Therapy Outside Your State/Country

Therapy Outside Your State/Country

Do you have a client traveling and still in need of their appointment?

Are you wanting to broaden your clientele base by expanding across borders? 

Are you from outside the US and wondering how to offer your services here?


All this is possible and here is how you can do it!

STEP 1: Verify with your licensing board

In order to offer therapy elsewhere, you have to get the approval first from your licensing board.  Let them know the circumstances.

“My client is a student and studying abroad,”
is a fairly common concern as well as
“My client is being temporarily stationed elsewhere.” 

These are temporary situations and as such, it is important to note whether or not the client is changing their permanent address and let your licensing board know those details. 

TIP: Links are provided at the end of this blog to get contact info for licensing boards nationally and internationally! 

In the states, a common response is that they are okay with it, but that it depends on the state/country that client is going. This leads us to:


STEP 2: Verify with the licensing board of where the client is going. 

So, you sought the approval of your licensing board and now you need to find out the regulations of the area your client is going. In the states, this is rather easy as HIPAA compliance and currency remain the same. All you have to do is reach out and gain permission from that state’s licensing board. 

NOTE: If this is a permanent change, other options include getting PSYPACT licensed with that state. More on this to come!

If your client is leaving the country, you need to contact the licensing board there and check with any additional laws/regulations. 

For example, HIPAA is our federal protection in the US for medical information as I’m sure you are very well aware of. Yet, in Canada, they use PHIPA which covers more personal information than HIPAA. 

For permanent situations, this is critical to know. US centered therapy platforms, such as iTherapy, are built and designed to meet all the criteria of the US. Therefore, asking the board for permission as well as potential law/regulation variations is highly recommended. Even Though iTherapy can be used anywhere with an internet connection, it is important to find out what additional information/regulation needs to be added. Once you find this out, you can always contact us at to find out if our platform has what you’ve been told is a necessity. 

Sometimes, it’s much simpler! Some countries have very little to no regulations on mental health. You’ll never know your full potential of clients abroad until you try! (again, links below for contact info)



Whether your client is going on vacation or you’re trying to get clients from elsewhere, if you are accepting insurance, this can cause an issue if not addressed beforehand. Simply ask your client to verify with their insurance that it covers them, even while traveling, or being located in different states/countries as their therapist. They may not have specific regulations on telehealth but it is best to verify before billing. 

It may be simpler to only allow out of pocket payments only, especially for clients in different countries. This is where currency comes in play:


STEP 4: Getting paid

If your client has a bank account located outside the US, chances are things could get hairy when trying to bill them with a US based EHR system. But, as the famous saying goes “there’s always another way!” For sticky situations like these, we have found that using a more globalized currency system, like Paypal, is an easy solution. You can still keep payment records with your EHR system and then bill your client through Paypal. If this be the route you so choose, you can check the currencies they currently accept here:

More ways to broaden your horizons (or clientele base)

If you are a licensed psychologist and interested in practicing outside your state, PSYPACT may be for you! They are continuously adding new states to their participating list. If you want to learn more on how to do this, click here to be directed to the PSYPACT overview: 

You can also check out our blog specifically on this topic here! 

To verify your state’s participation, and the states you’re interested in qualifying for, you can use the following link: 

Concluding statement

Practicing outside your area has already become possible by joining the online world. Take it a step further, and you can participate beyond those borders even more. It is possible to achieve and for those confined to states with lower populations, or perhaps you’re in a very rural area, this may be the answer you were looking for! 


As promised, the links below are the contact information of licensing boards both nationally and internationally. 




Best of luck!


January 11, 2023 / iTherapy Blog, Mental Health

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