Pennsylvania to Fully Implement Three Health Care Licensure Compacts
July 1, 2025
By: Lindsay D. Petrosky and Brontë G. Arreola
On June 23, 2025, Governor Shapiro issued a press release announcing that starting July 7, 2025, Pennsylvania will become a full participant in three health care licensure compacts, which will make it easier for qualified doctors, nurses, and physical therapists to provide care in multiple states.[1]This is the culmination of almost a decade of efforts in the Commonwealth to fully implement interstate health care compacts.
Health care licensure compacts consist of states and territories that agree upon a uniform standard of care and enact laws reflecting this standard.[2] Compacts allow qualified, licensed professionals to streamline the application process to practice in other compact member states.[3]
In May 2020, Pennsylvania fully implemented its first compact, the Psychology Interjurisdictional Compact (“PSYPACT”), allowing psychologists licensed through the compact to practice telepsychology in participating states.[4] There have also been prior partial implementations of compacts, such as the Nurse Licensure Compact (“NLC”) in September 2023[5] and the Interstate Medical Licensure Compact (“IMLC”) in August 2024.[6] The following provides an overview of how medical professionals may take advantage of the newly fully implemented health care compacts:
Physicians:
The IMLC is managed by the Interstate Medical Licensure Compact Commission.[7] More than 40 states and territories (including bordering states Ohio, West Virginia, Maryland, Delaware, and New Jersey) are part of the agreement.[8]
Eligible physicians can qualify to practice in multiple states with just one application within the Compact, rather than having to receive separate licenses from each state in which they wish to practice.[9] Licenses are still issued by the individual states and are state-based; there is no “Compact license”, and only states and territories that have formally joined the Compact can participate in this licensure process.[10]
Licensure is streamlined through an expedited process, in which states share a physician’s information that has been previously submitted in their State of Principal Licensure (“SPL”) — where the physician holds a full and unrestricted medical license.[11] For a physician to participate in the IMLC, they must 1) designate an SPL, 2) complete an application through the IMLC website, and 3) receive a formal Letter of Qualification from that state, verifying they meet the IMLC’s eligibility requirements.[12]
Nurses:
The NLC is managed by the Interstate Commission of Nurse Licensure Compact Administrators.[13] More than 40 states and territories (including bordering states Ohio, West Virginia, Maryland, Delaware, and New Jersey) are part of the agreement.[14]
Registered nurses (RNs) and licensed practical/vocational nurses (LPNs/VNs) that live in a compact state and meet the uniform licensure requirements may be able to apply for a multistate license through their primary state of residence’s (“PSOR’s”) board of nursing.[15] These are still considered state-licenses, not a national license, but the process reduces the time and expense that accompanies applying for multiple state licenses and continuing education requirements for multiple states. As part of the NLC, a nurse is also able to move to a new PSOR in the compact and not face any delays in continuing their practice.[16]
Physical Therapists:
The Physical Therapy Compact (“PT Compact”) is managed by the Physical Therapy Compact Commission.[17] More than 30 states (including bordering states Ohio, West Virginia, Maryland, Delaware, and New Jersey) are part of the agreement.[18]
Interested physical therapists or physical therapist assistants must first meet the eligibility criteria for compact privileges.[19] Once they meet this threshold, they must determine the compact privilege fees and jurisprudence requirements for each state they want to obtain a privilege in.[20] This may require passing a jurisprudence requirement/exam, although not all states have his requirement.[21] After successfully passing the jurisprudence exam (if required), a privilege can be purchased for the state through the PT Compact website, which will guide the applicant through the remaining steps to obtain an initial compact privilege.[22] Obtaining compact privileges will allow a physical therapist to practice across state lines, increasing access to physical therapy services for the public.
Your Jackson Kelly health care team is ready to advise you or your organization about these new privilege opportunities or any other health care compliance matter you may encounter.
[1] Shapiro Administration Expands Job Opportunities for Doctors, Nurses, and Physical Therapists by Fully Implementing Multistate Healthcare Compacts, Commonwealth of Pennsylvania (June 23, 2025), https://www.pa.gov/governor/newsroom/2025-press-releases/shapiro-expands-job-opportunities-for-doctors--nurses--physical-.html.
[2] Licensure Compacts, Telehalth.HHS.gov (March 25, 2025), https://telehealth.hhs.gov/licensure/licensure-compacts
[3] Shapiro Administration Expands Job Opportunities for Doctors, Nurses, and Physical Therapists by Fully Implementing Multistate Healthcare Compacts, Commonwealth of Pennsylvania (June 23, 2025), https://www.pa.gov/governor/newsroom/2025-press-releases/shapiro-expands-job-opportunities-for-doctors--nurses--physical-.html.
[4] 35 P.S. Ch. 48
[5] Shapiro Administration Takes Action to Address Nursing Shortage, Allows Additional Licensed Nurses to Practice in PA, Commonwealth of Pennsylvania (August 22, 2023), https://www.pa.gov/agencies/dos/newsroom/shapiro-administration-takes-action-to-address-nursing-shortage-allows-additional-licensed-nurses-to-practice-in-pa-.html.
[6] Shapiro Administration Increases Access to Healthcare by Allowing Additional Licensed Physicians to Practice in PA, Commonwealth of Pennsylvania (August 26, 2024), https://www.pa.gov/agencies/dos/newsroom/shapiro-admin-increases-access-to-healthcare-by-allowing-more-ph.html.
[7] Interstate Medical Licensure Compact (IMLC), Commonwealth of Pennsylvania, https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/physical-therapy/physical-therapy-compact.html.
[8] Participating States, Interstate Medical Licensure Compact, https://imlcc.com/participating-states/.
[9] About the Compact, Interstate Medical Licensure Compact, https://imlcc.com/a-faster-pathway-to-physician-licensure/.
[10] Id.
[11] Id.
[12] Id.
[13] About the NLC, Nurse Licensure Compact, https://nursecompact.com/about.page.
[14] Nurse Licensure Compact, https://www.nursecompact.com/files/NLC_Map.pdf.
[15] Applying for Licensure, Nurse Licensure Compact, https://nursecompact.com/how-it-works/applying-for-licensure.page#uniform-licensure-requirements.
[16] Id.; Note that a nurse that moves to a new PSOR will still need to apply for licensure by endorsement in their new PSOR.
[17] Physical Therapy Compact, Commonwealth of Pennsylvania, https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/physical-therapy/physical-therapy-compact.html.
[18] Compact Map, PT Compact, https://ptcompact.org/ptc-states.
[19] How to Get Compact Privileges, PT Compact, https://ptcompact.org/How-to-Get-Privileges; FAQ, PT Compact, https://ptcompact.org/Resources-News/FAQ.
[20] Id.
[21] Id.
[22] Id.