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Licensing across state lines

The ability to deliver health care services across state lines varies based on state regulations.

Illustration of a map of the United States with seven health care providers standing on various state lines.

Cross-state licensure

Many states are revisiting their licensure process to ensure access. There are various ways a health care provider may provide services across state lines:

  • Obtaining a full license;
  • Checking temporary practice laws;
  • Seeing if there is licensure reciprocity;
  • Joining a licensure compact; and/or
  • Applying for telehealth registration if available.

Tip: Prior to an appointment, providers should verify patient location and obtain consent.

Full license

A full license granted by a state health care professional licensing board permits a provider to legally practice in that state. To practice in a state, providers must meet many requirements. Requirements include education, exams, and background checks. Health care providers are expected to maintain and renew their license. Maintenance may require an annual fee, continuing education, and self-reporting disciplinary actions.

Temporary practice laws

Ensuring continuity of care for patients can be challenging for providers treating transient populations. This may include young adults attending college or retirees who live in different states during certain seasons.

Some states have temporary practice laws to support existing provider-patient relationships. This allows a provider to practice for a limited time in another state their patient is visiting.

Licensure reciprocity

Some states allow providers from another state to provide telehealth services if they share a common border. Some states have an exception to state licensure for health care providers in specific situations.


Multi-state licensure compacts streamline the licensing process across states, while preserving state oversight. Compacts allow participating health care providers to practice in participating states.

Telehealth registration

Some states allow out-of-state providers to practice telehealth in their states through telehealth registrations. Licensed out-of-state providers may provide telehealth services after completing registration requirements.

Under this telehealth registration pathway, there are certain state requirements and conditions. States have some variation in how they oversee telehealth registration. Typically, providers must meet these terms:

  • Current, valid, and unrestricted license in another state;
  • Not subject to any past disciplinary proceedings;
  • Must maintain and provide evidence of professional liability insurance;
  • Must not open an office or offer in-person treatment in that state; and
  • Must annually register and pay a fee with the appropriate state licensing board.

More information: