100+ Free BC-TMH Practice Questions

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A counselor wants to incorporate mindfulness practice in TMH. Which is the BEST approach?

Guide brief practices live, share recordings/resources, and integrate practice into homework

Avoid mindfulness because it requires a quiet office

Tell the client to figure it out alone

Use only third-party apps without integration

to track

Same family resources

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FREE NCE Study Guide 2026: 12-Week Plan + NBCC Format13 min read FREE NCMHCE Exam Guide 2026: 11 Case Studies, Pass Rate & Plan28 min read

2026 Statistics

Key Facts: BC-TMH Exam

120

TMHE Items

12 cases × 10 items (100 scored + 20)

3 hrs

Exam Time

CCE

$250

Total Cost

$100 exam + $150 application

988

Suicide Lifeline

Replaced 1-800-273-TALK 2022

CCE BC-TMH is the telemental health specialty credential for licensed MH providers. TMHE: 120 MCQ (12 cases × 10 items), 3 hours, $100 exam + $150 app. Master HIPAA BAA requirement (Doxy.me/Zoom for HC compliant; FaceTime/consumer NOT), PSYPACT for psychologists (39+ states), Counseling Compact, location verification at session start, Tarasoff in TMH, and 988 Suicide & Crisis Lifeline.

Sample BC-TMH Practice Questions

Try these sample questions to test your BC-TMH exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which document MUST a telemental health (TMH) provider have in place with their video platform vendor to maintain HIPAA compliance?

A.Business Associate Agreement (BAA)

B.Memorandum of Understanding (MOU)

C.End User License Agreement (EULA)

D.Service Level Agreement (SLA)

Explanation: HIPAA requires a Business Associate Agreement (BAA) with any vendor that creates, receives, maintains, or transmits PHI on behalf of a covered entity, including TMH platform providers.

2A counselor licensed only in Ohio receives a session request from a long-term client who has just moved to Florida and is now physically located in Tampa. What is the MOST appropriate action?

A.Provide the session because the therapeutic relationship was established in Ohio

B.Decline to provide TMH services unless the counselor is licensed in Florida or covered by an applicable compact

C.Provide the session and document Ohio as the client's location

D.Refer the client to the Ohio licensing board for guidance

Explanation: Jurisdiction is determined by where the client is physically located at the time of the session. The counselor must be licensed in Florida or operate under a recognized compact (e.g., Counseling Compact privilege) to provide services.

3PSYPACT primarily authorizes which professionals to deliver telehealth across state lines in member states?

A.Licensed Professional Counselors

B.Licensed Clinical Social Workers

C.Licensed Psychologists

D.Licensed Marriage and Family Therapists

Explanation: The Psychology Interjurisdictional Compact (PSYPACT) authorizes licensed psychologists in participating states to practice telepsychology and conduct temporary in-person services across state lines.

4Which element is REQUIRED in a TMH-specific informed consent that is NOT typically required in standard in-person informed consent?

A.Risks related to technology failure and breaches of electronic privacy

B.Limits of confidentiality regarding child abuse

C.The provider's training and credentials

D.Fees and payment policies

Explanation: TMH consent must specifically disclose risks unique to remote care, including technology failures, interruptions, and electronic privacy/security risks.

5During the COVID-19 Public Health Emergency, HHS issued an enforcement discretion notice that allowed providers to use which of the following platforms temporarily?

A.Public-facing platforms such as Twitch and TikTok Live

B.Non-public-facing communication products such as FaceTime and Skype

C.Any platform regardless of public exposure

D.Only platforms with signed BAAs

Explanation: HHS OCR's COVID-era enforcement discretion temporarily permitted non-public-facing remote communication products (e.g., FaceTime, Skype, Zoom) without a BAA. The discretion ended in 2023.

6A client receiving substance use disorder treatment via TMH at a Part 2 program asks the counselor to share progress with their employer. Under 42 CFR Part 2, what is required for this disclosure?

A.Verbal consent documented in the chart

B.Specific, written client consent that meets Part 2 requirements

C.A standard HIPAA authorization signed once a year

D.No consent because employment is a treatment-related disclosure

Explanation: 42 CFR Part 2 is stricter than HIPAA and requires specific written consent for each disclosure of SUD treatment information from a Part 2 program.

7Which of the following BEST describes the ethical responsibility of a TMH provider regarding client identity at the START of the therapeutic relationship?

A.Accept the name the client provides without verification

B.Verify identity with a government-issued photo ID and document the verification

C.Verify identity only if insurance is being billed

D.Verify identity only when prescribing medication

Explanation: Best practice is to verify client identity at the first TMH session using a government-issued photo ID and document this in the record; subsequent sessions can use a password or other verification.

8A TMH client discloses that their roommate, who is identifiable, will 'pay for what they did.' The client describes a plan and access to a weapon. The counselor's PRIMARY duty under Tarasoff jurisprudence is to:

A.Maintain confidentiality and continue treatment

B.Take reasonable steps to warn or protect the identifiable third party

C.End the session immediately and refer to inpatient care

D.Notify the client's family

Explanation: Tarasoff and its progeny establish a duty to warn or protect identifiable third parties from credible threats. Counselors must take reasonable steps such as warning the target, notifying law enforcement, and considering hospitalization.

9A counselor records TMH sessions for supervision. Which step is MOST critical before recording?

