Laws about going across state lines for therapy

If I live in NH can I go to therapy in Boston, MA? Or does the therapist have to be board certified for New Hampshire too (because as we all know we’re a special kind of crazy lol)

If it's in person, I don't think it matters. I believe the rules are about where the client and therapist are. Though it could affect insurance coverage maybe? I think it's more complicated if it's telehealth and may depend on the state's rules? The best thing to do would probably be to ask the therapist, if you're considering a particular one. Or check with your insurance.

If you are paying out of pocket, then it doesn’t matter.

If you want insurance to cover it, then it’s a bit different. You want to ask your insurance.

My insurance reimburses medical visits and prescription anywhere in the world as long as doctor fills out quick form. I just went to UK at Christmas time and got sick, I went to random private doctor and paid out of pocket and my insurance in MI reimburses me upon return.

Pretty sure if it was mental health emergency like going to psychiatric hospital, it would cover it. But therapy isn’t the same thing. Unless maybe MD provides therapy?

I’d call insurance first
.

T and L have told me that if they went out of state, we could still do therapy. Same if I go out of state. They said so long as they maintain a license in that state, they can still practice.

I think md's might be different because when I do teledoc, they say I have to be in the same state as the doctor. Maybe that's more due to insurance?

When I lived in NH, I was both hospitalized and one of my psychiatrists were in Massachusetts. I think it might have been due to insurance issues. Sometimes my ex worked out of NH and sometimes Massachusetts. I think also my psychiatrist was licensed in both states.

Was also hospitalized in NH and later my psychiatrist was in NH too.

I don’t think there are laws about that. Just insurance issues. If you have state insurance it may require pre-authorization . Years ago I was hospitalized with a woman from Canada. They didn’t have a specialized treatment for trauma and sent her to USA. Also years ago I went to Texas for a specialist hospital in dissociation. My insurance had to be pre approved. But most insurance now days doesn’t cover specialist hospitals and they are private pay now.

Oh. Because of where I live now there isn’t enough in- patient beds for emergency mental health care. Often people here are sent to one of the three states that borders us. Often that means the police drive them there which is ridiculous.

Your T has to be licensed in the state where you are physically located when you are being treated. So if you are doing telehealth from your location in your state, and your T is in another state, they have to be licensed or qualified to practice in your state, where you are physically located while you are doing the therapy. This is a law related to licensure, and it applies whether you private pay or use insurance. Private pay does not absolve your T from following licensure laws. Insurance may also have opinions about paying for an out-of-state therapist, but that is different than the licensure laws.

If you travel to your T's state and do therapy from there, then you are fine from a legal/licensure status, assuming the T is licensed in their own state. But, you might need to get prior authorization from your insurance company to pay an out-of-state provider.

insurance wise it matters. most insurance companies have preset or member selects their treatment providers from the handbook of covered agencies, facilities and physicians listing.

so first suggestion is consult your insurance handbook and online handbook for listings of agencies, facilities and physicians /mental health treatment providers.

unless you plan to pay hundreds of dollars out of pocket for each session. also keep in mind that out of state usually costs more than in state treatment. same treatment but the difference is each state is only allowed so much state and federal funds from the government based on things like how many clients in state they are treating.

Many mental health agencies and treatment providers limit their services to instate only.

before going out of state treatment providers contact mental health agencies to verify if there is indeed openings at those facilities and mental health agencies for you.

there is also the travel issues, number of skipped, missed sessions and so on requirements. you may want to consider how reliable you would be able to drive or travel to and from another state just for an hour of therapy. gas alone for your vehicle, or train fair every week or plane and taxi fare every week or so or paying someone 50 or so buck a week or so for gas, and food may not make it worth it.

theres also what happens if you are in new hampshire in crisis and your treatment provider is in boston. its not like they can hop in a car and meet you at the office or hospital.

lots to think about. good luck in what ever you decide to do.

It’s only like. 45 min drive from the cities on the border to Boston. When I was at my moms in rural NH thats what I was driving to the closest community mental health center for the shittiest “treatment” I’ve found. I’ve applied to homeless programs in Nashua and Manch Vegas. My nurse practitioner legit said to get treatment in Boston if I can because NH is the worst New England state in her opinion for mental health care. Idk if Southern NH is better because there is more people, but when I was getting treatment in Manch when I was at my dads it sucked too.

Should I instead be applying to places in MA?

What if you’re homeless but most recent address was NH?

if your homeless that does not stop you from getting treatment, mental health agencies dont turn people away because they are homeless.

its up to you whether you want to be in treatment or not. if you are homeless contact various places that help the homeless in your area. they will be able to help you decide what you want to do and whether you should be applying wher, when, how and wy... all that stuff.

if you decide to contact/ apply to other mental health agencies maybe you can ask whether they have "sliding fee rates" or pro bono (free for those who qualify)

I pretty much did just quit treatment as I’m over an hours drive from where I was getting treatment.
Don’t need it anyways. Did more harm than good so I have no hope for good treatment as long as I am in NH. I will say I do talk to peer supports on warm lines and get a lot out of that, but honestly since I got into a shelter and stopped couch surfing and being in drug dens and around toxic people things have been going better than ever. My friend is actually concerned I’m going to get addicted to homelessness like he did (he is in a section 8 apartment now though and says it’s much healthier and he’s much happier).

Seriously feels great to feel free after the shyt I went through though.