Telehealth Psychiatry Visit Checklist: Tech, Privacy and Location Rules

A good telehealth psychiatry visit depends on four things: being physically located in a state where your clinician is licensed, a private space where you can talk freely, technology you have tested in advance, and the information your prescriber needs at hand, including your pharmacy and medication list. Add a plan for what happens if the connection drops, and you have covered almost everything that goes wrong.

This checklist is written for psychiatric medication visits, but most of it applies to therapy by video too. The location rules are the part people most often get wrong, so they come first.

The checklist at a glance

Location: be where your clinician is licensed

With this practice, what counts for telehealth is where you are physically located during the visit. Dr. Lewis sees patients by telehealth when they are physically located in a state where she holds an active medical license, and her team confirms eligibility for your state before the first visit. The practice's state pages cover New York, New Jersey and California.

That has practical consequences:

• If you will be traveling on the day of a visit, tell the team in advance and ask how they handle it. Do not simply log in from another state.
• College students, people with second homes and frequent business travelers should plan visit dates around where they will be.
• If you live outside a clinician's licensed states, ask what they can offer. Some practices, including this one, offer educational consultations that do not establish a patient-doctor relationship.

The full explanation, including how New York, New Jersey and California state the rule, is in seeing Dr. Lewis by telehealth: where you must be.

Technology: test before the day

• Use the device and browser or app the practice recommends, and open the link once in advance.
• Check camera, microphone and speakers. Headphones with a microphone usually sound better and are more private.
• Charge your device fully, or keep it plugged in.
• Close other apps and pause large downloads or streaming on your network.
• Place the camera at eye level with light in front of you rather than behind you, so your clinician can see your face clearly. Facial expression is part of a psychiatric assessment.
• Keep your phone nearby and charged as a backup, with notifications silenced.
• If you use assistive technology, captions or an interpreter, tell the practice ahead of time.

Privacy: a space where you can speak freely

A psychiatric visit covers topics you may not want anyone to overhear. Choose a room with a door, tell others in the household you need privacy, and consider a fan or white-noise app outside the door. A parked car can work if you are not driving. Avoid public places, open-plan offices and shared Wi-Fi in cafes or hotels where possible.

Think twice about using a work laptop or work email for appointments, since employers may manage or monitor those devices. A personal device on a home network is usually the better choice.

What HIPAA means for the video platform

During the COVID-19 public health emergency, the HHS Office for Civil Rights relaxed enforcement so clinicians could provide telehealth through widely available, non-public-facing communication apps. That enforcement discretion expired when the emergency ended on May 11, 2023, and OCR gave covered providers a 90-calendar-day transition period, ending August 9, 2023, to bring their telehealth into compliance with the HIPAA Rules. Since then, practices covered by HIPAA are expected to meet the HIPAA Rules for the remote communication technology they use.

You can ask which platform the practice uses and how it protects your information. The practice's HIPAA Notice of Privacy Practices describes how health information is handled. Never share passwords or one-time codes with anyone who calls you claiming to be from a practice; use the contact details you already have.

What to have within reach

Pharmacy details matter more than people expect. In New York, practitioners have been required to prescribe both controlled and non-controlled substances electronically since March 27, 2016, with some exceptions. If your pharmacy is wrong or closed, the prescription goes to the wrong place. If you have had trouble finding a medication in stock, the guide to what to do if your pharmacy is out of ADHD medication has practical steps. For a full medication history template, see how to prepare your medication history.

Controlled medications by telehealth

If you take a stimulant, a benzodiazepine or another controlled medication, ask your prescriber how telehealth rules apply to you. Under federal law, prescribing controlled substances by telemedicine has generally required at least one in-person evaluation, with exceptions; temporary flexibilities that allow prescribing by audio-video telemedicine have been extended through December 31, 2026. What replaces them after that date has not been finalized, so ask your prescriber whether any in-person visits may be needed and how they would handle a change. Do not stop a controlled medication abruptly because of uncertainty about the rules; talk to your prescriber first.

If the connection drops

Agree on a plan in the first minute of the visit. A simple version:

1. Confirm the phone number where you can be reached.
2. If video freezes, both of you try rejoining the same link once.
3. If that fails, the clinician calls your phone to finish by audio or to reschedule.
4. If you cannot reconnect at all, contact the office through the usual channel the same day so prescriptions and follow-up are not missed.

Audio-only can be a reasonable backup for part of a visit, but it is not always a full substitute. Ask whether the practice allows it and in which situations.

Safety during a telehealth visit

At the start of the visit, your clinician may ask for your exact location and an emergency contact. This is routine. If something urgent comes up, the clinician needs to know where you are to get help to you.

Telehealth visits are scheduled care. They are not a crisis service, and messages sent through a portal may not be read right away.

If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room.

If you have had thoughts of suicide before, it can help to keep a written safety plan next to you during visits. The guide to safety planning for suicidal thoughts explains how one is built.

