APRN Compact Explained
The APRN Compact promises to do for nurse practitioners, midwives, and nurse anesthetists what the Nurse Licensure Compact did for RNs: one license to practice across multiple states. But unlike the NLC, the APRN Compact isn’t active yet—it’s waiting for more states to sign on.
Here’s what you need to know about this emerging opportunity.
What Is the APRN Compact?
The APRN Compact is an interstate agreement that will allow advanced practice registered nurses to hold one multistate license and practice in any member state. It covers:
- Nurse Practitioners (NPs) — All specialties (FNP, PMHNP, AGNP, etc.)
- Certified Nurse Midwives (CNMs)
- Certified Registered Nurse Anesthetists (CRNAs)
- Clinical Nurse Specialists (CNSs)
Like the RN/LPN Nurse Licensure Compact, the APRN Compact creates a system where your home state issues the license and other member states recognize it.
Current Status: 5 States Enacted, 7 Required
The APRN Compact needs 7 states to enact legislation before it can go into effect. Here’s where things stand:
States That Have Enacted the APRN Compact
| State | Enacted | Status |
|---|---|---|
| Delaware | 2020 | Awaiting activation |
| North Dakota | 2021 | Awaiting activation |
| South Dakota | 2022 | Awaiting activation |
| Utah | 2021 | Awaiting activation |
| Wyoming | 2022 | Awaiting activation |
5 down, 2 to go.
States Considering APRN Compact Legislation
Several states have introduced or are expected to introduce APRN Compact bills:
- Idaho
- Nebraska
- Kentucky
- Montana
- Iowa
Legislative sessions in 2026 could push the compact past the 7-state threshold.
Timeline Projection
Once the 7th state enacts the compact:
- Implementation planning begins immediately
- Interstate Commission forms within 12 months
- Compact goes live approximately 6 months after commission formation
Realistic activation: Late 2026 or 2027, assuming two more states enact in 2026.
How the APRN Compact Will Work
The Multistate License Model
The APRN Compact follows the same principles as the NLC for RNs:
| Concept | How It Works |
|---|---|
| Home state | The state where you live (primary residence) |
| Multistate privilege | Authority to practice in other member states |
| Single license | One APRN license covers all compact states |
| State authority | Each state retains regulatory oversight |
Your home state issues your APRN license. That license automatically grants you practice privileges in all other APRN Compact member states.
Eligibility Requirements
To qualify for an APRN multistate license, you’ll need:
- RN License: Active multistate or single-state RN license
- Graduate Education: Master’s or doctoral degree from accredited program
- National Certification: Current certification in your APRN role
- No Encumbrances: No disciplinary actions or restrictions
- Primary Residence: In a compact member state
- Background Check: Meet FBI criminal background check requirements
The Prescriptive Authority Question
Here’s where it gets complicated. Prescriptive authority (the ability to prescribe medications) varies significantly by state:
- Some states grant full independent prescriptive authority
- Others require collaborative agreements with physicians
- Controlled substance prescribing has additional requirements
The APRN Compact does NOT standardize prescriptive authority. You’ll still need to meet each state’s specific requirements for prescribing.
This means:
- Your multistate APRN license lets you practice in member states
- Prescriptive authority may require additional state-specific steps
- DEA registration remains federal and practice-location based
APRN Compact vs. NLC: Key Differences
If you’re familiar with the Nurse Licensure Compact, here’s how the APRN Compact compares:
| Factor | NLC (RN/LPN) | APRN Compact |
|---|---|---|
| Roles covered | RN, LPN/LVN | NP, CNM, CRNA, CNS |
| States enacted | 43 states | 5 states |
| Active? | Yes, since 2018 | No, needs 7 states |
| Prescriptive authority | N/A | Not standardized |
| Education requirement | Accredited program | Graduate degree |
| Certification | NCLEX | National APRN certification |
Can You Hold Both?
Yes. The NLC and APRN Compact are separate agreements. An NP could potentially hold:
- A multistate RN license (through NLC)
- A multistate APRN license (through APRN Compact)
They serve different purposes: the RN license covers your underlying nursing practice, while the APRN license covers your advanced practice authority.
Why the APRN Compact Matters
Current Pain Points for APRNs
Right now, APRNs face significant barriers to multistate practice:
Licensing burden: An NP who wants to practice in 10 states needs 10 separate state licenses—each with its own application, fees, and renewal schedule.
Telehealth limitations: Remote patient care requires licensure in the patient’s state. Many telehealth APRNs hold licenses in 15+ states.
