Health Coach Scope of Practice: What You Can Do and Why It Matters

What exactly do health coaches do (and what don’t they do)? To answer this question, we look to the health coach’s scope of practice, a set of standards set forth by the National Board for Health & Wellness Coaching (NBHWC). These standards define the role of a health coach and create a clear ethical framework for how coaches work with clients.

“Health and wellness coaches engage individuals and groups in evidence-based, client-centered processes that facilitate and empower clients to develop and achieve self-determined, health and wellness goals.“ — National Board for Health & Wellness Coaching (NBHWC)

Within these standards, health coaches offer wide-ranging support. They educate, guide, and empower clients to make meaningful progress toward better health, while not diagnosing or prescribing. They use their expertise to provide information, offer guidance, and help create pathways to lasting change.

In this article, we’ll look at what scope of practice means for health coaches today, why it matters, and how it supports both client outcomes and a successful coaching career.

Defining the Health Coach Scope of Practice

The National Board for Health & Wellness Coaching (NBHWC) sets the standards that define scope of practice for health and wellness coaches. As the national governing body for the profession, NBHWC establishes clear expectations for how coaches work with clients in a way that is safe, ethical, and effective.

In accordance with NBHWC’s standards, health coaches work in a client-centered partnership to educate, guide, and support individuals in achieving self-directed health goals.

In practice, this means that coaches facilitate behavior change, build awareness, and apply health knowledge in real-world ways, including:

• Helping clients set and achieve health goals
• Educating clients using evidence-based health information
• Providing general lifestyle guidance
• Offering advice related to habits and behavior change
• Helping clients turn lab results into actionable lifestyle change
• Providing accountability, motivation, and long-term progress

Health coaches do not:

• Diagnose health conditions
• Treat disease
• Prescribe medications or treatments
• Provide psychotherapy or mental health treatment

In general, the coach approach is facilitative rather than directive. Coaches don’t position themselves as the authority telling clients what to do; instead, they use evidence-based coaching techniques to help clients clarify what they want, identify next steps, and follow through on meaningful change.

Why do we need NBHWC’s scope of practice definition?

Because health coaching is not a licensed medical profession like medicine or nursing, NBHWC’s standards are essential in establishing consistency, credibility, and client safety across the field.

What if a client asks me to work outside the health coach’s scope?

At times, a client may have needs outside a health coach’s scope of practice. When this happens, and the client doesn’t already have an appropriate provider, it’s the ideal moment for the coach to lean on their referral network. Connecting a client with a qualified professional protects the client, builds trust, and reinforces the coach’s professionalism. It also expands the coach’s network—because thoughtful referrals often lead to referrals in return.

Can a coach ever diagnose, prescribe, or treat?

If a coach holds additional credentials—think physicians, nurses, dietitians, clinical therapists, etc. who are also certified coaches—they may, of course, practice within the scope of their licensed roles when appropriate. However, when working as a health coach, NBHWC’s coaching standards still apply, and the coaching role remains distinct (meaning, if a client is seeing you as a health coach, not a doctor, you’d work according to the coach’s scope).

This clarity allows health coaches to operate confidently within their role as they provide support to clients.

Scope in Action: What Health Coaches Can Do with Clients

Being a health coach means turning knowledge and compassion into real-world impact. Within the NBHWC-defined scope, coaches guide clients to make meaningful changes across virtually all aspects of their health.

• Nutrition and movement: Helping clients translate evidence-based guidance into habits that fit their lifestyle, from meal planning strategies to creating realistic exercise routines.
• Sleep, stress, and mindset: Identifying patterns that affect energy, focus, and emotional well-being, then co-creating a path to increased resilience and balance.
• Behavior change and accountability: Using motivational interviewing, goal-setting, and reflective questioning to help clients stay consistent (and celebrating wins!).
• Lab insights and medical guidance: Partnering with clients who use direct-to-consumer lab testing or work with healthcare providers by helping them make sense of results and translate recommendations into actionable lifestyle changes.
• Self-advocacy and empowerment: Guiding clients to ask the right questions, clarify priorities, and confidently engage with their healthcare team.

Through a combination of education, compassionate support, and personalized action plans, FMCA-trained coaches help clients take ownership of their health.

