Frequently Asked Questions

The Nurse Licensure Compact (NLC) lets nurses practice in 43 states with one multistate license, according to NCSBN. Your home state issues the license, and it’s valid in all compact member states.

Feature	Details
Member states	43 (as of January 2026)
License type	Single multistate license
Application	Through home state only
Additional fees	None for compact states

Key benefits:

• Practice in 43 states with one license
• No separate applications for each state
• Immediate ability to work across state lines
• Essential for travel nurses and telehealth providers

To qualify (per NCSBN requirements):

• Primary residence in a compact state
• Pass NCLEX
• Federal background check
• No disciplinary actions

See our compact states guide for the full member list.

Initial RN/LVN licenses take 2-8 weeks after passing NCLEX, according to NCSBN processing data. Endorsement (transferring states) takes 4-12 weeks depending on the destination state.

License Type	Typical Timeline	Source
Initial RN/LVN (post-NCLEX)	2-8 weeks	NCSBN
Endorsement	4-12 weeks	State board averages
APRN credentials	4-12 weeks	After RN + certification

Factors that affect processing time:

• Background check completion (2-4 weeks alone)
• Verification of education via Nursys
• State board processing backlog (varies seasonally)
• Completeness of your application—missing documents add 2+ weeks

Check our state guides for state-specific timelines.

Initial nursing licensure costs $300-$500 total, including the NCLEX exam ($200, set by Pearson VUE) plus state fees.

Fee Type	Amount	Source
NCLEX exam	$200	Pearson VUE (2026)
State application	$50-$200	Varies by state
Background check	$30-$100	FBI/state
Fingerprinting	$25-$75	LiveScan/IdentoGO
Total	$305-$575

Cost varies by license type:

• RN/LVN initial: $300-$500
• Endorsement (transfer): $150-$400
• APRN certification: Add $200-$500 for national certification

Check our state guides for exact fees in your state.

As of 2026, 43 states are members of the enhanced Nurse Licensure Compact (eNLC), allowing RNs and LPN/VNs to practice across state lines with one multistate license:

Current NLC Member States: Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming

Pending Implementation: Several states have passed NLC legislation and are in the implementation phase.

Non-Compact States: California, Connecticut, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, Nevada, New York, Oregon, Rhode Island, Washington, and Alaska remain non-compact states.

To Practice with a Multistate License:

• Declare your primary state of residence as an NLC member state
• Meet all uniform licensure requirements
• Apply for a multistate license through your home state

Use our reciprocity checker to verify compact status.

Yes, all states require criminal background checks as part of the nursing license application process:

What’s Checked:

• FBI national criminal database
• State criminal records
• Sex offender registry
• Sometimes abuse registries (dependent adults, children)

Process:

1. Fingerprinting: Most states require electronic fingerprinting through an approved vendor
2. State check: Your state’s criminal database
3. Federal check: FBI database for nationwide records
4. Processing time: 2-8 weeks depending on state

Typical Costs:

Component	Cost
Fingerprinting	$25-$75
State background check	$25-$50
FBI background check	$20-$40

Criminal History Considerations: Having a criminal record doesn’t automatically disqualify you. Each state board reviews:

• Nature and severity of the offense
• Time since the offense
• Evidence of rehabilitation
• Relationship to nursing practice

Many states offer pre-application review processes for applicants concerned about their history.

The Nurse Licensure Compact (NLC) is a mutual recognition agreement that allows registered nurses (RNs) and licensed practical/vocational nurses (LPNs/LVNs) to hold one multistate license while practicing in any of the 43 member states without obtaining additional licenses.

Key Benefits

• One License, Multiple States: Practice nursing in any compact state with a single license issued by your home state
• Reduced Costs: Eliminate fees for multiple state licenses (savings of $1,000+ for nurses working across state lines)
• Faster Mobility: No waiting weeks for license endorsement when relocating or traveling
• Telehealth Friendly: Legally provide telehealth services to patients in other compact states

How It Works

To obtain a multistate license, you must:

1. Declare a compact member state as your primary state of residence
2. Meet the uniform licensure requirements set by the NLC
3. Apply for licensure through your home state’s Board of Nursing
4. Pass required background checks

Your multistate license automatically grants practice privileges in all other NLC member states.

