Telehealth – Interstate Compacts – Multi-state Guidance

Interstate compacts simplify cross-state telehealth for specialists in participating states. This expedites the licensing process or allows members to practice under a single multistate license. However, this depends on certain state rules and federal policies.

Physicians

For physicians, there are two ways to qualify for compact licensure: SPL eligibility and general eligibility.

SPL (State of Principal License) Eligibility

This requires physicians to hold a full, unrestricted medical license in a state that is a member of the Compact. Refer to this map to see if your state participates in the Compact. 

Additionally, one of the following must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes

General Eligibility

In addition to having basic SPL status, there are several General Eligibility requirements. You must:

• Have graduated from an accredited medical school, or a school listed in the International Medical Education Directory
• Have successfully completed ACGME- or AOA-accredited graduate medical education
• Have passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts for each component
• Hold a current specialty certification or time-unlimited certification by an ABMS or AOABOS board
• Not have any history of disciplinary actions toward your medical license
• Not have any criminal history
• Not have any history of controlled substance actions toward your medical license
• Not currently be under investigation

Information regarding how to apply and renew, the cost to participate, and more can be found here.

Nurses

There are two ways to qualify for a compact: by examination and by endorsement. 

By Examination

If your state of residence is a compact state (refer to this map to determine if it is), then you will apply for licensure in that state, take the NCLEX examination, and be granted the privilege to practice in other states upon passing the examination and remaining a resident of the issuing state. 

By Endorsement 

The first step is to determine if the state you want a compact for is a compact state, which can be determined by referring to this map. After that, if your current state is not a compact state, then you must apply for an RN or LPN license in the state you want compact privileges in/the state that will be your new primary state of residence. This then grants you the privilege to practice in all compact states contingent upon remaining a resident of the state that issued you the multistate license. 

Psychologists

To practice telepsychology across states, psychologists must obtain an Authority to Practice Interjurisdictional Telepsychology. This requires holding a full, unrestricted license to practice this in a state that recognizes this (refer to this to see if your state does) and the possession of an active ASPPB E.Passport (requirements for the Passport are here). 

Physical Therapists

Physical therapists that are interested in obtaining compact privileges to work in other states, must meet the following requirements: (1) have a current PT or PTA license in your state of residence, (2) your state of residence must be issuing and accepting compact privileges, (3) valid driver’s license to prove permanent residence in your state, (4) no active encumbrances or disciplinary action against your license for at least two years, (5) the state that you are seeking privileges from must be issuing and accepting compact privileges.

To see if your state of residence and the state you are seeking privileges from participates in this, consult this map. If the answer to both of those is yes, then refer to this site for specific state fees and requirements/exams that need to be acquired before receiving compact privileges.