If your organization employs or credentials physicians who practice across state lines — whether through telehealth, locum tenens, or a multi-state health system — you’ve likely run into the same problem time and time again: state medical licensure. Getting a physician licensed in a new state can take months, and every state has its own application, its own requirements, and its own timeline.

The Interstate Medical Licensure Compact (IMLC) was built to address that problem, and it just got bigger. In June 2026, Alaska became the Compact’s 44th member state and 46th member jurisdiction, joining a group that also includes the District of Columbia and Guam. Several more states (Arkansas, New Mexico, and Rhode Island) have already passed IMLC legislation and are in the process of implementing it, and Massachusetts has introduced legislation to join. 

The pool of physicians who can practice across states is only going to keep growing, and while licensing will become easier, the credentialing process for organizations will be more complex. 

In this blog, I’ll cover what the Compact is, what it means for providers and credentialing teams, and why licensure speed doesn’t translate into credentialing speed unless you have the right systems in place. 

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What is the Interstate Medical Licensure Compact?

The Interstate Medical Licensure Compact (the Compact) is an agreement that allows states to work together to significantly streamline the licensing process for physicians who want to practice in multiple states. 

It’s important to understand that the Compact doesn’t create a national medical license, and it doesn’t take licensing authority away from individual states. Physicians still receive a separate license from each state where they want to practice, issued by that state’s own medical board. The Compact simply changes the process behind the scenes, and streamlines the application process for other state licenses. 

A physician designates one participating state as their “State of Principal License,” that state verifies the physician’s credentials and issues a Letter of Qualification, and other Compact states can then use that verification to issue licenses of their own without physicians duplicating paperwork from scratch every time.

The Compact launched in 2017 as new technologies expanding access to health care, namely telehealth, were becoming mainstream. State medical boards, with support from the Federation of State Medical Boards, wanted to maximize the benefits of these new technologies to improve outcomes for patients in underserved or rural areas, and thus the Compact was born. The growth since then has been dramatic. Just three licenses were issued in the Compact’s first month, April 2017; in March 2026 alone, 3,633 were issued. As of mid-2026, the numbers tell the story: 44 member states plus DC and Guam, 59 participating medical and osteopathic boards, more than 132,000 Letters of Qualification issued, over 64,000 physician members, and more than 221,000 licenses issued through the Compact. Roughly 80% of U.S. physicians meet the eligibility criteria to use it.

What’s in It for Healthcare Organizations?

For physicians, and the organizations that employ them, the appeal is greater options and opportunity. When physicians can obtain multiple state licenses quickly and with far less administrative burden, organizations can grow much faster. Expanding into a new state, merging with or acquiring a group across state lines, or practicing in a new service area is far easier. Rural health centers and FQHCs, in particular, gain access to a wider pool of specialists who can now get licensed and start seeing patients without the months-long delay that used to make out-of-state coverage impractical.

This matters most for the use cases that have been driving multi-state practice in the first place: telehealth organizations that need providers licensed everywhere their patients live, health systems that operate across state borders, locum tenens and travel physicians working short-term contracts, and rural and underserved communities that rely on out-of-state specialists to fill coverage gaps. The Compact was explicitly designed to expand access to care in these scenarios, and as more states join, the map of where a Compact-licensed physician can practice keeps expanding too. 

In the most recent 12-month period, physicians using the Compact obtained an average of four licenses each. This is the kind of multi-state footprint that would take months of duplicated paperwork through the traditional route.

The Caveat: Credentialing Complexity

Faster licensure sounds like it should mean faster onboarding across the board. However in practice, licensure is only one piece of the puzzle, and credentialing teams know that better than anyone.

Each state still expects to be notified of each new application and to receive its own primary-source verification for the purposes of credentialing and payer enrollment, regardless of how the license itself was issued. A physician holding five Compact licenses means five separate expiration dates to track, five sets of state-specific requirements to monitor, and five renewal cycles that don’t necessarily line up with each other.

Add to that the fact that every state has its own payers, so the number of enrollments needed to complete grows exponentially with each state the provider sees patients in. A physician can have a shiny new license in hand and still be weeks away from actually seeing patients in a new state because credentialing and payer enrollment haven’t caught up. 

As more states join the Compact and more providers hold licenses in more places, the gap between licensure and enrollment becomes a bigger operational risk for teams that are still working with outdated systems and tracking things manually. This is where the right systems separate the credentialing teams that scale smoothly from the ones that get buried.

The Right Tools Make All the Difference

Spreadsheets and shared drives can track a handful of licenses for a handful of providers. But, they’re ineffective when you’re managing dozens of providers across multiple states, each with different renewal dates, different documentation, and different payers.

A credentialing platform built for multi-state complexity should be able to track every license, certification, and renewal deadline in one place; flag expirations before they become lapses; automate primary-source verification instead of chasing it manually; automate steps in the enrollment process to keep up with the exponential growth as providers obtain more state licenses, and give compliance leaders a single, audit-ready view of every provider’s status across every state. As the Compact grows and more of your providers become eligible to add states quickly, that kind of visibility and automation is what keeps expansion from turning into delays and risk.

Keep Up with Multi-State Credentialing with MedTrainer

The Interstate Medical Licensure Compact is making it faster than ever for physicians to get licensed across state lines. But, expanded licensing puts more pressure on the teams responsible for verification, enrollment, and compliance behind the scenes.

MedTrainer’s credentialing software is built to help credentialing teams handle that pressure without working overtime. MedTrainer centralizes license and certification tracking, automates primary-source verification, and gives your team a real-time view of every provider’s status across every state they practice in.

Where multi-state growth creates the most risk, MedTrainer automates the work that used to be manual:

• Automated license verifications. DEA and state licenses are retrieved directly from licensing boards into each provider profile, logging the name, date, time, and source URL of every verification so you always have an audit-ready record. This is critical when a single physician holds licenses in five or more states, each with its own renewal cycle.
• Automated exclusions monitoring. Automated OIG, SAM, DMF and state exclusions checks flag issues before they become compliance problems, and help you maintain NCQA compliance as your provider roster grows across state lines.
• Faster provider enrollments. AI-powered enrollment workflows accelerate payer enrollment — the step that most often lags behind licensure — with a unified view of status and priority so nothing stalls and revenue keeps flowing.
• Real-time reports and dashboards. Track credentialing status across providers, payers, and locations to spot gaps and upcoming deadlines early, with customizable dashboards and scheduled reports delivered daily, weekly, or monthly.

As the Compact expands, MedTrainer helps your credentialing team keep pace, so faster licensure actually translates into faster, safer onboarding.

Ready to see how MedTrainer can improve your credentialing speed? Schedule a demo today.