First visit or follow-up: what changes

A first telehealth psychiatry visit is usually longer and broader than later ones. Expect questions about your current symptoms, past diagnoses and treatments, medical history, substance use, family history and safety. Complete any intake forms before the day, since filling them in during the visit uses up clinical time. Have your ID ready, and if you are seeking out-of-network reimbursement, have your insurance details at hand.

Follow-up visits are more focused: how you are responding, side effects, sleep, appetite, any safety concerns, and whether to continue, adjust or change a plan. A quick note of what has changed since the last visit, including new medications from other clinicians, makes these visits more useful. The guide to ongoing medication management describes how often follow-ups typically happen and what gets monitored.

Telehealth for teens and for family members helping out

For a teenager, the setup matters even more. Make sure the teen has a private space for the part of the visit they spend alone with the clinician, and agree beforehand which parts a parent will join. Parents should keep the pharmacy, insurance and medication details ready for their part of the visit.

If an adult family member helps someone with telehealth, the helper can handle the technology and then step out unless the patient wants them there. Ask the clinician how they prefer to involve family, and what consent they need before sharing information.

Common telehealth mistakes

• Logging in from a vacation or work trip in a state where the clinician is not licensed.
• Joining from a shared office, a cafe or a room where family members can hear.
• Giving an old pharmacy address, so prescriptions go to the wrong place.
• Waiting until the last minute to open the link and discovering an app update is needed.
• Forgetting to mention new medications prescribed by another clinician.
• Using portal messages for urgent problems that need a phone call or emergency care.
• Ending the visit without confirming the next appointment or how refills will be handled.

Questions to ask the practice about telehealth

Most of the uncertainty in telehealth disappears if you ask a few questions before the first visit:

• Which platform do you use, and do I need to download anything or create an account?
• Which states can you see me in, and how do you confirm my location?
• What happens if the video connection fails partway through?
• Are any visits required in person, for example for controlled medications or physical checks?
• How do I send a non-urgent message, and how quickly is it usually answered?
• How are prescriptions sent, and what should I do if the pharmacy does not receive one?
• If I need an interpreter, captions or other accommodations, how do I arrange them?

Write the answers down and keep them with your appointment details. If an answer changes later, for example because federal rules on controlled medications change, ask the practice to tell you how it affects your care.

After the visit

• Check that any new prescription has reached your pharmacy, ideally the same day.
• Write down medication changes and the date of your next appointment.
• Download any visit summary or receipt from the patient portal.
• If you plan to seek out-of-network reimbursement, keep superbills together with your claim records.

If video visits are not working for you, it is reasonable to ask for in-person visits. The comparison in telehealth vs in-person psychiatry covers when each works better.

How the practice runs telehealth visits

Dr. Lewis sees patients in person in Brooklyn and by telehealth for patients physically located in a state where she holds an active medical license; the team confirms eligibility for your state before your first visit. A patient-doctor relationship is established only for New York, New Jersey and California residents, and out-of-state Health Strategy Sessions are educational. You can read about the practice's online psychiatry services and what to expect from an online visit, check your state on the service areas page, or start with the questions in questions to ask on a discovery call. The Choosing Psychiatric Care guide covers the rest of the path.

Frequently asked questions

Can I have my telehealth visit from my car?

A parked car can give you privacy, but never take a visit while driving. Make sure you have a stable connection and are in a state where your clinician is licensed.

Do I need to be in the same state as my psychiatrist?

With Dr. Lewis, what matters is where you are during the visit: she sees telehealth patients who are physically located in a state where she holds an active medical license, and the team confirms eligibility for your state before the first visit. Other practices may apply their own rules, so ask.

Can someone else be in the room during my visit?

Yes, if you want them there, for example a parent of a teen or a supportive partner. Tell your clinician at the start, and expect to have some time alone as well.

What if I'm traveling on the day of my appointment?

Contact the practice before the visit. Depending on where you will be, they may reschedule, adjust the visit or confirm whether they can see you there.

Is a phone-only appointment as good as video?

Audio-only can work for some follow-ups, but video gives your clinician more information. Ask your practice when audio-only is allowed and whether it affects billing or insurance reimbursement.

Can I record my telehealth visit?

Ask first. Practices have different policies, and taking written notes or asking for a visit summary is often simpler.

Sources

1. Notice of Expiration of Certain Notifications of Enforcement Discretion Issued in Response to the COVID-19 Nationwide Public Health Emergency (FR Doc. 2023-07824). HHS Office for Civil Rights, Federal Register, 2023. federalregister.gov
2. Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications (FR Doc. 2025-24123). Drug Enforcement Administration and Department of Health and Human Services, Federal Register, 2025. federalregister.gov
3. Electronic Prescribing. New York State Department of Health, Bureau of Narcotic Enforcement, 2026. health.ny.gov

Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.