Washington Administrative Code
2022 Archive

Chapter 246-919 WAC
Last Update: 10/25/22

WASHINGTON MEDICAL COMMISSION
PDF of Chapter Digest
WAC Sections
246-919-010Definitions.
246-919-020Commission address.
246-919-110Commission meetings.
APPLICATIONS AND EXAMINATIONS
246-919-300Application withdrawals.
246-919-320Approved United States and Canadian medical schools.
246-919-330Postgraduate medical training.
246-919-340Additional requirements for international medical school graduates.
246-919-345Limited physician and surgeon clinical experience license.
246-919-355Examination accepted by the commission.
246-919-360Examinations accepted for licensure.
246-919-365FLEX examination standards.
246-919-370Special purpose examination.
246-919-395Substantially equivalent licensing standardsTemporary practice permit.
246-919-396Background checkTemporary practice permit.
246-919-397How to obtain a temporary practice permitMilitary spouse.
RENEWAL AND CME REQUIREMENTS
246-919-421Two year renewal cycle.
246-919-422Transition from post-graduate limited license to full license.
246-919-430Requirements for maintenance of licensure.
246-919-435Training in suicide assessment, treatment, and management.
246-919-460Categories of creditable continuing medical education activities.
246-919-470Approval not required.
246-919-475Expired license.
246-919-480Retired active license.
ADJUDICATIVE PROCEDURES
246-919-520Revocation of a physician's license.
OFFICE-BASED SURGERY RULES
246-919-601Safe and effective analgesia and anesthesia administration in office-based surgical settings.
246-919-602Administration of deep sedation and general anesthesia by physicians in dental offices.
STANDARDS FOR PROFESSIONAL CONDUCT
246-919-605Use of laser, light, radiofrequency, and plasma devices as applied to the skin.
246-919-606Nonsurgical medical cosmetic procedures.
246-919-610Use of drugs or autotransfusion to enhance athletic ability.
246-919-620Cooperation with investigation.
246-919-630Sexual misconduct.
246-919-640Abuse.
MANDATORY REPORTING
246-919-700Mandatory reporting.
OPIOID PRESCRIBINGGENERAL PROVISIONS
246-919-850Intent and scope.
Physicians
246-919-851Exclusions.
246-919-852Definitions.
246-919-865Patient notification, secure storage, and disposal.
246-919-870Use of alternative modalities for pain treatment.
246-919-875Continuing education requirements for opioid prescribing.
OPIOID PRESCRIBINGACUTE NONOPERATIVE PAIN AND ACUTE PERIOPERATIVE PAIN
246-919-880Patient evaluation and patient recordAcute nonoperative pain.
246-919-885Treatment planacute nonoperative pain.
246-919-890Treatment planAcute perioperative pain.
OPIOID PRESCRIBINGSUBACUTE PAIN
246-919-895Patient evaluation and patient recordSubacute pain.
246-919-900Treatment planSubacute pain.
OPIOID PRESCRIBINGCHRONIC PAIN MANAGEMENT
246-919-905Patient evaluation and patient recordChronic pain.
246-919-910Treatment planChronic pain.
246-919-915Written agreement for treatmentChronic pain.
246-919-920Periodic reviewChronic pain.
246-919-925Long-acting opioidsChronic pain.
246-919-930ConsultationRecommendations and requirementsChronic pain.
246-919-935ConsultationExemptions for exigent and special circumstancesChronic pain.
246-919-940ConsultationExemptions for the physicianChronic pain.
246-919-945Pain management specialistChronic pain.
246-919-950Tapering considerationsChronic pain.
246-919-955Patients with chronic pain, including those on high doses of opioids, establishing a relationship with a new physician.
OPIOID PRESCRIBINGSPECIAL POPULATIONS
246-919-960Special populationsChildren or adolescent patients, pregnant patients, and aging populations.
246-919-965Episodic care of chronic opioid patients.
OPIOID PRESCRIBINGCOPRESCRIBING
246-919-970Coprescribing of opioids with certain medications.
246-919-975Coprescribing of opioids for patients receiving medication assisted treatment.
