Multi-state licensure is laborious and confusing. Let us help you make sense of it all so you can get to work and practice telemedicine across state borders with less hassle.
Update for 2020: To get started, watch our on-demand multi-state medical licensure webinar for physicians or multi-state medical licensure webinar for nurse practitioners and get all your telemedicine licensing questions answered.
As a telemedicine provider, the more states you are licensed to practice in, the better. With multiple state licenses, you are a more versatile physician and can access opportunities for more competitive jobs with the potential for a higher salary or hourly rate.
While some telemedicine companies will help you get licensed, it’s important to understand the process so you can make yourself the most valuable in the telemedicine job market.
Telemedicine Licensure Basics
Most telemedicine companies will take care of credentialing and help with licensure.
Every state has its own rules and regulations on licensure set by the state medical board.
More populous states like California, Florida, Texas, and New York are the best states to get supplemental licenses because of higher patient utilization of telemedicine.
You must be licensed in the state where the patient is located to provide treatment.
States can change their telemedicine credentialing guidelines every year, so it's important that the telemedicine company you work with is up-to-date on credentialing and licensure policies.
How State Medical Licensure Works
Each state’s medical board dictates requirements for state licensure. This can be as simple as providing documentation or as time-intensive as writing essays, taking tests, and conducting in-person interviews. Initial state licensure can take anywhere from a few weeks to up to six months. Note that the peak period for licensure applications is April through September and may impact processing time.
Basic requirements of every state medical board include:
Proof of graduation from an accredited medical school
Completion of at least one year of residency
Fee payment for licensure (usually a few hundred dollars, renewed annually or every few years)
Additional requirements may include:
Criminal background checks
Additional coursework/CME completion
Medical Licensure Compacts and Telehealth
Just like practicing traditional medicine, the first step is to get licensed in the state you reside in. But if you are a telehealth doctor, you may be seeing patients across the country. To promote the practice of telemedicine and expand healthcare access to rural patients, states have developed medical licensure compacts. These compacts streamline the licensure process for physicians to facilitate cross-state medical practice.
States within the compact agree to trust each other’s vetting process to expedite licensure. This means if you are licensed in Arizona (a compact state) and want to be licensed in Utah (another compact state), Utah’s medical board can see that Arizona already vetted you and more quickly approve your application for a license.
How to Get Licensed in a Compact State
Getting licensed in a compact state while you wait for individual licensure for other non-compact states is the best way to get up and running as a telemedicine provider fast.
To get a compact state licensure, you select a primary state (typically where you reside or where you will be practicing the most), and then leverage those requirements to get licensed in other compact states.
Physician medical license compact
The compact organization for physicians is the Interstate Medical Licensure Compact (IMLC), comprised of 24 compact states and 1 territory (as of late 2018). According to the IMLC, approximately 80% of physicians meet the criteria for licensure.
To get licensed, physicians select a state of principal license and then can select any number of compact states to practice in.
Can physicians get compact state licensure if they don’t reside in a compact state?
The state of principal license can be the state where you reside, but if you don’t reside in a compact state you can still qualify if: at least 25% of your practice will occur in the primary state you choose, your employer is located in the primary state, or you use the primary state as your state of residence for federal tax purposes.
Qualifications for physician compact state licensure:
Have a primary medical practice in one of the participating states
Medical school accreditation, either LCME, COCA, or IMED
Complete ACGME or AOA graduate medical education
Pass the USMLE or COMLEX-USA within three attempts
Hold specialty certification or time-unlimited by ABMS or AOA-BOS board
No prior convictions or criminal activity
No history of licensure actions
Clean DEA history
No active investigations
Must pass FBI Criminal Background Check
How long does it take to get a physician compact license?
Getting the initial state of principal license may take a few weeks. Once you have your initial license, getting licensed in compact member states will only take a few days.
How much does it cost to get a physician compact state license?
Initially, you will pay a $700 fee plus the cost of the primary state license to apply. When adding additional state licenses, you will pay the individual state license fees as set by state medical boards. State license fees vary between $75 and $700.
Also, you have one chance to select additional state licensures without paying a handling fee. After the first selection of states, if you want to get more compact state licensures you pay a $100 handling fee to add them.
Future of Telemedicine and Multi-State Licensure
As telemedicine adoption grows, you can expect more states to join the compact state licensure programs. In the meantime, it’s important to know the basics of multi-state licensure and keep up on the compacts as new states are added. Periodically ask your telehealth employer if there are new opportunities to get additional licenses and watch your telemedicine career grow as you reach more patients across the country.
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