Washington Administrative Code

The purpose of WAC 246-808-301 through 246-808-720 is to provide standards of care to guide the practitioner of chiropractic in the conduct of their practice.[Statutory Authority: Chapter 18.25 RCW. WSR 96-16-074, § 246-808-301, filed 8/6/96, effective 9/6/96.]

A chiropractor shall comply with the provisions of the Federal Health Insurance Portability and Accountability Act, 42 U.S.C. Sec. 1302(a) and 42 U.S.C. Sec. 1302d-1320d-9, the Health Information Portability and Accountability Act (HIPAA), 45 C.F.R. Parts 160, 162, and 165.[Statu…

If a chiropractor chooses to discontinue care, the chiropractor shall:(1) Advise the patient in writing and document in the patient record that the chiropractor is terminating the doctor-patient relationship; and(2) Advise the patient to seek any future treatment from another chi…

In difficult or protracted cases consultations are advisable, and the chiropractor shall be ready to act upon any desire the patient may express for a consultation, even though the chiropractor may not personally feel the need for it.[Statutory Authority: Chapter 18.25 RCW. WSR 9…

A chiropractor shall not aid a patient in the pretense or the concealment of a physical condition or disability.[Statutory Authority: RCW 18.25.0171 and 18.130.050. WSR 19-13-081, § 246-808-350, filed 6/17/19, effective 7/18/19. Statutory Authority: Chapter 18.25 RCW. WSR 96-16-0…

The health and welfare of the patient shall always be paramount.(1) A chiropractor owes their patient(s) the highest degree of skill and care.(2) Absolute honesty shall characterize all transactions with patients.(3) A chiropractor shall act in the best interest of the patient an…

A chiropractor shall safeguard their profession by exposing those who practice without proper credentials. This is in addition to mandatory reporting rules adopted by the secretary of health.[Statutory Authority: RCW 18.25.0171 and 18.130.050. WSR 19-13-081, § 246-808-390, filed …

(1) A chiropractor shall not enter into an agreement for, charge, or collect an illegal or clearly excessive fee.(2) A fee is clearly excessive when, after a review of the facts, a chiropractor would be left with a definite and firm conviction that the fee is in excess of a reaso…

(1) Procedures, instruments for treatment and/or diagnostic evaluation used by a doctor of chiropractic shall be classified by the commission as follows:(a) "Approved": A procedure or instrument which is taught by a commission approved chiropractic college for patient clinical ap…

"Auxiliary services" means those services, excluding those practices which are restricted to licensed chiropractors, which may be needed for the support of chiropractic care."Auxiliary staff" means personnel, except regular senior students and clinical postgraduate trainees, who …

(1) When using their name, a licensed chiropractor must clearly identify oneself as a chiropractor on their office signs, website, business cards, letterhead, electronic and other media with the use of one or more of the following: Doctor of chiropractic; D.C.; D.C., Ph.C.; chiro…

(1) A licensed chiropractor may delegate certain services to auxiliary staff, regular senior students, and clinical postgraduate trainees, if these services are performed under the licensed chiropractor's direct supervision and control. The supervising chiropractor shall be respo…

A doctor of chiropractic may bill for all provided services that are allowable under chapter 18.25 RCW and the rules adopted pursuant to the foregoing statute. The doctor shall utilize codes and/or descriptions of services that accurately describe the professional services render…

The following acts shall constitute grounds for which disciplinary action may be taken:(1) Rebating or offering to rebate to an insured any payment to the licensee by the third-party payor of the insured for services or treatments rendered under the insured's policy.(2) Submittin…

It shall be considered unprofessional conduct for any chiropractor to enter into a contract which would obligate a patient to pay for care to be rendered in the future, unless the contract provides that the patient is entitled to a complete refund for any care not received.[Statu…

A doctor of chiropractic must keep complete and accurate documentation on all patients and patient encounters. This documentation is necessary to protect the health, well-being and safety of the patient.(1) The patient record must detail the patient's clinical history, the ration…

The following requirements for chiropractic X-ray have been established because of concerns about over radiation and unnecessary X-ray exposure.(1) The following shall appear on the films:(a) Patient's name and age;(b) Doctor's name, facility name, and address;(c) Date of study;(…

The physical examination to determine the necessity for chiropractic care does not include vaginal (pelvic) examination or prostate examination. Chiropractors are prohibited from performing such examination and from directing any agent or employee to perform such examination.[Sta…

It shall be considered unprofessional conduct for a chiropractor to perform an adjustment of the coccyx through the vagina unless the following conditions are met:(1) The coccyx cannot be adjusted rectally or the patient is offered and declines the option of the rectal technique;…

No chiropractor shall:(1) Employ the use of needles in the treatment of a patient; or(2) Hold himself or herself out as practicing acupuncture in any form: This prohibition shall not restrict a chiropractor who is also a certified acupuncturist pursuant to chapter 18.06 RCW from …

All offers of free X-rays shall be accompanied by a disclosure statement that X-rays shall only be taken if clinically necessary in order to avoid unnecessary radiation exposure.[Statutory Authority: Chapter 18.25 RCW. WSR 96-16-074, § 246-808-585, filed 8/6/96, effective 9/6/96.…

(1) The following definitions apply throughout this section unless the context clearly requires otherwise.(a) "Patient" means a person who is receiving health care or treatment, or has received health care or treatment without a termination of the health care provider-patient rel…

(1) A chiropractor shall not, on behalf of himself/herself, his/her partner, associate or any other chiropractor affiliated with his/her office or clinic, use or allow to be used, any form of public communications or advertising which is false, fraudulent, deceptive or misleading…