Current Member States

As of 2026, 43 states have enacted NLC legislation. Non-member states include California, New York, Illinois, Michigan, Minnesota, Hawaii, Alaska, and Nevada.

For a complete list and interactive map, visit our Compact States Guide.

After passing the NCLEX exam, most nurses receive their official license within 1 to 6 weeks, depending on the state. Some states issue licenses within days, while others may take longer due to processing backlogs or additional requirements.

Typical Timelines by State Type

Fast-Processing States (1-2 weeks)

• Arizona, Texas, Florida, Colorado, Tennessee
• These states have streamlined online systems and minimal additional requirements

Moderate Processing (2-4 weeks)

• Most compact states fall into this category
• Pennsylvania, Ohio, Georgia, North Carolina

Slower Processing (4-8+ weeks)

• California, New York, Massachusetts
• Often due to high application volumes or additional review requirements

What Happens After You Pass

1. Pearson VUE notifies your state board - Results are transmitted electronically
2. Background check clearance - Must be completed if not already done
3. Board review - Your application is verified and processed
4. License issued - You’ll receive notification via email or mail

While You Wait

• Check your state board’s online verification system regularly
• Some states offer temporary permits allowing supervised practice
• Keep your application confirmation number handy for status inquiries
• Do not begin practicing until your license is officially issued

Expediting Your License

To avoid delays:

• Submit all required documents before taking NCLEX
• Complete fingerprinting early
• Respond promptly to any board requests
• Choose electronic delivery options when available

Yes, it is possible to obtain a nursing license with a felony conviction in most states, but approval depends on several factors including the nature of the offense, how much time has passed, and evidence of rehabilitation. Each state Board of Nursing evaluates applications individually.

Factors Boards Consider

• Type of offense: Crimes involving patient harm, theft, fraud, or drug-related offenses receive closer scrutiny
• Time elapsed: Older convictions with clean records since are viewed more favorably
• Rehabilitation evidence: Completion of probation, treatment programs, community service
• Honesty: Full disclosure on your application is critical—failure to disclose is often worse than the conviction itself

Automatic Disqualifiers

Some offenses may permanently bar licensure in certain states:

• Murder or violent felonies
• Sexual offenses, especially involving minors
• Certain drug trafficking convictions
• Healthcare fraud

State Variations

States handle criminal background differently:

• More restrictive: California, Texas, Florida conduct thorough reviews
• Fair chance states: Some states have “ban the box” policies or limit how far back they look
• Case-by-case review: Most boards allow applicants to present their case before a hearing

Steps to Take

1. Check your state’s specific requirements before applying
2. Request a pre-application review if your state offers one
3. Gather documentation: Court records, completion certificates, character references
4. Be completely honest on all application questions
5. Consult a nursing license defense attorney for complex cases

Expungement and Sealing

Even expunged records may need to be disclosed to nursing boards in some states. Check your specific state’s requirements, as boards often have access to sealed records.

If your nursing license expires, you cannot legally practice nursing until it is reinstated. Working with an expired license is considered practicing without a license—a serious offense that can result in fines, disciplinary action, and difficulty obtaining future licensure.

Immediate Consequences

• Must stop practicing immediately - No grace period for patient care in most states
• Employment impact - Employers are notified and may suspend or terminate your position
• Insurance issues - Malpractice coverage may be voided for care provided while expired

Reinstatement Process

The process to reinstate an expired license varies by state and how long it has been expired:

Recently Expired (within grace period)

• Many states offer a 30-90 day grace period for late renewal
• Pay renewal fee plus late penalty ($50-$200)
• Submit any outstanding CE documentation

Expired 1-5 Years

• Complete reinstatement application
• Pay higher fees (often double standard renewal)
• Catch up on all missed continuing education hours
• May require refresher course in some states

Expired 5+ Years

• May need to retake NCLEX or competency exam
• Possible clinical refresher course requirement
• Extensive documentation of any nursing activities
• Board review and possible hearing

State-Specific Requirements

State	Grace Period	Late Fee
Texas	None for practice	$50 first month
California	30 days	$50
Florida	None	Varies
New York	4 years to renew	$50 per month

Prevention Tips

• Set calendar reminders 90 days before expiration
• Sign up for Instant Notify for automatic alerts
• Use our CE Tracker to stay on top of requirements
• Keep your contact information current with your board

To update your address on your nursing license, you must notify your state Board of Nursing directly. Most states require address changes within 30 days of moving and offer online portals for quick updates.