How Coaches Can Support Clients’ Lab Testing Within Scope

Whether labs come from a provider or DTC testing, coaches can offer support by:

• Assisting clients in making sense of their results, including understanding what different biomarkers generally relate to in the body
• Helping them ask their doctors more informed questions
• Translating insights into sustainable lifestyle change
• Reflecting on how their daily habits may influence their results
• Noticing and tracking patterns over time
• Breaking down medical guidance into realistic, actionable steps

At FMCA, we teach this meaningful work directly in our Health Coach Certification Program. Our lab and biomarker coaching module (Month 11 in our Curriculum) ensures that our students develop the skills to work with clients thoughtfully, ethically, and within scope. For coaches who understand and honor their scope of practice, lab work becomes a powerful opportunity to help clients move from data to action.

Staying in scope doesn’t limit impact, it sharpens it. By honoring the distinct role of coaching, health coaches build trust and create the conditions for lasting transformation. As FMCA educator Monique Class says, “Labs don’t change people, coaches do.”

4 Myths About Health Coaches’ Scope of Practice

Despite clear standards from NBHWC, outdated assumptions about health coaching still persist. Here’s what scope of practice actually allows coaches to do.

1. Myth: Health coaches can’t work with lab tests.
   Fact: Though coaches won’t (and, thanks to DTC labs, don’t need to!) order labs themselves, they do work with clients’ lab results by educating, spotting patterns, and guiding lifestyle changes, without diagnosing or treating.
2. Myth: Health coaches can’t give advice.
   Fact: Coaches are trained educators who can offer guidance on healthy habits, routines, and behavior change within a client-centered framework.
3. Myth: Health coaches can’t discuss supplements.
   Fact: Coaches can educate about supplementation and help clients implement provider recommendations, without prescribing or treating disease.\
4. Myth: Health coaches can’t really do much.
   Fact: Coaches do the work that makes change possible: helping clients translate knowledge into consistent, life-changing action.

Together, these realities reflect the true scope of health coaching as defined by NBHWC: expansive, impactful, and grounded in safety and ethics.

Scope of Practice, Collaborative Care, and Coaching Independently

A clear understanding of their scope of practice allows FMCA-trained coaches to collaborate effectively with physicians, dietitians, therapists, and other healthcare professionals. This is one reason FMCA graduates are sought after in medical and integrative settings: they know how to interpret care plans, reinforce recommendations, and help clients follow through in daily life, without overstepping clinical boundaries.

Scope also aligns with independent practice. Many FMCA coaches build successful private practices, group programs, and online offerings where they work directly with clients. Within scope, they educate, guide lifestyle change, and provide accountability—the work that drives lasting results. Whether collaborating on a care team or running their own business, FMCA coaches show up with clarity, confidence, and real-world impact.

6 Practical Ways Health Coaches Stay Within Scope

In practice, operating within scope is much more about clarity than it is about rigidity. In accordance with NBHWC standards, coaches adhere to their scope by:

1. Setting expectations clearly: Provide a written scope of practice statement or coaching agreement at the start of work with a new client.
2. Staying informed about state laws: Especially when coaching virtually or across state lines, make sure you know which laws apply to you.
3. Using appropriate disclaimers: In any written, digital, and marketing materials, make sure to represent your role as a coach accurately.
4. Relying on evidence-based sources: When sharing education or resources related to health and wellness, look for materials grounded in science from trusted experts.
5. Separating education from personal medical advice: Offer general health education and keep your coaching client-centered and non-prescriptive.
6. Collaborating when appropriate: Refer to or work alongside licensed professionals when needed to support the client’s overall care.

These practices protect clients, coaches, and the integrity of the profession and allow coaches to do the work they are trained to do.

Expertise Meets Impact: The Value of Coaching in Scope

When health coaches follow their scope of practice, they align expertise with impact. Understanding their role allows coaches to work creatively and ethically, without second-guessing themselves.

FMCA trains coaches to operate with this confidence from day one. The result is graduates who are trusted by clients, respected by healthcare professionals, and equipped to build fulfilling, sustainable careers. Within scope, health coaches do some of the most powerful work in healthcare: turning insight into action and possibility into lasting change.