MULTI-STATE PRACTICE
Licensure compacts for mental health providers
Explore the licensure compacts and portability pathways for therapists, social workers, psychologists, and psychiatric providers. Check what is available for your profession and what to verify before practicing across state lines.
Status reviewed September 22, 2026
BEFORE YOU APPLY
Check your pathway to practice.
- Your professionEach compact has its own eligibility rules.
- Your statesConfirm which states are ready to issue or accept authorization.
- Your approvalReceive the required license, privilege, or authorization before providing care.
STATUS BY PROFESSION
Current status of mental health licensure compacts
Some professions already have operational compact pathways. Others are still waiting for implementation or use state-by-state portability rules.
| Profession | Compact or pathway | Current status | What to check or do |
|---|---|---|---|
| Social workers | Social Work Licensure Compact |
In implementation
Multistate licenses are not yet being issued. |
Continue using current state licenses or other lawful authorization. |
| Professional counselors | Counseling Compact |
Live in 10 states
Eligible counselors can apply for privileges in participating live states. |
Check your home-state eligibility and apply for each remote-state privilege. |
| Psychologists | PSYPACT |
Operational
Available to eligible psychologists in participating jurisdictions. |
Obtain APIT for telepsychology or TAP for temporary in-person practice. |
| Marriage and family therapists | MFT license portability |
State by state
There is no broad operational LMFT compact. |
Check endorsement, portability, and telehealth rules in each state. |
| Psychiatrists and physicians | Interstate Medical Licensure Compact |
Operational
Expedites individual state medical licenses for qualified physicians. |
Apply for the state licenses you need through the IMLC pathway. |
| Physician assistants | PA Licensure Compact |
In implementation
Privileges are projected for early 2027; the date may change. |
Monitor implementation and maintain your current state authorization. |
| APRNs and PMHNPs | APRN Compact and PMHNP licensing |
Separate requirements
The active RN/LPN compact does not cover APRN or PMHNP practice authority. |
Verify state-specific APRN licensure and prescribing requirements. |
This guide is for general education and planning. Before making practice decisions, verify current requirements with the relevant compact commission and state licensing boards.
HOW COMPACTS WORK
What is a licensure compact?
A licensure compact is an agreement among participating states or jurisdictions that creates a shared pathway for eligible providers to practice across state lines. Compacts are created through state legislation, and each compact has its own rules, commission, eligibility criteria, application process, fees, and terminology.
Some compacts create a multistate license. Some create a compact privilege. Some create an expedited pathway to obtain individual state licenses. Some apply only to telehealth, while others also include limited in-person practice.
COMPARE YOUR OPTIONS
Compacts and other licensing pathways
Licensure compacts are only one pathway for practicing across state lines. Depending on the profession and the state, providers may also encounter full state licensure, licensure by endorsement, reciprocity rules, temporary practice laws, or telehealth registration.
Individual state licensure
Individual state licensure means applying directly to each state where you want to practice. This is often the broadest form of authorization, but it may require separate applications, fees, documentation, background checks, jurisprudence requirements, renewals, and continuing education obligations.
Licensure by endorsement or portability
Endorsement and portability pathways may make it easier to obtain a license in a new state if you already hold a license elsewhere. These pathways are still usually state-by-state and do not automatically authorize practice everywhere.
Telehealth registration
Some states allow out-of-state providers to register for limited telehealth practice. Telehealth registration rules vary widely and may include limits on in-person services, insurance requirements, annual fees, or other conditions.
Licensure compacts
Compacts can streamline some forms of interstate practice, but each compact works differently. A provider may need a home-state license, compact privilege, multistate license, authorization, background check, jurisprudence exam, or separate state license depending on the profession and state.
Official overview: HHS guidance on licensing across state lines
ONLINE THERAPY ACROSS STATES
Why licensure compacts matter for online therapy
In most cross-state telehealth situations, the client’s physical location during the session matters. A provider generally needs to be licensed, compact-authorized, registered, or otherwise legally permitted in the state where the client is located at the time care is provided.
This matters when clients move, travel, attend college out of state, split time between seasonal homes, work remotely from another state, or need specialized care that is not available locally.
For providers, licensure compacts can make it easier to build a multi-state online practice. But legal authorization is only one part of the picture. Providers also need visibility, accurate state listings, referral relationships, informed consent processes, professional liability coverage, payer clarity, and a plan for verifying client location.
CHOOSE YOUR PROFESSION
Licensure compact guides by profession
Each compact or portability pathway has its own rules. Use these profession-specific guides to understand the details that matter most for your license type.
SOCIAL WORKERS
Social Work Licensure Compact
The Social Work Licensure Compact has reached activation status, but multistate licenses are not yet being issued.
Once operational, the compact is expected to create a multistate license pathway for eligible bachelor’s, master’s, and clinical social workers in participating states. Until then, social workers should continue relying on individual state licenses or other lawful authorization pathways.
PROFESSIONAL COUNSELORS
Counseling Compact
The Counseling Compact is operational in 10 states: Arizona, Arkansas, Georgia, Indiana, Louisiana, Minnesota, Ohio, Oklahoma, Tennessee, and Wyoming. This list was checked October 3, 2026.
Eligible counselors must apply for a privilege in each remote live state. License titles vary by state and include LPC, LPCC, LMHC, and LPC-MHSP. Check your home-state eligibility and each destination state’s status before applying.
PSYCHOLOGISTS
PSYPACT
PSYPACT is operational for eligible psychologists in participating jurisdictions. It allows qualified psychologists to apply for authorization to practice telepsychology across participating jurisdictions and to provide temporary in-person services under specific conditions.
PSYPACT applies to psychologists, not to counselors, social workers, MFTs, or other therapist types. Psychologists should verify whether they need APIT for telepsychology, TAP for temporary in-person practice, or an individual state license for practice that falls outside PSYPACT.
