How to Choose a Covering Therapist: 9 Questions to Ask Before Anyone Sees Your Clients

Why "I'll just ask a colleague" is harder than it sounds

For most private practice clinicians, coverage starts with a text to a trusted peer. The trouble is that the people you trust are often full. In the American Psychological Association's 2024 Practitioner Pulse Survey of 853 psychologists, 53% had no openings for new patients, and 34% did not accept any form of health insurance.

So the colleague you would naturally call may have no room, may not be licensed where your telehealth clients live, or may not take your clients' insurance. That is why it helps to know exactly what you are looking for before you start asking. And coverage does not have to look the same for every client: Headway's leave planning guide notes that some clients see an interim therapist while others may pause therapy, depending on their needs.

The 9 questions to ask a covering therapist

1. Are you licensed where each of my clients is located?

This is the first filter, and the one that rules out the most people. Clinicians practice under the rules of the state where the client is located, including over telehealth, so a covering therapist needs a license or a valid compact privilege for every client's state (Triad, August 2026; PRMS risk management guidance).

Interstate compacts are changing what is possible, but unevenly:

• Counselors. As of October 2026, the Counseling Compact is issuing privileges to practice for licensees in 10 states: Arizona, Arkansas, Georgia, Indiana, Louisiana, Minnesota, Ohio, Oklahoma, Tennessee and Wyoming. Another 29 states and the District of Columbia are completing readiness steps.
• Psychologists. Under PSYPACT, an Authority to Practice Interjurisdictional Telepsychology allows telepsychology across participating states, and an ASPPB E.Passport is a prerequisite (PSYPACT). Temporary in person practice is capped at 30 calendar days a year (ASPPB).
• Social workers. The Social Work Licensure Compact was activated in 2024 and about 30 states have enacted it, but as of April 2026 multistate licenses were not yet being issued (Agents of Change).

Make a list of every state your current clients live in, then ask the covering therapist to confirm each one.

2. Do you work with the people on my caseload?

A great clinician can still be the wrong fit. Risk management guidance from PRMS advises covering clinicians to consider whether they can manage the colleague's patient population, giving children and eating disorders as examples. Ask about the age groups, presenting concerns and modalities your clients rely on, and where the covering therapist would refer if something falls outside their scope.

3. Do you work with the insurance my clients use?

A plan's network is the set of providers it has contracted with (HealthCare.gov). With a third of psychologists accepting no insurance at all, it is worth asking early whether the covering therapist is in network with your clients' plans. If not, agree on how clients will pay before anyone books a session. PRMS also suggests confirming payment arrangements for managed care clients ahead of time.

4. What exactly are you covering?

"Coverage" can mean very different things. Blueprint's guide separates two common models: crisis consultation only, or full clinical coverage with regular sessions. It suggests a simple coverage agreement, often a single page, covering scope, contact protocols, documentation, whether coverage is reciprocal or paid, and what client information will be shared and when.

5. What client information will you need, and how will we share it?

Under HIPAA, a covered provider may disclose protected health information for another provider's treatment activities without the client's authorization, and the minimum necessary standard does not apply to those treatment disclosures (HHS). Psychotherapy notes are different: disclosing them generally requires the client's authorization, even to another treating provider (HHS).

In practice, that means you can usually share what the covering therapist needs to treat safely, such as diagnosis, treatment plan, current symptoms, risk history and medications, while your separate process notes stay with you. If you are unsure what your state or licensing board expects, ask your board or your liability carrier's risk management line.

6. Who will clients contact after hours, and for what?

Blueprint recommends offering every client the covering clinician's contact information, while noting most lower acuity clients will never use it. It is mainly for clients with active safety concerns or significant instability, and it should be the covering therapist's professional contact details, for genuine emergencies rather than scheduling questions.

PRMS adds the other half: tell the covering clinician which clients you are most concerned about and when you want to be contacted. Every plan should also name the 988 Suicide and Crisis Lifeline and 911 for emergencies.

7. Where will your notes live while I am away?

Decide this before day one. PRMS guidance suggests the covering clinician log every call with your clients and with third parties about them. It also notes a covering clinician does not necessarily need to open a full chart for clients who are not theirs, and can keep notes of each interaction in a separate administrative file, sending copies to you when you return.

8. Does your malpractice policy cover this work?

PRMS describes covering for a colleague as generally low risk when the handoff is thorough. Still, ask the covering therapist to confirm with their own carrier that the arrangement is covered. In a Counseling Today article on shared practice arrangements, the executive director of the ACA Insurance Trust recommended that each counselor carry an individual policy and that colleagues carry the same limits, because courts may look to the policy with the highest limits to pay a claim.

9. How will clients pay you, and how will they come back to me?

Settle the money and the ending at the start. Will the covering therapist bill clients directly, or is the arrangement reciprocal? And how will clients return to you? Headway recommends a warm handoff, where you personally introduce the client to the interim therapist, so plan the return with the same care. For absences longer than two weeks, PRMS also suggests deciding who handles correspondence and requests that are not clinical.

The one page checklist

Copy this into your coverage agreement or your notes from the first call.