Licensure.
As a general rule, clinicians must be licensed in the state where the patient is physically located at the time of service. However, states vary widely in whether they:
- Grant limited licensure exceptions,
- Offer special telehealth registrations, or
- Participate in interstate licensure compacts.
Because these variations differ by state and profession, it is important for providers to verify requirements before delivering interstate telehealth services.
Foundational Center for Connected Health Policy (CCHP) Video Resources
- Licensure and Telehealth Overview Video
- Frequently Asked Questions on Licensure Video
Key CCHP Licensure Resources
- The Cross-State Licensure Continuum: Out-of-State Telehealth Provider Policies - July 2024
- Out-of-State Telehealth Provider Policies Trend Map
- Cross-State Licensing policies by State
- Telehealth Policy Finder where you can look up all telehealth-related policies and regulations across all 50 states and the District of Columbia, as well as at the federal level.
For a deeper dive, check out this webinar from August 2, 2024 on Cross-State Licensure & Compacts:
Additional National Resources:
Policy Frameworks and Analyses
- Cicero Institute State Policy Agenda for Telehealth Innovation - includes a 50-state telehealth innovation report card looking at telehealth laws that prioritize quality, affordability and innovation.
- Johns Hopkins University Summary of Cross-State Telehealth Advocacy Framework (May 20, 2025, Policy Summit) and analysis of how Cross-State Telehealth Telehealth Laws Restrict Access to Essential Care.
Licensure Support Tools for Clinicians
- Provider Bridge supports rapid provider mobilization during public health emergencies and assists clinicians in navigating licensure pathways for telehealth. It offers:
- A dedicated help center for licensure questions,
- State-by-state emergency telehealth licensure information
- A vetted database of volunteer clinicians available for telehealth deployments
Profession-Specific Licensure Resources
- Several national organizations maintain continuously updated maps and databases:
-
- Association of Social Work Boards Laws and Regulations Database
- National Society of Genetic Counselors State Licensure for Genetic Counselors
- Multi-Discipline Licensure Resource Project for Occupational Therapists, Physical Therapists, Psychologists and Social Workers
- Telehealth Certification Institute - States' Telemental Health Laws, Rules and Regulations for counselors, social workers, marriage and family therapists and psychologists.
Other Key Policy Considerations for Interstate Telehealth Practice: When providing telehealth services across state lines, it's essential to understand more than just state-specific telehealth law. Here are some other key policy considerations:
- Interstate Licensure Compacts: As telehealth has expanded, many professions and states have taken steps to facilitate interstate practice. A state that participates in a compact is known as a 'compact state'. These states have joined with other states to allow licensed professionals to obtain a multi-state compact license. To participate in a compact, a state must first enact legislation to authorize participation. Compact structures vary by profession. For example, nurses, physicians, psychologists, physical therapists, and other professionals each have their own compacts and structures. Learn more....
- Scope of practice laws: Each state defines the scope of practice for licensed providers differently. Practitioners licensed in multiple states and providing telehealth services must adhere to the scope of practice laws in the patient’s location at the time of service.
- The NCSL Scope of Practice Policy website offers state-by-state information on the scope of practice for behavioral health providers, nurse practitioners, oral health providers, pharmacists, and physician assistants.
- In some states, certain providers must have collaborative practice agreements with physicians. In these cases, the collaborating physician must also be licensed in the state where the patient is located, with occasional exceptions.
- Malpractice coverage: Providers (and collaborating physicians, if applicable) should confirm with their malpractice carriers that their coverage includes telemedicine services across state lines. Most malpractice policies cover telehealth, but some require an additional rider for interstate services. Coverage limits vary widely by state; some impose caps on damages, while others have none. The best practice is to maintain coverage that meets or exceeds the highest damage cap in any state where you are licensed.
