What are licensure compacts?  As interstate practice through telehealth has expanded, many professions and states have developed efforts to facilitate interstate practice.  A state that has decided to participate in a compact is called a "compact state".  These states have joined together with other states to legally permit different licensed professionals to obtain a multi-state license called a compact license. In order to participate in a compact, a state must pass legislation approving it. The following are the compacts that have been developed (or are in process of being developed) for licensed health professionals.

  • Advanced Practice Registered Nurse (APRN) Compact:  The APRN Compact allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states.  This compact has been adopted, but has not yet been implemented.  It will be implemented once 7 states have enacted legislation for joining the compact.
  • Audiology & Speech-Language Pathology Interstate Compact (ASLP-IC): The ASLP-IC facilitates the interstate practice of audiology and speech-language pathology while maintaining public protection.
  • Counseling Compact:  The Counseling Compact is an interstate compact, or a contract among states, allowing professional counselors licensed and residing in a compact member state to practice in other compact member states without need for multiple licenses.
  • Dentist and Dental Hygienist Compact:  The Dentist and Dental Hygienist Compact has reached activation status, however compact privileges are not yet being issued. The implementation process for the compact will take 18 to 24 months before compact privileges are able to issued.
  • Dietitian Licensure Compact: The Dietitian Licensure Compact has been finalized. The model legislation is now available to states for enactment. The compact will be active once enacted into law by seven states.
  • Emergency Medical Services Personnel Licensure Compact: The EMS Licensure Compact facilitates the day to day movement of EMS personnel across state boundaries in the performance of their EMS duties as assigned by an appropriate authority. The EMS Compact authorizes state EMS offices to afford immediate legal recognition to EMS personnel licensed in any other member state.
  • Interstate Compact for School Psychologists: The Interstate Compact for School Psychologists is still in the formative stages.  The model language is not available.
  • Interstate Medical Licensure Compact (IMLC):  The Interstate Medical Licensure Compact offers a voluntary, expedited pathway to licensure for qualified physicians who wish to practice in multiple states.  Please note that this is not the same as reciprocity between participating states.  Some states who do not participate in the Compact have a process called "Licensure by Endorsement" that also creates a more efficient/expedited process for a physician who is licensed and in good standing in one state to get licensed in another state.
  • Nurse Licensure Compact (NLC)  The Nurse Licensure Compact allows a nurse to have a multistate license with the ability to practice in their home state and all participating compact states.  This is considered reciprocity between participating states.
  • Occupational Therapy Licensure Compact: Under the OT Compact, Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs) who are licensed in good standing in a Compact member state may practice in other Compact member states via a “compact privilege,” which is equivalent to a license.
  • Physician's Assistant (PA) Licensure Compact: The PA Licensure Compact has been activated but the process for becoming fully operational can take up to 24 months.
  • Physical Therapy Compact (PT Compact):  The PT Compact is an agreement between participating states that allows PTs and PTAs more mobility in where they practice.
  • Psychology Interjurisdictional Compact (PSYPACT):  PSYPACT is designed to facilitate the practice of telepsychology and the temporary in-person, face-to-face practice of psychology across state boundaries.
  • Social Work Licensure Compact:  The SW Licensure Compact has reached activation status, however multistate licenses are not yet being issued. The implementation process for the compact will take 12 to 24 months before multistate licenses are able to issued.

For more information about which states participate in which compacts, you may check each of above compact websites or search by state at the CCHP Licensure Compacts database.  An at-a-glance summary may also be found on pages 6-8 of this publication:  The Cross-State Licensure Continuum: Out-of-State Telehealth Provider Policies - July 2024

CCHP also has a 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.  If you are a behavioral health provider, the Telehealth Certification Institute has created a resource for locating States' Telemental Health Laws, Rules and Regulations for counselors, social workers, marriage and family therapists and psychologists.

The Council of State Governments has created the National Center for Interstate Compacts with a section on Occupational Licensure Compacts with a full list of all existing compacts and compacts in development.  There is also a Compact Database that serves as an information clearinghouse related to all interstate compacts in use today.  This includes occupational licensure of health professions, but is not specific to health professions.  You will need to select "health" and "occupational licensure" as filters.