Licensure Compacts for Therapists, Psychologists, Social Workers, and Psychiatric Providers
Written by: Meghan Gilliland, LCSW, LICSW
Last updated: May 9, 2026
Licensure compacts are changing how some mental health providers think about online therapy, telehealth, continuity of care, and multi-state practice. For eligible clinicians, a compact may create a more streamlined pathway to serve clients across participating states.
But compact rules are profession-specific, state-specific, and often changing. A compact does not automatically mean a provider can practice anywhere. Some compacts are fully operational. Some are partially live. Some have been enacted but are not yet issuing privileges or multistate licenses. Some professions do not currently have a compact at all.
This guide explains the main licensure compacts and portability pathways relevant to online mental health care, including social work, counseling, psychology, marriage and family therapy, psychiatry, physician assistants, APRNs, and nurse practitioners.
Therapy Expanded helps providers think beyond licensure alone. If you are licensed in more than one state, preparing for compact-era practice, or building an online practice across state lines, the next step is making sure your licensed states, specialty focus, and referral network are visible to the clients and professionals who need to find you.
Current Status of Mental Health Licensure Compacts
The compact landscape is uneven. Some professions already have operational compact pathways. Others are still waiting for implementation. For some professions, portability still happens mostly through traditional state licensure, endorsement, or state-by-state portability rules.
Use this status snapshot as a starting point for planning, not as legal advice or practice authorization. Providers should verify current rules with the relevant compact commission and state licensing boards before relying on any compact or portability pathway.
Social Workers
Social Work Licensure Compact
Current status: Activated and in implementation. Multistate licenses are not yet being issued.
Provider takeaway: Prepare and monitor updates, but do not rely on compact authority yet.
Professional counselors
Counseling Compact
Current status: Operational, but only partially live. As of this update, live jurisdictions are Arizona, Louisiana, Minnesota, and Ohio.
Provider takeaway: Eligible LPCs and LPCCs must apply for privileges in each remote live state.
Psychologists
PSYPACT
Current status: Operational for eligible psychologists in participating jurisdictions.
Provider takeaway: Psychologists need the appropriate PSYPACT authorization, such as APIT for telepsychology or TAP for temporary in-person practice.
Marriage and family therapists
MFT license portability
Current status: No broad LMFT compact is currently operational. Portability remains state-by-state.
Provider takeaway: LMFTs should verify endorsement and portability rules in each state where they want to practice.
Psychiatrists and physicians
Interstate Medical Licensure Compact
Current status: Operational expedited pathway for qualified physicians to obtain individual state licenses.
Provider takeaway: IMLC can speed up licensing, but it does not create one universal physician license.
Physician assistants
PA Licensure Compact
Current status: Adopted by member states, but compact privileges are not yet being issued. Privileges are currently estimated for early 2027.
Provider takeaway: PAs should monitor implementation and continue relying on ordinary state authorization until privileges are available.
APRNs and PMHNPs
APRN Compact and Nurse Licensure Compact
Current status: The Nurse Licensure Compact is active for RNs and LPN/VNs, but it does not cover APRN or PMHNP practice authority. APRN compact implementation remains separate.
Provider takeaway: PMHNPs and APRNs should verify state-specific APRN licensure and prescribing rules.
Important: This page is for general educational and planning purposes. It is not legal advice. Before making practice decisions, verify current requirements with the licensing board in the state where your client is located.
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.
That is why it is important to look at the compact for your specific profession instead of assuming all mental health providers follow the same rules.
Compact vs. Reciprocity vs. Telehealth Registration vs. Multiple State Licenses
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.
Why Licensure Compacts Matter for Online Therapy
Online therapy is not automatically borderless. 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 may eventually 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.
Important reminder: Online therapy is not automatically borderless. The client’s physical location during the session usually matters, and providers should verify current rules before relying on a compact or portability pathway.
Which Mental Health Licensure Compacts Are Usable Now?
PSYPACT for psychologists
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.
Counseling Compact for LPCs and LPCCs
The Counseling Compact is operational, but only partially live. As of this update, the compact is live for licensees in Arizona, Louisiana, Minnesota, and Ohio. Many other jurisdictions have enacted the compact but are not yet live for issuing or accepting privileges.
This distinction matters. A state can pass compact legislation before the compact privilege is usable there. Eligible counselors must still apply for a privilege to practice in each remote live state where they want to practice.
Interstate Medical Licensure Compact for 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.
Which Mental Health Compact Pathways Are Pending, Limited, or State-by-State?
Social Work Licensure Compact
The Social Work Licensure Compact has reached activation status, but multistate licenses are not yet being issued. That means social workers should not assume they can practice under compact authority today.
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.
MFT license portability
There is not currently a broad operational LMFT compact in the same way there is PSYPACT for psychologists or the Counseling Compact for eligible professional counselors. For MFTs and LMFTs, portability remains largely state-by-state.
That means LMFTs should verify endorsement, portability, and telehealth rules in each state where they want to practice.
PA Compact, APRN Compact, and Nurse Licensure Compact
Prescriber-related compact questions can be confusing because physicians, PAs, APRNs, PMHNPs, RNs, and LPNs do not all use the same pathway.
The PA Licensure Compact is moving through implementation, but PA compact privileges are not yet being issued. 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.
