What Is Telehealth Counseling?
Telehealth counseling is counseling by live video or by phone, with a licensed professional who is somewhere else. People also call it online therapy or virtual counseling. The National Institute of Mental Health says of care by video call or phone: “This approach to care is often called telehealth or telemedicine.”
Ohio law has its own definition. Section 4743.09 of the Ohio Revised Code defines telehealth services as “health care services provided through the use of information and communication technology by a health care professional” who is at a different site from the patient.
Ohio’s Counselor, Social Worker and Marriage and Family Therapist Board uses the word teletherapy. Its teletherapy rule, in effect since July 1, 2024, defines it as “the use of real-time audio or audiovisual communications that permit accurate and meaningful interaction between at least two persons”. The rule counts phone, video, text, email and chat.
Two parts of these rules matter to a new client:
- The standard is the same as in the office. The statute says each board’s rules “shall establish a standard of care for telehealth services that is equal to the standard of care for in-person services.”
- Counseling can start online. The board’s rule says “No initial in person or face to face audiovisual visit is necessary to initiate services using teletherapy modalities.”
A provider can still decide telehealth is the wrong fit. The statute says “A health care professional may deny a patient telehealth services and, instead, require the patient to undergo an in-person visit.”
What Do You Need for an Online Counseling Session?
The federal government’s telehealth site gives a short answer on what you need: “For most telehealth visits, you need a device that has video and sound. This could be a computer, smartphone, or tablet.”
If you have none of those, the same page says to “ask your health care provider if you can have a phone call for your telehealth visit.”
You also need a private place. The U.S. Department of Health and Human Services, in its privacy tips for telehealth patients, advises: “Find a place away from others (like a private room with a door or your parked car) where you can control who hears or sees your conversation.” If you cannot find one, it suggests wearing headphones and turning your screen away from other people. It also advises against public Wi-Fi networks.
Privacy is part of Ohio’s rule too. A counselor “shall not provide teletherapy when either the client or licensee is in a setting where the confidentiality of the session could reasonably be expected to be compromised.” Expect to be asked where you are, because the rule requires counselors to “confirm the client(s) location at the time services are rendered.”
Who Can Provide Telehealth Counseling to Someone in Ohio?
Ohio’s telehealth statute lists the licensed professionals who may provide their services by telehealth. For counseling and behavioral health, the list includes:
- psychologists
- professional clinical counselors
- independent social workers
- independent marriage and family therapists
- independent chemical dependency counselors
- physicians and advanced practice registered nurses
Where you are during the session decides which state’s rules apply. The federal telehealth site’s page on licensure compacts puts it this way: “A telehealth appointment occurs in the state where the patient is located at the time of the appointment.”
Ohio’s board rule follows the same idea: “All licensees and registrants providing services via teletherapy to persons physically present in Ohio shall be licensed in Ohio.” So an Ohio license is the thing to look for when you choose a counselor or social worker.
The rule works in the other direction as well. When a client is outside Ohio, an Ohio licensee must follow the laws of the place where the client is. If you plan to join a session while traveling, ask your counselor first.
Can an Out-of-State Therapist Treat an Ohio Resident?
Sometimes. Ohio has enacted three interstate compacts into state law:
- the Counseling Compact, for professional counselors
- the Social Work Licensure Compact, for social workers
- the Psychology Interjurisdictional Compact, known as PSYPACT, for psychologists
A compact is an agreement among states that sets terms for a professional licensed in one member state to practice in another. Taking part is up to each provider. In the federal site’s words, “Provider participation in a compact is voluntary.” Ask an out-of-state therapist which Ohio license or compact authorization they hold before you start.
How Do You Check a License?
The board’s For the Public page is where you can “Verify your therapist’s license, learn about your rights, and more.” The teletherapy rule also requires each licensee to “provide a link to the board online license verification site on their web page.”
Does Insurance Cover Online Therapy in Ohio?
Ohio law addresses this directly. Section 3902.30 of the Ohio Revised Code, in its current form since March 23, 2022, says:
- “A health benefit plan shall provide coverage for telehealth services on the same basis and to the same extent that the plan provides coverage for the provision of in-person health care services.”
- “A health benefit plan shall not exclude coverage for a service solely because it is provided as a telehealth service.”
The same section limits what you pay. A plan “shall not impose a cost-sharing requirement for telehealth services that exceeds the cost-sharing requirement for comparable in-person health care services.” Cost sharing is the part of the bill you pay yourself, such as a copayment or a deductible.
The law ties telehealth coverage to what your plan covers in person. Your plan’s own terms still decide which services are covered and what you pay.
Some coverage falls outside this statute. Ohio’s definition of a health benefit plan leaves out “coverage under a plan through medicare, medicaid, or the federal employees benefit program”. Medicaid’s telehealth rules are in the next section.
