a maximum of 30 days per calendar year in each PSYPACT member state.
Telepsychology
What are the requirements to practice telepsychology under the authority of PSYPACT?
In order to conduct telepsychology in another PSYPACT member state under PSYPACT, a psychologist must obtain an Authority to Practice Interjurisdictional Telepsychology (APIT).
What do I need to obtain the Authority to Practice Interjurisdictional Telepsychology (APIT) so that I can provide telepsychology services in a PSYPACT state?
To obtain an APIT, you must:
- Hold a full, unrestricted license to practice psychology in a PSYPACT state
- Complete attestations.
- Possess an active ASPPB E-Passport.
- Pay a one-time $40 fee.
What are the requirements for the ASPPB E-Passport?
To obtain the E-Passport, you must:
- Possess a current, active psychology license based on a doctoral degree in at least one PSYPACT member state
- Have no disciplinary action listed on any psychology license
- Possess a doctoral degree in psychology from a program that was APA/CPA accredited or designated as a psychology program by the ASPPB/National Register Joint Designation Committee at time of conferral; or deemed to be equivalent by a recognized foreign credential evaluation service.
NOTE. Applicants who have been continuously licensed (active or inactive) to practice psychology at the independent level in one or more ASPPB member jurisdictions since January 1, 1985, based on a doctoral degree in psychology from a regionally accredited institution, are deemed to have met the educational requirements for the E-Passport.
- Have your degree-granting institution send your official transcripts to ASPPB
- Have successfully completed the Examination for Professional Practice in Psychology with a score that meets or exceeds the established ASPPB recommended passing score at the time of the application.
NOTE. Psychologists licensed before January 1, 1985, are exempt from this requirement.
- Complete annual renewals with 3 hours of Continuing Education (CE) relevant to the use of technology in psychology.
- Pay an initial application fee of $400 and a yearly renewal fee of $100.
Are there restrictions on where I can be located when I provide telepsychology across state lines under PSYPACT authority?
A psychologist practicing telepsychology across state lines under PSYPACT authority must be physically located in their declared PSYPACT Home State when services are delivered. As a reminder, the Home State is defined as a PSYPACT member state where a psychologist is licensed by the psychology state regulatory body. If the psychologist is licensed in more than one PSYPACT member state, the Home State is the PSYPACT member state where the psychologist is physically present when the telepsychology services are delivered. The location of the patient at the time services are delivered is known as the Receiving State.
For example: Dr. Johnson holds 2 professional licenses to practice psychology - one license is in Virginia (a PSYPACT member state) and the second is in New York (a non-PSYPACT state). After obtaining an E-Passport, Dr. Johnson’s Home State would be Virginia. If Dr. Johnson wanted to deliver telepsychology services to an individual in Kentucky (another PSYPACT member state, which in this case would be the designated Receiving State), Dr. Johnson must be physically located in Virginia at the time they deliver the telepsychology services in order to legally provide services under PSYPACT. If Dr. Johnson was visiting New York, they would not be permitted to deliver telepsychology services to their patient in Kentucky under PSYPACT.
Is the APIT also time-limited?
The APIT does not have any time restrictions on the practice of telepsychology in PSYPACT states. Psychologists can provide as much telepsychology services as desired as long as they possess a valid APIT and a valid E-Passport.
Is it true that I have to have a certain passing EPPP score to be eligible for an E-Passport?
This is true for applicants who received their license to practice on or after January 1, 1985. Any applicant who received their license before January 1, 1985, is exempt from that requirement. The designated passing score is set by ASPPB.
I heard that only psychologists who graduated from APA-accredited doctoral programs are eligible for an E-Passport or the Interjurisdictional Practice Certificate (IPC). Is this true?
The initial criteria for the E-Passport and the IPC were more restrictive and required licensed psychologists to have earned their doctoral degree from an APA accredited institution. In response to concerns raised by many psychologists across the nation, the PSYPACT Commission amended this requirement so that applicants who have been continuously licensed (active or inactive) to practice psychology at the independent level in one or more ASPPB member jurisdictions since January 1, 1985, based on a doctoral degree in psychology from a regionally-accredited institution, are deemed to have met the educational requirements for the IPC and E-Passport.
Will the PSYPACT Commission ever modify or amend the eligibility criteria for the IPC and/or E-Passport?
The PSYPACT Commission has a designated Mobility Committee that meets regularly to examine the policies, procedures, and eligibility criteria. PSYPACT Leadership have indicated that further revisions to the eligibility criteria and PSYPACT’s Policies and Procedures remain under discussion.
Regulation/Oversight/Liability/Ethics
Does PSYPACT identify standards of clinical practice?
No. However, the PSYPACT model legislation requires psychologists to “provide attestations in regard to areas of intended practice, conformity with standards of practice, competence in telepsychology technology, criminal background, and knowledge and adherence to legal requirements in the home and receiving states…” In addition, the renewal application for the E-Passport also requires completion of 3 CEs in telehealth.