What Providers Should Know Before Relying on a Compact
Before using any compact for practice planning, providers should slow down and verify the details. Compact rules are not interchangeable across professions.
- Your profession matters. Social workers, counselors, psychologists, LMFTs, psychiatrists, PAs, and PMHNPs all have different interstate practice pathways. A compact for one profession does not apply to another profession.
- Your home state may matter. Many compact pathways depend on a qualifying home-state license or residence. Holding a license in a compact state is not always enough if that state is not your home state or if your license does not meet compact eligibility rules.
- The client’s location matters. For telehealth, the client’s physical location during the session is usually central to licensure analysis. Providers should have a reliable process for confirming where the client is located at each session.
- Enacted does not always mean live. A state may pass compact legislation before applications, privileges, authorizations, or multistate licenses are available. This is especially important for compacts that are still being implemented or only partially live.
- A compact may not replace individual state licensure. Some providers will still need individual state licenses for nonmember states, practice situations outside compact rules, payer requirements, permanent in-person practice, or states where a compact is not yet operational.
- Marketing language should be precise. Providers should avoid saying they can practice in all compact states unless they actually hold the required authorization for those states. Safer language lists where the provider is currently licensed, privileged, authorized, or accepting clients.
What Clients Should Know Before Booking Across State Lines
Clients may hear about licensure compacts and assume online therapy is now available from any provider in any state. That is not how interstate practice works.
If you are moving, traveling, attending college out of state, splitting time between states, or trying to continue care with a provider after your location changes, ask whether the provider is currently authorized to see clients in the state where you will be physically located during the session.
Questions to ask before booking
- Are you licensed or otherwise authorized to see clients in the state where I will be located?
- If I move or travel, can we continue care?
- Do you hold individual state licenses, compact privileges, compact authorizations, or another type of authorization?
- How do you verify client location before telehealth sessions?
- If I move to a new state, can you help with referrals or transition planning?
How Therapy Expanded Supports Compact-Era Practice
Licensure expansion and compact privileges can help providers serve more clients, but they do not automatically create visibility, referrals, or a sustainable practice.
Therapy Expanded is built for online mental health providers who need to clearly communicate where they are available, connect with other professionals, and support clients whose care may cross state lines.
Make your licensed states easier to find
If you are licensed in more than one state, your profile should make that clear. Clients and referral partners need to understand where you can currently provide care.
Build referral relationships across states
Multi-state practice requires more than a license or compact privilege. Providers also need trusted referral relationships in the states where clients may need care, testing, medication management, family therapy, or specialized support.
Prepare for compact changes without overstating them
As compacts evolve, accurate communication matters. Therapy Expanded helps providers build visibility around current authorization while preparing for future compact-era growth.
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 Work Licensure Compact
The Social Work Compact has reached activation status, but multistate licenses are not yet being issued. This guide explains current status, state participation, eligibility concepts, telehealth implications, and what social workers can do now.
Counseling Compact
The Counseling Compact is operational but only partially live. This guide explains the difference between enacted and live states, who may qualify, how privileges work, and what LPCs and LPCCs should verify before practicing across state lines.
PSYPACT
PSYPACT is an operational pathway for eligible psychologists. This guide explains APIT, TAP, E.Passport, IPC, telepsychology, temporary in-person practice, participating jurisdictions, and verification resources.
MFT License Portability
There is not currently a broad operational LMFT compact. This guide explains MFT portability, why it differs from a compact, and what LMFTs and clients should know about cross-state online therapy.
Medical and Prescriber Compacts
Prescriber-related compact questions are different from therapist licensure questions. This overview explains the Interstate Medical Licensure Compact, PA Compact, APRN Compact, and Nurse Licensure Compact limitations for psychiatric and medication-management providers.
Official Licensure Compact Resources
Because compact rules, state participation, fees, and implementation timelines can change, providers should verify current information through official sources.
HHS guidance on licensing across state lines for telehealth
Official Resource
HHS overview of licensure compacts
Official Resource
Council of State Governments compact database
Official Resource
Official Social Work Licensure Compact
Official Resource
Official Counseling Compact
Official Resource
Official PSYPACT
Official Resource
Official PSYPACT map and participating jurisdictions
Official Resource
PSYPACT authorization directory
Official Resource
AAMFT strategic portability effort
Official Resource
Interstate Medical Licensure Compact Commission
Official Resource
PA Licensure Compact
Official Resource
NCSBN licensure compacts for nursing
Official Resource
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. Online therapy is not automatically borderless.
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.
Plan for Multi-State Practice With Therapy Expanded
Licensure compacts may make some forms of interstate practice easier, but they are only one part of building a sustainable online practice.
If you are already licensed in multiple states, preparing for compact privileges, or planning for future compact-era growth, Therapy Expanded can help you communicate where you are available, build referral relationships, and get found by clients and professionals navigating cross-state care.
Related Therapy Expanded Resources
Networking for Online Mental Health Providers
Guidance for building a strong cross-state provider referral network
Grow Your Multi-State Therapy Practice
Practical guidance for building visibility across states
Therapist Networking Community
Connect with online providers navigating cross-state practice
Find a Therapist Licensed in Multiple States
Directory of providers available for cross-state care
Online Therapy Across State Lines
Understand telehealth regulations and requirements