Travel practice: APRN travel assignments require state-by-state licensing, unlike RN travel nurses in NLC states.
Locum tenens: Filling temporary APRN positions across state lines requires advance planning and multiple licenses.
What the Compact Will Change
Once active, the APRN Compact will:
- Reduce licensing costs: One fee instead of many
- Enable telehealth expansion: Practice across state lines more easily
- Improve access to care: APRNs can serve underserved areas in multiple states
- Simplify career mobility: Move or travel without re-licensing
- Support disaster response: Deploy quickly across state lines
The Telehealth Opportunity
Telehealth is the biggest driver of APRN Compact interest. Mental health NPs (PMHNPs) are in especially high demand for remote care. Currently, a PMHNP serving patients in 20 states needs 20 licenses—costing thousands annually in fees and hours of administrative work.
The compact would reduce that to one license.
What APRNs Should Do Now
If You’re in an Enacted State
Delaware, North Dakota, South Dakota, Utah, and Wyoming nurses:
- Monitor activation timeline: Watch for the 6th and 7th states
- Ensure eligibility: Meet all compact requirements now
- Maintain certification: Keep national certification current
- Plan ahead: Consider how multistate practice could expand your options
If You’re in a Non-Compact State
- Contact legislators: Express support for APRN Compact adoption
- Join advocacy efforts: State nursing associations often lead compact initiatives
- Stay informed: Track legislation in your state
- Maintain current licenses: Keep practicing under existing rules
For Telehealth APRNs
- Track compact progress closely: This directly affects your practice
- Document your multi-state costs: Useful for advocacy
- Plan for transition: How will compact change your licensing approach?
- Consider location strategy: Moving to a compact state may accelerate benefits
Challenges and Criticisms
Prescriptive Authority Complexity
The compact’s biggest limitation is that it doesn’t standardize prescriptive authority. An NP with full practice authority in one state may need a collaborative agreement in another compact state.
This creates a two-tier system:
- Multistate APRN license for general practice
- State-specific requirements for prescribing
Critics argue this limits the compact’s usefulness, especially for primary care NPs who prescribe regularly.
Slow State Adoption
With only 5 states enacted after several years, progress is slower than the NLC experienced. Possible reasons:
- Physician organization opposition in some states
- Complexity of APRN scope-of-practice variations
- Legislative priorities focused elsewhere
- Less urgency without pandemic-era telehealth pressure
Regulatory Concerns
Some state boards worry about:
- Oversight of out-of-state practitioners
- Disciplinary action coordination
- Quality assurance across state lines
The compact includes mechanisms for interstate discipline reporting, but concerns persist.
Frequently Asked Questions
Will the compact affect my current licenses?
No. Existing single-state APRN licenses remain valid. The compact adds a multistate option—it doesn’t replace current licensing.
Do I need a multistate RN license to get a multistate APRN license?
The compact doesn’t explicitly require a multistate RN license, but you must have an active RN license (multistate or single-state) to hold APRN licensure.
What about CNS recognition?
Not all states recognize Clinical Nurse Specialists. The compact only provides multistate privileges in states that recognize your specific APRN role.
Will compact licenses cost more?
Likely similar to current APRN license fees—possibly with a small compact privilege fee. Exact costs will be determined during implementation.
Can I choose single-state or multistate?
Yes. Like the NLC, you can opt for a single-state license if you prefer, though there’s usually no advantage to doing so.
The Path Forward
The APRN Compact represents a significant opportunity for advanced practice nurses, but it needs momentum. Two more states must enact the compact before any APRN can benefit.
What to watch in 2026:
- State legislative sessions (January-May in most states)
- Advocacy efforts by AANP, AANA, ACNM, and NACNS
- Telehealth policy discussions that may drive compact interest
If you’re an APRN interested in multistate practice, telehealth expansion, or simply reducing your licensing burden, the APRN Compact is worth following closely.
Resources
- NP License Information — State-by-state NP requirements
- CRNA License Information — State-by-state CRNA requirements
- CNM License Information — State-by-state CNM requirements
- CNS License Information — State-by-state CNS requirements
- NP Requirements by State — Including practice authority status
- NLC Compact Guide — The RN/LPN multistate compact
Stay informed as the APRN Compact moves toward activation. When it does, it will fundamentally change how advanced practice nurses can serve patients across state lines.
About the Author
License Guide Team
Clinical Editorial Team
Our editorial team includes licensed nurses and healthcare professionals dedicated to providing accurate, up-to-date nursing licensure information sourced directly from state boards of nursing.