What Locum Tenens Providers Need to Know about Multistate Licensure Compacts

What Locum Tenens Providers Need to Know about Multistate Licensure Compacts

All Star Healthcare Solutions is ready to match you to locum tenens assignments at hospitals, clinics, private practice groups, and other healthcare organizations across the country. Before packing up your gear, though, there’s the pressing issue of licensure. Each state has its own licensing body that grants doctors, nurse practitioners (NPs), physician assistants (PAs), and certified registered nurse anesthetists (CRNAs) authority to treat patients within their jurisdictions. That critical step in the road to locum tenens jobs can vary in timing. Some licensing boards are quick to process applications and others meet less frequently, thereby prolonging the span between application and receiving an active license. To expedite matters and get providers practicing within their borders, many states have entered into interstate licensure compacts.

Here, we’ve compiled the major points of three compacts applicable to locum tenens providers.

Interstate Medical Licensure Compact (IMLC)

This agreement between states pertains exclusively to physicians. Established in 2017, the IMLC currently covers 40 states, the District of Columbia, and the U.S. Territory of Guam, and is being considered by other state legislatures. However, the IMLC organization does not issue its own license. Rather, individual state boards within the compact grant their licenses, just within a more expedient timeframe due to member bodies agreeing to share information on eligible physicians. For a state or territory to enter the compact, its lawmakers must pass the authorizing legislation and have the governor sign the bill into law.

For individual physicians to qualify, you must apply to the IMLC and meet the following criteria:

  • Hold an unrestricted license in your State of Principal License (SPL), which also is an IMLC member and is defined by at least one of these parameters:
  • Home state of primary residence;
  • Where at least 25 percent of your medical practice is conducted;
  • Where you are employed as a practicing doctor; or
  • You list the state as your residence for U.S. federal income taxes.
  • Plus, you must request and receive a formal Letter of Qualification from the appropriate SPL licensing body.
  • Doctors must show proof of graduation from an accredited medical school in the United States or an institution listed in the International Medical Education Directory.
  • Physicians must have successfully completed an Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA) accredited education program.
  • Providers must pass each component of the United States Medical Licensing Examination (USMLE), or the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA), or an equivalent in no more than three attempts for each component.
  • Individuals must hold specialty certification or time-unlimited certification by the American Board of Medical Specialties (ABMS) or American Osteopathic Association Bureau of Osteopathic Specialists.

Additionally, a physician’s background must be free from:

  • A history of disciplinary actions on your license(s), including controlled substance actions;
  • A criminal record (individuals are required to submit fingerprints to an SPL-designated criminal justice agency); or
  • An open investigation into professional or criminal conduct.

According to IMLC data, an estimated 80 percent of physicians in the United States meet the compact criteria. For more information, go to

PA Licensure Compact

In 2024, the governor of Virginia signed a bill authorizing the state to become the seventh member to join the PA Licensure Compact, which has been endorsed by the American Academy of Physician Associates (AAPA), the Federation of State Medical Boards (FSMB), the National Commission on Certification of Physician Assistants (NCCPA), and the Council of State Governments (CSG). With the minimum state membership requirement met — and surpassed when several more states followed suit — the compact is now official.

For the next phase, the PA Compact Commission, consisting of representatives from each of the participating state licensing organizations, will finalize the operational details, including but not limited to, the licensure process for PAs seeking to participate. So far, the organization has outlined the following as mandatory factors:

  • You must hold an active, unencumbered license within a compact state.
  • You must alert the commission of your intent to practice under the compact.
  • You agree to undergo an FBI background check.
  • You graduated from a PA educational program accredited by the Accreditation Review Commission on Education for the Physician Assistant Inc., or other programs authorized by the commission, and hold a current certification from the National Commission on Certification of Physician Assistants (NCCPA).

Officials anticipate the commission will begin granting compact licenses by late 2025. For updates, go to

Advanced Practice Registered Nurse (APRN) Compact

APRNs, a.k.a., NPs and CRNAs, are on track for a multistate licensure compact, too. In 2020, the National Council of State Boards of Nursing (NCSB) took the initial steps toward an agreement similarly structured to the existing enhanced Nurse Licensure Compact for registered nurses. Currently, proponents are lobbying state lawmakers to introduce and pass model legislation to enact membership into the compact. As of June 2024, four states — Delaware, North Dakota, South Dakota, and Utah — have become official members. When a total of seven states take the necessary legislative steps, the compact can move onto the next stage of finalizing operations.

Per, the compact for NPs and CRNAs intends to grant a multistate license that will allow advanced practitioners to care for patients in other APRN Compact states without securing additional licenses. Stay abreast of new happenings at

The respective compacts carve out a more direct route for locum tenens professionals and staffing agencies like All Star Healthcare Solutions to better serve facilities and patients. Our licensing specialists stay attuned to compact developments and can help clarify information. Share your questions with your All Star consultant.

Are you ready to start your locum tenens journey? Call All Star Healthcare Solutions today at 800-928-0229, or contact us online.