How to Update Your Address

Online (Fastest Method)

1. Log into your state board’s online licensing portal
2. Navigate to “Update Information” or “Change of Address”
3. Enter your new address and submit
4. Print or save confirmation for your records

By Mail or Email

If online update isn’t available:

1. Download your state’s address change form
2. Complete with old and new address
3. Include your license number
4. Mail or email to your state board

Important Considerations

For Compact (NLC) License Holders

Changing your address has significant implications if you hold a multistate license:

• Moving within your home state: Simple address update, license remains valid
• Moving to another compact state: Your multistate license converts to single-state; you must apply for a new license in your new home state
• Moving to a non-compact state: You’ll need to obtain a new license in that state

Timeframes

Most states require notification within:

• 30 days - Most common requirement
• 10-14 days - Some states (Texas, Florida)
• 60 days - A few states allow longer

What Happens If You Don’t Update

• May not receive renewal notices
• Could miss important board communications
• May face fines for non-compliance
• License renewal could be delayed

State Board Contact Links

Find your state board’s address change portal in our State Directory or use the License Lookup Tool to find direct links to your board’s website.

The NCLEX is challenging but passable—87% of US-educated first-time NCLEX-RN candidates pass, according to NCSBN 2025 data. Most test-takers who fail did not prepare adequately or underestimated clinical judgment questions.

What Makes NCLEX Difficult

Challenge	Why It’s Hard
Adaptive testing	Questions get harder as you answer correctly
Application focus	Tests critical thinking, not memorization
NGN format	Case studies require clinical judgment
Time pressure	5 hours feels short with 145 questions

Pass Rates by Education Type

Program Type	First-Time Pass Rate
BSN programs	~90%
ADN programs	~85%
International graduates	40-50%

Why Some Find It Easier Than Expected

Many nurses who pass report the NCLEX was “easier than expected” because:

• Nursing school prepared them well
• Practice questions were harder than the real exam
• Test ended at minimum questions (85)
• Good prep builds confidence

Why Some Find It Harder

Candidates who struggle often:

• Relied on memorization over understanding
• Didn’t practice enough application questions
• Underestimated the NGN clinical judgment focus
• Had test anxiety affecting performance

The NCLEX tests whether you can think like a safe, entry-level nurse—not whether you memorized every fact from nursing school. Focus your prep on clinical reasoning and prioritization.

Stopping at 85 questions does NOT automatically mean you passed or failed. The NCLEX ends at 85 questions when the computer is 95% confident it can determine your competency level—either above or below the passing standard.

Why the Test Stops at 85

The NCLEX uses Computerized Adaptive Testing (CAT):

• Minimum questions: 85 (changed from 75 in 2023)
• Maximum questions: 145 (RN) or 150 (PN)
• Test ends when statistical confidence reaches 95%

What 85 Questions Actually Means

Scenario	What Happened
Stopped at 85, passed	You demonstrated competence quickly
Stopped at 85, failed	You demonstrated incompetence quickly
Reached 145 questions	Computer needed more data to decide
Ran out of time	Score based on last 60 questions

The Statistics

According to NCSBN data, candidates who stop at the minimum:

• Many passed—they clearly demonstrated competence
• Some failed—they clearly demonstrated incompetence
• There’s no way to know without results

Don’t Read Into Question Count

The number of questions has no correlation with pass/fail rates. Both high performers and low performers can finish quickly. The only difference is the computer’s confidence in its determination.

