Practice Management Software for Therapists & Coaches in Washington

Washington licensing boards for therapists

The Washington State Department of Health (DOH) issues all four core mental health licenses, each with its own advisory committee or board.

License	Where to apply and renew	Source
LMHC (licensed mental health counselor)	DOH mental health counselor program	DOH mental health counselor
LICSW, LASW (social workers)	DOH social worker program	DOH social worker
Licensed psychologist	DOH and the Examining Board of Psychology	DOH psychologist
LMFT	DOH marriage and family therapist program	DOH marriage and family therapist

Washington titles its independent clinical social work license the LICSW (licensed independent clinical social worker), listed on the DOH social worker page above.

How Prexella stores this. Enter your DOH credential number, individual NPI, any group NPI, EIN and taxonomy code once in Prexella's billing settings. Each superbill prints them alongside the CPT, ICD-10 and place-of-service codes, so clients do not come back asking for a missing license number.

Telehealth: training, PSYPACT and the Counseling Compact

Washington treats telehealth as happening where the client is. The DOH telehealth resources page says a practitioner may treat a patient located in Washington only within their Washington scope of practice, and that a provider-client relationship may not be established by email, text or fax alone.

• Telemedicine training is mandatory. Since January 1, 2021, RCW 43.70.495 has required licensed professionals other than physicians who provide clinical services by telemedicine to complete training on state and federal law, liability and informed consent, and to sign an attestation (DOH interpretive statement).
• PSYPACT: yes. The 2022 legislature passed SHB 1286, which allowed Washington to join PSYPACT. DOH's psychologist page says anyone treating a client located in Washington needs a Washington license, a temporary permit, or active PSYPACT participation, with no other exceptions (DOH psychologist).
• Counseling Compact: member. Washington appears on the Counseling Compact member map. Check the compact's site for when privileges to practice are issued.

How Prexella's telehealth calendar handles it. Clients pick telehealth or in office at booking, the visit type stays on the session, and the superbill uses your default telehealth place-of-service code (10 or 02) for video visits and 11 for the office. Prexella has no separate client-location field, so confirm and note the client's location at the start of each video session; Washington's rules depend on it.

Washington insurers and cash-pay rates

Washington's commercial market is shared between the Blue plans, Kaiser and Medicaid-focused carriers. KFF's 2024 data (large group, small group, individual) puts these five among the three largest in at least one market:

1. Premera Blue Cross: 35% of large group, 24% of small group
2. Kaiser Permanente: 32% of large group, 20% of small group
3. Cambia Health Solutions (Regence BlueShield): 49% of small group, 18% of large group
4. Centene (Coordinated Care / Ambetter): 29% of the individual market
5. Molina Healthcare: 15% of the individual market

The Office of the Insurance Commissioner publishes its own premium-based market share tables, which show Molina leading the individual and "other" segment (OIC market share).

Washington cash-pay rates are among the highest in the country: a 2026 estimate puts the average private-pay session at $200 (TherapyExplained, March 2026), compared with a $139 national average in SimplePractice's 2023–2024 session data (SimplePractice).

E-signatures and records retention in Washington

E-signatures. Washington's Uniform Electronic Transactions Act is chapter 1.80 RCW; RCW 1.80.060 gives electronic records and signatures legal recognition. Prexella's e-signatures capture the consent statement, typed name, drawn signature, time, IP address and browser for every signed form.

Records retention. WAC 246-809-035 requires licensed counselors to keep all client records for five years following the last visit, and to plan for records if the practice closes or the counselor dies or becomes incapacitated. Psychologists follow minimum retention periods in WAC 246-924-354. Prexella keeps records in your practice's database until you remove them, which makes a documented succession plan simpler: the records are in one place.

Setting up a Washington practice in Prexella

A Washington-specific setup checklist, drawn from the rules above:

1. Telemedicine attestation on file. Keep your RCW 43.70.495 training attestation with your practice records before the first video session; Prexella's telehealth calendar assumes you are cleared to see clients by video.
2. Default telehealth place of service. Choose 10 (client at home) or 02 (elsewhere) in billing settings so every video session's superbill carries the right code for Premera, Regence or Kaiser claims.
3. Credential and identifiers. Enter your DOH credential number, NPI and EIN once; LICSWs, LMHCs and LMFTs all print the same way on superbills.
4. Telehealth consent and informed consent forms. Send them from the Forms tab so they are e-signed in the portal before session one, with the audit trail RCW 1.80 gives legal effect.
5. A five-year record plan. Counselors must keep records five years after the last visit under WAC 246-809-035. Decide who will hold the Prexella account if the practice closes or you become unavailable, as the rule asks you to plan for.
6. Compact status check. If you hold PSYPACT authority or later a Counseling Compact privilege, note which states your video clients are in; Prexella does not track client location for you.

Practices that follow this list start their first week with forms signed, superbills coded and the telehealth rules covered.

Washington professional associations

• NASW Washington Chapter
• Washington Mental Health Counselors Association
• Washington State Psychological Association

Washington metro pages

See how telehealth scheduling and the client portal work, compare Prexella vs Jane App, or request a demo. Moving from another system? Read how to switch.

Sources verified 10/10/2026.