The specific attestation language related to standards of practice is:
“I acknowledge that I must be knowledgeable of and will practice within the specified legal requirements of my Home State and all other Receiving States, including but not limited to any requirement to have liability insurance in the state into which the services are being provided. Where there is a conflict between states with regard to laws, regulations, and standards, psychologists shall adhere to the laws, regulations and standards of my Home State in a manner consistent with the Receiving States’ laws and regulations as is reasonably possible. I will inform the patient/client of all significant conflicts that may adversely impact the professional services that I will provide with a particular emphasis on any limits to confidentiality, privilege, and duties to report.”
What happens if the rules and regulations differ between the Home State and the Receiving or Distant State?
PSYPACT addresses this in the PSYPACT Model Legislation, whereby PSYPACT member states agree to the following:
- If a psychologist is providing telepsychology services to a Receiving State under the Authority to Practice Interjurisdictional Telepsychology, they are subject to their Home State’s authority and laws.
- If a psychologist is providing in-person services to a Distant State under the Temporary Authorization to Practice, they will be subject to the Distant State’s authority and law.
Who is responsible for regulating the practice of a psychologist providing services in another state under PSYPACT authority?
The psychologist’s designated Home State has the power to impose adverse action against the professional license to practice psychology that they issued to the psychologist. Distant and Receiving States have the power to take adverse action on a psychologist’s authority to practice under PSYPACT. PSYPACT member states can collaborate in investigating alleged misconduct. When a joint investigation occurs, the psychologist’s Home State will take the lead. It is important to note that a psychologist practicing under PSYPACT cannot change their designated home state when an investigation is underway.
For example, Dr. Kay is licensed in Arizona (their PSYPACT Home State) and regularly provides telepsychology services to residents of Arkansas (the PSYPACT Receiving State). The Arkansas psychology board learns that Dr. Kay committed an egregious ethical violation when providing telepsychology services to Patient X in Arkansas. The Arkansas psychology regulatory board contacts the Arizona psychology regulatory board and informs them of the violation. The Arizona psychology board takes the lead on the investigation and imposes adverse action against the professional license to practice psychology that they issued to Dr. Kay. This adverse action will result in revocation of the E-Passport and/or IPC.
Do PSYPACT member states share their investigative findings with one another?
A PSYPACT member state must notify the PSYPACT Commission that investigative information is available to other PSYPACT member states when it has determined that probable cause exists that the allegations against the psychologist may constitute a violation of that PSYPACT member state’s statutes or regulations.
Does PSYPACT have a reporting out function to all PSYPACT member states when an adverse action is identified?
Yes. PSYPACT has a process for collecting, storing, and sharing information about psychologists' licensure and enforcement activities related to psychology licensure laws. Adverse actions are reported to the Coordinated Database that serves as an internal, searchable directory of psychologists practicing under PSYPACT authority. The Coordinated Database is available to the PSYPACT Commission and to the licensing board staff of PSYPACT member states. PSYPACT member states are responsible for submitting a uniform data set to the Coordinated Database for each psychologist in their state that is authorized to practice under PSYPACT. The required information includes:
- Psychologist identifying information
- Licensure data
- Significant investigative information
- Adverse actions against a psychologist’s license
- An indicator that a psychologist’s Authority to Practice Interjurisdictional Telepsychology and/or Temporary Authorization to Practice None is revoked
- Confidential information related to alternative program participation information
- Any denial of application for licensure and the reasons for such denial
- Other information which may facilitate the administration of PSYPACT, as determined by the rules of the PSYPACT Commission
There is also a public directory that was created at the request of insurance companies. This directory can be searched by anyone. When a psychologist’s E-Passport is revoked, their name is simply removed from the public directory. As such, there is no indication to the public that an E-Passport was revoked.
Does PSYPACT revoke an individual’s E-Passport or IPC indefinitely if adverse action is taken against the psychologist in the state in which they are licensed and/or practicing under PSYPACT?
Yes, any disciplinary action will lead to revocation of PSYPACT privileges (both temporary in-person practice and telepsychology). The revocation remains permanent in spite of any remediation or reinstatement of an individual’s license to practice by the psychology state regulatory body. PSYPACT leadership has informed NYSPA’s PSYPACT Subcommittee that this will not change in the future.
As a psychologist practicing under PSYPACT authority, am I obligated to report any disciplinary action for violations that were enacted by the psychology state regulatory body under which I am licensed?
A psychologist holding an Authority to Practice Interjurisdictional Telepsychology and/or a Temporary Authorization to Practice under PSYPACT authority must report to the PSYPACT Commission any adverse action placed upon any license within 30 days of the effective date (this includes adverse action against a license to practice psychology in states that are not members of PSYPACT).