MARRIAGE AND FAMILY THERAPISTS
MFT license portability
There is not currently a broad operational LMFT compact. For MFTs and LMFTs, portability remains largely state-by-state.
Verify endorsement, portability, and telehealth rules in each state where you want to practice. The AAMFT portability effort tracks state-specific pathways.
PSYCHIATRIC AND MEDICATION-MANAGEMENT PROVIDERS
Medical and prescriber compacts
Psychiatrists and physicians
The Interstate Medical Licensure Compact is an operational expedited pathway that helps qualified physicians obtain individual state medical licenses more efficiently. This may be relevant to psychiatrists and telepsychiatry groups.
The IMLC is not the same as one universal physician license. Physicians still receive state licenses and remain subject to the laws and boards of the states where they practice.
Physician assistants
PA compact privileges are not yet being issued. The PA Compact Commission projects availability in early 2027. Continue relying on current state authorization until privileges are available.
APRNs and PMHNPs
The Nurse Licensure Compact is active for RNs and LPN/VNs, but it does not cover APRN or PMHNP practice authority. APRNs and PMHNPs should verify state-specific APRN licensure, practice authority, and prescribing requirements.
Official sources: IMLCC · PA Compact FAQ · NCSBN nursing compacts
BEFORE YOU PRACTICE
What providers should check before using a compact
Verify the requirements for your profession, home state, and the states where clients will attend sessions.
- Check your profession’s requirements.Social workers, counselors, psychologists, LMFTs, psychiatrists, PAs, and PMHNPs have different interstate practice pathways. Use the requirements for your license type.
- Confirm your home-state eligibility.Many compacts require a qualifying license in your primary state of residence. Holding a license in a compact state may not be enough.
- Verify the client’s location.Confirm where the client is physically located at each session and that you are authorized to provide care there. Check the requirements where you practice as well.
- Check that the states are live.A state may enact compact legislation before applications or practice privileges are available. Verify operational status before applying or scheduling care.
- Keep any individual licenses you still need.You may need separate licenses for nonmember states, practice outside compact rules, payer requirements, or states where the compact is not yet operational.
- Describe your current authorization accurately.List the states where you are currently licensed, privileged, or authorized to practice. Confirm that your liability coverage, payer arrangements, and telehealth processes fit the care you plan to provide.
BEFORE YOU BOOK
What clients should ask about care across state lines
If you are moving, traveling, attending college out of state, or splitting time between states, ask whether your provider can see you in each location.
Questions to ask your provider
- Are you licensed or otherwise authorized to see me in the state where I will be located?
- If I move or travel, can we continue care?
- How can I verify your license or compact authorization?
- How do you confirm my location before telehealth sessions?
- If you cannot see me in a new state, can you help with referrals or transition planning?
COMMON QUESTIONS
Frequently asked questions about licensure compacts
What is a licensure compact?
A licensure compact is an agreement among participating states or jurisdictions that creates a shared pathway for eligible providers to practice across state lines. Each compact has its own rules, eligibility requirements, application process, and terminology.
Do licensure compacts replace state licensure?
No. Compacts do not erase state licensing authority. Depending on the compact, a provider may still need a home-state license, compact privilege, multistate license, authorization, or individual state license. Providers also need to follow the rules of the state where the client or patient is located.
Can online therapists practice across state lines because of compacts?
Sometimes, but only when the provider's profession has an applicable compact, the relevant states participate, the provider meets eligibility requirements, and the provider has received the required authorization.
Which mental health licensure compacts are live now?
PSYPACT is operational for eligible psychologists. The Counseling Compact is operational but only partially live in a limited number of jurisdictions. The Interstate Medical Licensure Compact is operational as an expedited licensing pathway for physicians. Other pathways, including the Social Work Licensure Compact and PA Compact, are still in implementation stages.
Is there an LMFT compact?
There is not currently a broad operational LMFT compact. MFT license portability remains largely state-by-state, and LMFTs should verify endorsement, portability, and telehealth rules with each relevant state licensing board.
Does the Social Work Compact let LCSWs practice across state lines now?
No. The Social Work Licensure Compact has reached activation status, but multistate licenses are not yet being issued. Social workers should continue relying on current state licenses or other lawful authorization pathways until the compact is operational for licensees.
What does it mean if a compact state is "live"?
Does the client's location matter for online therapy?
Yes. In most cross-state telehealth situations, the client's physical location during the session matters. Providers should verify where the client is located and confirm whether they are authorized to practice in that state.
What should providers do if their compact is not live yet?
Providers can monitor official compact updates, keep current licenses in good standing, verify eligibility requirements, maintain accurate public profiles, and continue using individual state licensure or other lawful authorization pathways where needed.
How often should compact information be checked?
Compact information should be reviewed regularly. State participation, live status, fees, rules, and implementation timelines can change. Providers should verify with official compact sources and state boards before making practice decisions.
BUILD YOUR MULTI-STATE PRACTICE
Make your licensed states easier to find.
Therapy Expanded helps online mental health providers communicate where they are available, connect with other professionals, and build referral relationships across states.
VERIFY CURRENT REQUIREMENTS
Official licensure compact resources
Because compact rules, state participation, fees, and implementation timelines can change, providers should verify current information through official sources.
Telehealth and portability
Therapist and psychology compacts
Medical and nursing compacts
CONTINUE EXPLORING
Related Therapy Expanded resources
Guidance for building a cross-state provider referral network.
Practical guidance for building visibility across states.
Connect with online providers navigating cross-state practice.
Search the directory for providers licensed in the states you need.
Understand how session locations affect online care.
Written by Meghan Gilliland, LCSW, LICSW. Updated .