246-919-980Coprescribing of naloxone.
OPIOID PRESCRIBINGPRESCRIPTION MONITORING PROGRAM
246-919-985Prescription monitoring programRequired registration, queries, and documentation.
PHYSICIAN AND SURGEON FEES
246-919-990Physician and surgeon fees and renewal cycle.
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
246-919-030Current address. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-030, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-919-100Panel composition. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-100, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-120Appearance and practice before agency—Solicitation of business unethical. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-120, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-130Appearance and practice before agency—Standards of ethical conduct. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-130, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-140Appearance and practice before agency—Appearance by former member of attorney general's staff. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-140, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-150Appearance and practice before agency—Former employee and board/commission member as witness. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-150, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-200Petitions for rule making, amendment or repeal—Who may petition. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-200, filed 1/17/96, effective 2/17/96.] Repealed by WSR 96-19-042, filed 9/12/96, effective 10/13/96. Statutory Authority: RCW 18.71.017.
246-919-210Petitions for rule making, amendment or repeal—Requisites. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-210, filed 1/17/96, effective 2/17/96.] Repealed by WSR 96-19-042, filed 9/12/96, effective 10/13/96. Statutory Authority: RCW 18.71.017.
246-919-220Petitions for rule making, amendment or repeal—Agency must consider. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-220, filed 1/17/96, effective 2/17/96.] Repealed by WSR 96-19-042, filed 9/12/96, effective 10/13/96. Statutory Authority: RCW 18.71.017.
246-919-230Petitions for rule making, amendment or repeal—Notice of disposition. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-230, filed 1/17/96, effective 2/17/96.] Repealed by WSR 96-19-042, filed 9/12/96, effective 10/13/96. Statutory Authority: RCW 18.71.017.
246-919-240Declaratory rulings. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-240, filed 1/17/96, effective 2/17/96.] Repealed by WSR 96-19-042, filed 9/12/96, effective 10/13/96. Statutory Authority: RCW 18.71.017.
246-919-305Refunds. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-305, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-919-310Credentialing of physicians and surgeons. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-310, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-350Examinations. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-350, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-380AIDS prevention and information education requirements. [Statutory Authority: RCW 43.70.280. WSR 98-05-060, § 246-919-380, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-380, filed 1/17/96, effective 2/17/96.] Repealed by WSR 21-07-055, filed 3/12/21, effective 4/12/21. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-390Temporary permits—Recognized jurisdictions. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-390, filed 1/17/96, effective 2/17/96.] Repealed by WSR 17-18-098, filed 9/6/17, effective 10/7/17. Statutory Authority: RCW 18.71.017 and 18.130.075.
246-919-400Scope. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-400, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-919-410License renewal. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-410, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-919-420License renewal form. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-420, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-919-440Certification of compliance. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-440, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-919-450Categories of creditable continuing medical education activities. [Statutory Authority: RCW 18.71.017, 18.130.050(1), 18.130.040(4), 18.130.050(12) and 18.130.340. WSR 99-23-090, § 246-919-450, filed 11/16/99, effective 1/1/00. Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-450, filed 1/17/96, effective 2/17/96.] Repealed by WSR 16-16-028, filed 7/22/16, effective 8/22/16. Statutory Authority: RCW 18.71.002, 18.71.017, and 18.71.080.
246-919-500Brief adjudicative proceedings—Denials based on failure to meet education, experience, or examination prerequisites for licensure. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-500, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-09-118, filed 4/22/98, effective 5/23/98. Statutory Authority: RCW 18.71.017.
246-919-510Adjudicative proceedings. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-510, filed 1/17/96, effective 2/17/96.] Repealed by WSR 98-09-118, filed 4/22/98, effective 5/23/98. Statutory Authority: RCW 18.71.017.
246-919-600Prescriptions—Schedule II stimulant drugs. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-600, filed 1/17/96, effective 2/17/96.] Repealed by WSR 05-10-065, filed 5/2/05, effective 6/2/05. Statutory Authority: RCW 18.71.017.