Ohio law also limits extra fees. Under section 4743.09, a professional who provides telehealth may not charge you or your plan “a facility fee, an origination fee, or any fee associated with the cost of the equipment used at the provider site to provide telehealth services.”
Before the first session, call the number on your insurance card. Ask whether the provider and the service are covered by telehealth, and what your share will be. Your counselor should raise it too: the board’s rule says informed consent “should include a discussion of how teletherapy may affect billing and access to insurance benefits.”
Does Ohio Medicaid Cover Online Counseling?
Yes, for services that are medically necessary. Section 5164.95 of the Ohio Revised Code tells the Ohio Department of Medicaid to set payment standards for telehealth services. The department did that in rule 5160-1-18, and the current version took effect on January 1, 2026.
The rule lists the services Ohio Medicaid pays for by telehealth. Two entries cover counseling. One is mental health or substance use disorder services described as psychotherapy. The other is “behavioral health services covered under Chapter 5160-27 of the Administrative Code”, the chapter of Medicaid rules for behavioral health providers.
The rule also names who may provide telehealth to Medicaid members. The list includes psychologists, licensed independent social workers, licensed professional clinical counselors and licensed independent chemical dependency counselors.
One provision applies to long-term telehealth. When a practitioner serves someone by telehealth for more than twelve consecutive months, the rule expects that practitioner to hold one in-person visit a year or to refer the person for one.
The rule does not say that a given provider or program is covered for you. That depends on your plan and on what is medically necessary in your case. Leora accepts every Ohio Medicaid plan, and the Ohio Medicaid page lists them.
How Is Your Privacy Protected in Online Counseling?
Federal privacy law covers a video session as it covers an office visit. HIPAA is the Health Insurance Portability and Accountability Act of 1996. The federal telehealth site’s page on data and privacy says: “HIPAA rules keep your paper and digital medical histories private, including what you share during telehealth visits.”
Ohio adds its own requirements. Section 4743.09 says a professional “shall ensure that any username or password information and any electronic communications between the professional and a patient are securely transmitted and stored.”
Community mental health and addiction services providers have further duties under section 5119.368 of the Ohio Revised Code, as amended effective September 30, 2025:
- Before telehealth starts, the provider must describe its risks to you, including “Confidentiality for individual and group counseling”, and record that you agreed.
- The provider must have a plan for technical problems.
- The provider must give you “written information on how to access assistance in a crisis, including one caused by equipment malfunction or failure.”
- A video session begins with a check of who you are, “through a name and password or personal identification number”.
Recording is covered as well. The board’s rule says its licensees “shall document permission prior to recording any part of the teletherapy session.”
What Cannot Be Done by Telehealth?
A telehealth session is scheduled care, and an emergency cannot wait for one. If you or someone near you is in immediate danger, call 911. For a suicide or mental health crisis, call or text 988, the 988 Suicide and Crisis Lifeline.
Some care needs you in the building. At Leora, ambulatory detox takes place on site only, at the Columbus and Dayton facilities.
A provider can also decide that telehealth does not suit your situation. Ohio’s board rule says a counselor “is under no obligation to provide services via teletherapy if their clinical judgement indicates teletherapy is not an appropriate modality”. The rule also tells counselors to keep reviewing whether teletherapy is meeting your needs.
How Telehealth Works at Leora Behavioral Health
Leora Behavioral Health is an outpatient provider with facilities in Columbus and Dayton. The program it runs online is a virtual intensive outpatient program, or virtual IOP. An intensive outpatient program is a set weekly schedule of group and individual sessions, so it asks for more of your week than a single appointment does.
What to know about virtual IOP at Leora:
- It is fully remote and runs by telehealth.
- It is available anywhere in Ohio.
- A daytime program is for mental health, and an evening program is for substance use.
- Admissions can tell you the session times.
For a sense of scale, Leora’s in-person intensive outpatient program meets 3 to 5 days a week, for 3 hours a day. The virtual program has its own schedule, which admissions can give you.
Leora accepts every Ohio Medicaid plan and every commercial insurance carrier. The Ohio Medicaid page and the insurance page have the details. Leora is CARF accredited and LegitScript certified.
To ask about virtual IOP, call admissions in Columbus or Dayton. Each facility’s admissions number is on this page. Have your insurance card with you, and admissions can check your coverage during the call.
If you are looking for a single online appointment each week, two neutral places to search are FindTreatment.gov and your insurance plan’s provider directory. SAMHSA describes FindTreatment.gov as “The confidential and anonymous resource for persons seeking treatment for mental and substance use disorders in the United States and its territories.”
What to Do Next
If you want a structured program you can attend from home, call Leora admissions and ask about virtual IOP. Admissions can check your coverage and tell you the session times.
If you want one online session a week with a counselor, search FindTreatment.gov or your plan’s directory. Then check the counselor’s Ohio license with the state board before your first session.