What CEs are required by PSYPACT?
The annual renewal application for an E-Passport requires completion of 3 hours of Continuing Education (CE) relevant to the use of technology in psychology. Approved CE for the E-Passport may include academic courses and content offered by approved sponsors of CE (PSYPACT currently does not specify which sponsors of CE are approved by them to meet the CE requirement). All CE required by PSYPACT must be directly relevant to the practice of telepsychology and would include, but not be restricted to, any one or more of the following areas as defined in the APA/ASPPB/APAIT Telepsychology Guidelines (note: relevance to the practice of telepsychology is determined by PSYPACT’s Mobility Committee):
- Competence of the psychologist
- Standards of care in the delivery of telepsychology services
- Informed consent
- Confidentiality of data and information
- Security and transmission of data and information
- Disposal of data and information and technologies
- Testing and assessment when providing telepsychology services
- Interjurisdictional practice
PSYPACT does not require any other CE for the E-Passport. Nor do they require any CEs for Temporary In-Person Practice. Psychologists would still be responsible for completing CEs required by individual states in which they are licensed, however.
For example, Dr. Luna is licensed to practice in Virginia and holds an PSYPACT E-Passport. Dr. Luna is responsible for completing the CEs required by the Virginia Board of Psychology each time they renew their psychology license. Dr. Luna is also responsible for completing the 3 CEs in technology related to psychology practice that PSYPACT requires as part of the E-Passport renewal.
How does PSYPACT ensure psychologists are aware of region-specific cultural factors that are critical to consider in clinical practice?
At this time, PSYPACT does not have any specific requirements related to serving diverse populations in various regions. Psychologists practicing in other regions under PSYPACT would need to self-initiate research into important cultural/regional factors that they should consider in their clinical practice.
How are malpractice policies, coverage, and rates impacted by PSYPACT? Do the malpractice insurance companies acknowledge the E-Passport as legal permission to practice in PSYPACT member states?
The PSYPACT Subcommittee members contacted their own malpractice insurance providers to inquire about this. They were told that the insurance covers the psychologist’s “license”, so the insurance is deemed portable and covers services provided to patients wherever the psychologist is legally sanctioned to do so. So as long as the state regulatory board where the psychologist is practicing recognizes the psychologist’s license to practice, the malpractice insurance company will provide coverage.
Please note that the PSYPACT Subcommittee did not contact every malpractice insurance provider. In addition, coverage policies can change over time. As such, the above answer does not reflect official guidance on malpractice insurance coverage. All psychologists should contact their individual malpractice insurance provider to confirm coverage policies when providing any telepsychology or temporary, in-person services in other states.
How do psychologists familiarize themselves with standards of practice for each PSYPACT member state? Does PSYPACT provide a central repository for changes to rules and regulations of practice in each PSYPACT member state?
At this time, PSYPACT does not have a central repository for changes to rules and regulations of practice in each PSYPACT member state. Psychologists practicing in another state under PSYPACT authority are responsible for being aware of such changes, which can generally be accomplished by visiting the website for each psychology board in each state in which they are practicing.
Service Utilization
Do residents generally prefer to work with psychologists who live/work in their local community/state? Are there factors that inform their decision, such as cost, in-network provider, specialty, etc.?
There are currently no data available to answer these questions.
How has PSYPACT increased access to more specialized care for certain populations in PSYPACT member states?
There are currently no data available to answer this question.
What data are available to provide insight into PSYPACT in practice?
Psychologists are asked to provide information about their practice when they renew their registration for authority to practice telepsychology or temporary, in-person practice under PSYPACT authority. Below are the data that PSYPACT Leadership shared with the PSYPACT Subcommittee:
- 75% of the psychologists who were granted an E-Passport have provided telepsychology services.
- 30% of the telepsychology services were provided to patients located in rural communities.
- There are currently 5,500 psychologists practicing under PSYPACT Authority across the 28 states where PSYPACT is in practice. This reflects about 10% of the total number of licensed psychologists in these 28 states.
How are large corporate telehealth groups (e.g., TalkSpace, BetterHelp, etc.) positioning their organizations to capitalize on telepsychology opportunities created through PSYPACT?
There are currently no data available to answer this question. However, PSYPACT Subcommittee members have learned through publicly available job descriptions and reports from colleagues that large telehealth corporations are actively seeking psychologists who are licensed in PSYPACT member states and supporting the applications for E-Passports (through logistical and/or financial support). This anecdotal information suggests the large telehealth corporations see PSYPACT as an opportunity to expand their services across a large market.
Fiscal and Insurance Matters
What are the start-up and maintenance costs for pursuing licensure in multiple states vs costs of obtaining/sustaining an E-Passport?
Costs for licensure vary by jurisdiction. See below for an example comparison between 4 jurisdictions and PSYPACT:
