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Resource Document on Across State Line Psychiatric Consultation Considerations Addendum to Risk

Approved by the Joint Reference Committee, June 2019

  • 2019

In 2013, an APA Resource Document on “Risk Management and Liability Issues in Integrated Care Models” was developed.1 This document outlined liability issues in a new and emerging area of collaborative /integrated care. In this model psychiatrists’ expertise is leveraged through curbside consultations and caseload reviews to provide more effective care for mild to moderate behavioral health conditions in the primary care setting. With the advent of CPT codes for the Collaborative Care Model, there has been a noticeable increase in the number of requests psychiatrists are receiving to do indirect consultations, caseload reviews, and education in states where they are not licensed. Further, the use of telecommunication solutions to enhance and expand existing services in one state can lead to increases in requests for psychiatric consultation to address patient choice, peer consultation, and workforce shortages in another state. States are actively developing policies to address the issue of licensure requirements for these consultation services, including physician to physician (P2P) consultation

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