246-919-615Delegation of authority to initiate investigations. [Statutory Authority: RCW 18.71.017, 18.71A.020, 18.130.050(12), 18.130.080. WSR 07-03-150, § 246-919-615, filed 1/23/07, effective 2/23/07.] Repealed by WSR 10-20-138, filed 10/5/10, effective 11/5/10. Statutory Authority: RCW 18.130.050(1), 18.71.017.
246-919-710Mandatory reporting requirement satisfied. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-710, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-720Health care institutions. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-720, filed 1/17/96, effective 2/17/96.] Repealed by WSR 03-20-109, filed 10/1/03, effective 11/1/03. Statutory Authority: RCW 18.71.017.
246-919-730Medical associations or societies. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-730, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-740Health care service contractors and disability insurance carriers. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-740, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-750Courts. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-750, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-760State and federal agencies. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-760, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-770Professional standards review organizations. [Statutory Authority: RCW 18.71.017 and 18.71A.020. WSR 96-03-073, § 246-919-770, filed 1/17/96, effective 2/17/96.] Repealed by WSR 20-22-003, filed 10/21/20, effective 11/21/20. Statutory Authority: RCW 18.71.017 and 18.130.050.
246-919-800Purpose. [Statutory Authority: RCW 18.71.017, 18.130.050(1) and (12) and 18.130.340. WSR 99-22-090, § 246-919-800, filed 11/2/99, effective 12/3/99.] Repealed by WSR 11-12-025, filed 5/24/11, effective 1/2/12. Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020.
246-919-810What specific guidance should a practitioner follow? [Statutory Authority: RCW 18.71.017, 18.130.050(1) and (12) and 18.130.340. WSR 99-22-090, § 246-919-810, filed 11/2/99, effective 12/3/99.] Repealed by WSR 11-12-025, filed 5/24/11, effective 1/2/12. Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020.
246-919-820What knowledge should a practitioner possess to treat pain patients? [Statutory Authority: RCW 18.71.017, 18.130.050(1) and (12) and 18.130.340. WSR 99-22-090, § 246-919-820, filed 11/2/99, effective 12/3/99.] Repealed by WSR 11-12-025, filed 5/24/11, effective 1/2/12. Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020.
246-919-830How will the commission evaluate prescribing for pain? [Statutory Authority: RCW 18.71.017, 18.130.050(1) and (12) and 18.130.340. WSR 99-22-090, § 246-919-830, filed 11/2/99, effective 12/3/99.] Repealed by WSR 11-12-025, filed 5/24/11, effective 1/2/12. Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020.
246-919-840How do advanced registered nurse practitioners qualify for prescriptive authority for Schedule II - IV drugs? [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-840, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-841Criteria for joint practice arrangement. [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-841, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-842Endorsement of joint practice arrangements for ARNP licensure. [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-842, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-843Process for joint practice arrangement termination. [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-843, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-844Seventy-two-hour limit. [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-844, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-845Education for prescribing Schedule II - IV drugs. [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-845, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-846Jurisdiction. [Statutory Authority: RCW 18.71.017 and 18.71.370. WSR 01-16-010, § 246-919-846, filed 7/19/01, effective 8/19/01.] Repealed by WSR 06-02-089, filed 1/4/06, effective 2/4/06. Statutory Authority: RCW 18.71.017 and 18.71.050.
246-919-853Patient evaluation. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-853, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-854Treatment plan. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-854, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-855Informed consent. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-855, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-856Written agreement for treatment. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-856, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-857Periodic review. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-857, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-858Long-acting opioids, including methadone. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-858, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-859Episodic care. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-859, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-860Consultation—Recommendations and requirements. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-860, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-861Consultation—Exemptions for exigent and special circumstances. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-861, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-862Consultation—Exemptions for the physician. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-862, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.
246-919-863Pain management specialist. [Statutory Authority: RCW 18.71.450, 18.71A.100, 18.71.017, and 18.71A.020. WSR 11-12-025, § 246-919-863, filed 5/24/11, effective 1/2/12.] Repealed by WSR 18-23-061, filed 11/16/18, effective 1/1/19. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297.