For providers › ‹ Policy changes during COVID-19
Providers can deliver telehealth services across state lines, depending on rules set by state and federal policies. Interstate compacts simplify cross-state telehealth for specialists in participating states.
On this page:
- State licensing policies
- Exceptions for interstate telehealth practice and liability under the PREP Act
- Interstate compacts
State licensing policies
Almost every state has modified licensure requirements/renewal policies for health care providers in response to COVID-19, including out-of-state requirements for telehealth.
For emerging updates and the latest requirements for each state, see:
See also:
- Provider Bridge from the Federation of State Medical Boards — a comprehensive directory of resources to help health care providers navigate state licensure requirements during COVID-19 and future public health emergencies.
Specialty-specific resources:
Exceptions for interstate telehealth practice and liability under the PREP Act
The 2005 Public Readiness and Emergency Preparedness Act (PREP Act) authorizes HHS to make declarations that provide immunity from liability in certain emergency circumstances. On December 3, 2020, HHS published Amendment 4 to the PREP Act to preclude state and local governments from enforcing more restrictive policies that keep “qualified persons” from administering countermeasures recommended by a PREP Act declaration. Specifically, this allows for interstate practice of telemedicine to improve public health outcomes in an emergency. This amendment provides liability protection when delivering specific COVID-19 related services, expands telehealth access, and makes it easier to treat and prevent COVID-19.
Many states already allow providers to deliver out-of-state telehealth services. The new Declaration, however, ensures specific COVID-19 “covered countermeasures” can be provided or ordered via telehealth across state lines without additional state licensure. The countermeasures covered by liability immunity include:
- Qualified products used to treat, diagnose, cure, prevent, or mitigate COVID-19
- Drugs, biological products, or devices authorized for COVID-19 emergency use
- Respiratory-protective devices approved by the National Institute for Occupational Safety and Health
This exception from state licensure and liability protection applies only to providers ordering or administering the specific covered countermeasures. For more details, see: 4th Amendment to the Declaration Under the PREP Act
In 2021, HHS ratified additional amendments to the Declaration under the PREP ACT. Amendments 5 through 8 expand on the definition of “qualified persons”. Amendment 8 clarifies that if a practitioner is providing covered COVID-19 countermeasures to a patient in another state, the laws of the state where the practitioner is licensed apply. For more details, see: 8th Amendment to the Declaration Under the PREP ACT section V (e) - from the Federal Register.
Interstate compacts
Interstate compacts (agreements between two or more states) make it easier for health care providers to practice in multiple states — expediting the licensing process or allowing members to practice under a single multistate license. The list below includes some of the larger compacts backed by well-established regulatory boards. Many also meet the federal licensing requirements of the Centers for Medicare & Medicaid Services. For details, see Medicare Clarifies Recognition of Interstate License Compacts .
For physicians
The Interstate Medical Licensure Compact (IMLC)
For nurses
The Nurse Licensure Compact (NLC) authorizes eligible nurses to practice across multiple member states while maintaining a single license. For a list of member states, see Nurse Licensure Compact (NLC)
For psychologists
The Psychology Interjurisdictional Compact (PSYPACT)
PSYPACT released its ASPPB InFocus 2021
For physical therapists
The PT Compact
For Emergency Medical Services (EMS) workers
The EMS Compact authorizes EMS personnel to work in multiple member states under a single license. For a list of member states, see EMS Compact member states & commissioners.
For speech language therapists
The Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC)
Last updated: September 28, 2022