The Multi-State Licensing Playbook for Telehealth Hiring

The three compacts that matter

Interstate Medical Licensure Compact (IMLC)

For MDs and DOs. Covers 39 states + DC + Guam. Cuts state licensing from 60–90 days to as little as 2 weeks per state.

Nurse Licensure Compact (NLC)

For RNs and LPNs. 41 member states allow practice across all members on one multistate license. NPs are not included — they need PSYPACT or individual state licensure.

PSYPACT

For psychologists. 40+ states allow telepsychology and temporary in-person practice across borders.

Practical hiring strategy

1. Filter candidates by current licenses — don't pay for licensing you don't need.
2. Reimburse new state applications as a hiring perk ($300–$1,500 per state).
3. Sequence licenses by patient demand — don't pursue all 50 states upfront.
4. Use a credentialing service like Medallion or CredentialMyDoc for >5 states.

What it costs

• IMLC: $700 + state fees ($200–$1,000 per state)
• Individual state license: $300–$1,500
• Credentialing service: $200–$500 per provider per month

Timeline expectations

With IMLC: 14–30 days per added state.
Without: 60–120 days per state.

Build this into your hire-to-start timeline — surprises here are the biggest reason offers fall through.