A.Inform the supervisor

B.Obtain explicit, written client consent and document storage and retention policies

C.Encrypt the recording after it is uploaded

D.Use a personal hard drive for storage

Explanation: Recording requires explicit informed consent that addresses purpose, storage, encryption, retention, access, and destruction; this should be documented before recording begins.

10A 14-year-old in California seeks TMH counseling without parental knowledge. The counselor should FIRST:

A.Refuse services until a parent is present

B.Determine the state's age of consent for outpatient mental health services and the relevant statute

C.Bill the parent's insurance and notify them

D.Provide unlimited sessions to build rapport before discussing consent

Explanation: Age of consent for minors to access outpatient mental health varies by state (commonly 12-18). California, for example, allows minors 12+ to consent to mental health services under specific conditions; the counselor must verify the law before proceeding.

About the BC-TMH Exam

CCE Board Certified TeleMental Health Provider — for licensed counselors, psychologists, and social workers practicing telemental health. Telemental Health Examination (TMHE): 120 MCQ items organized as 12 case studies of 10 items each, 3 hours. Covers legal and ethical issues (HIPAA, informed consent, jurisdictional licensure, PSYPACT/Counseling Compact, mandated reporting), technology (HIPAA-compliant platforms, BAA, encryption, MFA), clinical practice (assessment, working alliance, modality adaptation), crisis and safety in TMH (suicide assessment via video, location verification, 988), and cultural/developmental considerations.

Questions

120 scored questions

Time Limit

3 hours

Passing Score

Per CCE

Exam Fee

$100 exam + $150 application (Center for Credentialing & Education (CCE — NBCC affiliate))

BC-TMH Exam Content Outline

30%

Legal & Ethical

HIPAA, informed consent, jurisdiction, PSYPACT/Counseling Compact, mandated reporting, Tarasoff, 42 CFR Part 2

30%

Clinical Practice

Assessment, working alliance, CBT/DBT/EMDR/MI adaptation, group/couples TMH, video fatigue

20%

Technology & Platforms

HIPAA-compliant platforms, BAA, E2EE, MFA, audit logs, recording, AI scribe

15%

Crisis & Safety in TMH

C-SSRS suicide assessment via video, 988 Lifeline, Stanley-Brown safety planning, emergency dispatch

Cultural & Developmental

Adolescent consent, peds engagement, digital divide, language access, accessibility

How to Pass the BC-TMH Exam

What You Need to Know

Passing score: Per CCE
Exam length: 120 questions
Time limit: 3 hours
Exam fee: $100 exam + $150 application

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

BC-TMH Study Tips from Top Performers

1Master HIPAA platform compliance: requires BAA; Zoom for HC / Doxy.me YES, consumer FaceTime/Skype NO

2Memorize PSYPACT (39+ psychology states), Counseling Compact (LPCs growing), Social Work Compact (LCSW newer)

3Drill location verification: ALWAYS confirm client's exact address at session start; document in note

4Know 988 Suicide & Crisis Lifeline (replaced 1-800-273-TALK in 2022); have local crisis line + 911 dispatch ready

5Apply Tarasoff in TMH: duty to warn/protect; document target identification + warning attempts

Frequently Asked Questions

Which video platforms are HIPAA-compliant for telemental health?

HIPAA-compliant platforms with available BAA (Business Associate Agreement): Zoom for Healthcare, Doxy.me, SimplePractice, TheraNest, TherapyNotes, VSee, Spruce Health. NOT compliant by default: consumer FaceTime, Skype, WhatsApp, Google Meet (consumer), Facebook Messenger. Note: HHS issued a public health emergency waiver during COVID-19 (2020-2023) allowing non-compliant platforms; the waiver ENDED in May 2023 — providers must now use HIPAA-compliant platforms.

What is PSYPACT and how does it differ from the Counseling Compact?

PSYPACT (Psychology Interjurisdictional Compact): allows psychologists licensed in member states to practice telepsychology AND temporary in-person practice across state lines (39+ states as of 2024). Requires E.Passport for telepsychology. Counseling Compact (different agreement, also growing): allows licensed professional counselors (LPCs) to practice across compact-member states. Social Work Compact (separate, newer) for LCSWs. Verify license + compact membership for client's STATE OF PHYSICAL LOCATION at every session.

How is suicide risk assessed via telemental health?

Use validated tools (Columbia C-SSRS, ASQ) adapted for video. Critical TMH-specific steps: (1) verify client's exact LOCATION at start of every session (address, nearest ER); (2) collect emergency contact + local crisis resources; (3) document client's physical setting; (4) for high-risk clients, arrange in-person support (family, mobile crisis); (5) keep 988, local crisis line, and 911 dispatchable to client's address ready. If session disconnects during crisis: call client, dispatch wellness check to verified address.

How should I study for CCE BC-TMH?

Plan 40-80 hours over 6-10 weeks. Focus weighted study on Legal/Ethical (30%) and Clinical Practice (30%) — together 60% of exam. Master HIPAA BAA requirements + post-COVID waiver expiration, PSYPACT + Counseling Compact + Social Work Compact, Tarasoff in TMH, location verification protocols, and 988 Lifeline. Review the CCE TMHE Handbook + CCE 9-hour TMH training (prerequisite). The case-study format requires applying concepts to scenarios — practice case-based questions.