(1) If a chiropractor advertises a fee for a service, the chiropractor must render that service for no more than the fee advertised.(2) Unless otherwise specified in the advertisement, if a chiropractor publishes any fee information authorized under chapter 246-808 WAC, the chiro…

A chiropractor shall not compensate or give anything of value to representatives of the press, radio, television or other communication media in anticipation of or in return for professional publicity of any individual chiropractor in a news item.[Statutory Authority: Chapter 18.…

In his/her use of professional notices, letterheads, cards, and mailings, a chiropractor is subject to the same regulations of chapter 246-808 WAC which apply to his/her use of other print media.[Statutory Authority: Chapter 18.25 RCW. WSR 96-16-074, § 246-808-615, filed 8/6/96, …

A chiropractor who has given in-person, unsolicited advice to a lay person that he/she should obtain chiropractic care shall not accept employment resulting from that advice except that:(1) A chiropractor may accept employment by a close friend, relative, former patient (if the a…

(1) Public testimonial advertising includes the use of a statement testifying as to a chiropractor's qualifications, abilities and character, or to the value of chiropractic services.(2) The use of testimonial advertising shall not be considered false or misleading if the followi…

(1) This rule shall apply to all representations made in public advertising regarding the provision of chiropractic services, including X-rays or chiropractic examinations, on a free basis or at a reduced cost. This rule shall also apply to all billings or other written or oral c…

(1) Any chiropractor who treats patients in the state of Washington shall maintain all treatment records regarding patients treated. These records may include, but shall not be limited to, X-rays, treatment plans, patient charts, patient histories, correspondence, financial data,…

Any chiropractor who ceases practice in their community for any reason, including retirement, illness, disability, or relocation shall comply with the following duties:(1) The chiropractor shall notify all current patients that they shall not be able to provide chiropractic servi…

(1) All reports required by these regulations shall be submitted to the commission as soon as possible, but no later than sixty days after a determination is made.(2) A report shall contain the following information if known:(a) The name, address, and telephone number of the pers…

The president or chief executive officer of any chiropractic association or society within this state shall report to the commission when an association or society determines that a chiropractor has committed unprofessional conduct or that a chiropractor may not be able to practi…

The executive officer of every insurer, licensed under Title 48 RCW operating in the state of Washington, shall report to the commission any evidence that a chiropractor has charged fees for chiropractic services not actually provided, or has otherwise committed unprofessional co…

Every institution or organization providing professional liability insurance directly or indirectly to chiropractors shall send the commission a complete report of any malpractice settlement, award or payment over thirty thousand dollars as a result of a claim or action for damag…

The commission requests the assistance of all clerks of trial courts within the state to report to the commission, all professional malpractice judgments and all criminal convictions of licensed chiropractors, other than for minor traffic violations.[Statutory Authority: Chapter …

The commission requests the assistance of executive officers of any state or federal program operating in the state of Washington, under which a chiropractor has been judged to have demonstrated incompetence or negligence in the practice of chiropractic, or has otherwise committe…

Members of the commission shall not participate in deciding a case or in rule making where their participation presents a conflict of interest, creates an appearance of a conflict of interest or where the commission determines the member's participation raises questions as to the…

The commission recognizes the need to establish a means of proactively providing early recognition and treatment options for chiropractors whose competency may be impaired due to the abuse of drugs or alcohol. The commission intends that such chiropractors be treated and their tr…

The following general terms are defined within the context used in this chapter:"Aftercare" is that period of time after intensive treatment that provides the chiropractor and the chiropractor's family with group or individual counseling sessions, discussions with other families,…

The commission shall approve the monitoring program(s) which shall participate in the commission's substance abuse monitoring program. A monitoring program approved by the commission may be contracted with an entity outside the department but within the state, out-of-state, or a …

(1) In lieu of disciplinary action, the chiropractor may accept commission referral into the approved substance abuse monitoring program.(a) The chiropractor shall undergo a complete physical and psychosocial evaluation before entering the approved monitoring program. This evalua…

(1) Licenses and registrations must be renewed on the practitioner's birthday every year as provided in chapter 246-12 WAC.(2) The following nonrefundable fees will be charged for chiropractic licensure:Title of FeeFeeOriginal application Application$625.00 Jurisprudence examinat…

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Associate" means a prelicensure candidate who is working towards full licensure in their profession, has a graduate degree in a mental health field under RCW 18.225.09…

(1) The definition in this subsection applies throughout this section unless the context clearly requires otherwise. The term "licensure candidate" means an individual seeking supervised experience to fulfill requirements for a license. This includes the following individuals who…

(1) The licensed counselor or associate providing professional services to a client or providing services billed to a third-party payor, must document services, except as provided in subsection (2) of this section. The documentation includes:(a) The following business information…

As required by chapter 26.44 RCW, all licensed counselors and associates shall immediately report abuse or neglect of a child if the counselor has reasonable cause to believe that an incident has occurred.As required by chapter 74.34 RCW, all licensed counselors and associates mu…

The definitions and prohibitions on sexual misconduct described in WAC 246-16-100 apply to licensed counselors and associates, except a licensed counselor or associate shall never engage, or attempt to engage, in the activities listed in WAC 246-16-100 (1) and (2) with a current …

All reports required by this chapter shall be submitted to the department as required by chapter 246-16 WAC, but no later than twenty days after a determination is made.[Statutory Authority: RCW 18.225.040. WSR 17-13-082, § 246-809-060, filed 6/16/17, effective 7/17/17. Statutory…

(1) Effective October 1, 2023, the licensed counselor supervisor directory (directory) is established.(2) The purpose of the directory is to facilitate placement of associates seeking supervision with eligible providers or facilities for postgraduate supervision as required by WA…