To know your results:

• Quick Results: Available for $7.95 after 48 hours via Pearson VUE
• Official Results: 2-6 weeks from your state board
• Pearson Vue Trick: Unreliable—don’t rely on it

The “Pearson Vue trick” (PVT) is an unofficial, unreliable method to guess NCLEX results before official scores. It involves trying to re-register for the exam—if blocked with a specific message, you may have passed. NCSBN and Pearson VUE do not endorse this method.

How the PVT Works

1. After testing, go to pearsonvue.com
2. Attempt to re-register for NCLEX
3. If you get a “good” pop-up blocking registration, you may have passed
4. If you can complete registration, you may have failed

The “Good Pop-Up”

“Our records indicate that you have recently scheduled this exam. Another registration cannot be made at this time.”

Why It’s Unreliable

Issue	Reality
False positives	Some who got “good pop-up” failed
False negatives	Some who could register passed
System glitches	Website errors cause wrong messages
Timing issues	Results not immediately in system

Better Alternatives

Method	Timeline	Cost	Reliability
Quick Results	48 hours	$7.95	High (unofficial)
State board website	2-7 days	Free	Official
Mail notification	2-6 weeks	Free	Official

The Bottom Line

The PVT creates unnecessary anxiety. If you need to know quickly, pay $7.95 for Quick Results after 48 hours. It’s unofficial but far more reliable than the PVT and saves hours of stress-refreshing websites.

Don’t make important decisions based on the PVT. Wait for official results before notifying employers or celebrating.

If you fail the NCLEX, you must wait 45 days before retaking, re-register with Pearson VUE ($200), and obtain a new ATT from your state board. Most importantly: analyze your Candidate Performance Report (CPR) to identify weak areas before your next attempt.

Immediate Steps After Failing

Step	Action	Timeline
1	Process emotionally—it’s normal to feel disappointed	Day 1
2	Request your Candidate Performance Report (CPR)	1-2 weeks
3	Analyze CPR to identify content gaps	Week 2
4	Create new study plan targeting weak areas	Week 2-3
5	Begin focused studying	Week 3+
6	Re-register after 45-day waiting period	Day 45+

Understanding Your CPR

Your Candidate Performance Report shows performance in each content area:

• Above Passing Standard: You’re strong here
• Near Passing Standard: Needs some work
• Below Passing Standard: Priority study area

Focus 70% of your study time on “below passing” areas.

Retake Statistics

• First retake pass rate: ~45-50%
• Second retake pass rate: ~35-40%
• Most states allow: Unlimited attempts (8 per year max)
• Some states limit: Total attempts (check your state)

Common Reasons for Failure

Reason	Solution
Insufficient practice questions	Do 100-150 questions daily
Content memorization vs. application	Focus on “why” not “what”
Test anxiety	Practice under timed conditions
Rushing through questions	Read each question twice
Ignoring NGN format	Practice case studies

Changing Your Approach

Consider changing your prep strategy:

• Switch question banks (UWorld, Archer, Kaplan)
• Try a structured review course
• Join study groups or tutoring
• Address underlying content gaps
• Practice relaxation techniques

You can pass the NCLEX. Most people who fail once and properly prepare pass on their second attempt.

There’s no guaranteed UWorld score that predicts NCLEX success, but consistently scoring 55-65%+ with a “high” or “very high” pass probability correlates with NCLEX success based on user-reported data. The UWorld Self-Assessment is your best predictor.

UWorld Score Guidelines

UWorld Metric	Target for NCLEX Success
Overall QBank average	55-65%+
Self-Assessment 1	”High” or “Very High”
Self-Assessment 2	”High” or “Very High”
Percentile ranking	50th+ percentile

What the Scores Mean

QBank Percentage: Your average across all practice questions

• Below 50%: More content review needed
• 50-60%: Adequate, focus on weak areas
• 60%+: Strong foundation, keep practicing

Self-Assessment Pass Probability:

• Very Low / Low: Not ready—postpone test
• Borderline: Risky—more prep recommended
• High: Good position to pass
• Very High: Excellent—test when ready

Why Percentages Can Be Misleading

Factor	Impact
Question difficulty	UWorld is often harder than NCLEX
Learning mode vs. test mode	Review increases scores artificially
Repeating questions	Inflates scores on second pass
Content coverage	Early scores lower before full review

How to Use UWorld Effectively

1. Complete the full QBank (2,000+ questions)
2. Read every rationale—even correct answers
3. Take both Self-Assessments under test conditions
4. Focus on weak areas identified by category scores
5. Don’t repeat questions for at least 3 weeks

The Bottom Line

UWorld is an excellent predictor when used correctly, but no score guarantees success. If you’re scoring “High” or above on Self-Assessments and averaging 55%+ on new questions, you’re likely ready. Trust your preparation.

Technically yes, but it’s risky. Some nursing graduates pass the NCLEX without dedicated post-graduation study because their nursing program prepared them well. However, most successful candidates study 4-8 weeks using structured prep materials.

Who Might Pass Without Extra Prep

Factor	Impact on Success
Strong nursing program	High NCLEX pass rates indicate good prep
Recent graduation	Knowledge is fresh
High grades in clinical courses	Strong application skills
Naturally good test-taker	Performs well under pressure

Why It’s Risky

The 87% first-time pass rate for US-educated candidates means 13% fail. Those who fail often:

• Overestimated their nursing school preparation
• Underestimated the NGN format changes
• Had gaps in specific content areas
• Experienced test anxiety without practice

The Math

• ~264,000 people take NCLEX annually
• 13% failure rate = ~34,000 people fail each year
• Retake fee: $200 + new ATT + 45-day wait
• Average salary loss from delayed licensure: $3,000-6,000/month

Minimum Recommended Prep

Even if you feel confident, consider:

Prep Type	Time Investment	Purpose
1-2 Self-Assessments	2-3 hours	Identify weak areas
500 practice questions	10-15 hours	Verify readiness
Review NGN format	2-3 hours	Understand case studies

The Smart Approach

Don’t gamble with your career. At minimum, take a practice assessment to identify any gaps. If you score “Very High” pass probability, you may need minimal additional prep. If not, invest the 4-8 weeks—it’s cheaper than failing.

Next Generation NCLEX (NGN) is the updated exam format launched in April 2023 that adds clinical judgment case studies and new question types. About 20% of scored questions now use NGN format, testing your ability to recognize, analyze, and prioritize patient care decisions.

NGN Question Types

Question Type	Description
Extended Multiple Response	Select all that apply with partial credit
Cloze (Drop-Down)	Fill in blanks from dropdown menus
Extended Drag-and-Drop	Arrange items or match categories
Matrix/Grid	Select answers in table format
Highlight	Select relevant text from passage
Bow-Tie	Connect conditions, actions, and outcomes

The Case Study Format

NGN case studies present a patient scenario and ask 6 questions:

1. Recognize cues (what data is relevant?)
2. Analyze cues (what do they mean?)
3. Prioritize hypotheses (what’s most likely?)
4. Generate solutions (what should you do?)
5. Take action (which interventions first?)
6. Evaluate outcomes (did it work?)

How NGN Scoring Works

Feature	Pre-NGN	NGN
Correct answers	All or nothing	Partial credit available
Case studies	None	3 unfolding case studies
Scored NGN items	0%	~20% of scored items
Pretest items	15	15 (not scored)

How to Prepare for NGN

1. Practice case studies — Use UWorld, Archer, or ATI NGN sections
2. Focus on clinical judgment — Think like a nurse, not a student
3. Learn the question types — Each type has strategies
4. Practice prioritization — Most NGN questions involve “what first?”
5. Read carefully — Case studies have lots of data to synthesize

Impact on Pass Rates

NCSBN data shows pass rates remained stable after NGN implementation. If you can think critically and prioritize patient care, NGN won’t be harder—just different.

Yes, you can hold multiple state nursing licenses simultaneously. There’s no limit to how many state licenses you can hold. However, with the Nurse Licensure Compact (NLC), you may not need multiple licenses if your home state is a compact member.

When You Need Multiple Licenses

Situation	License Needed
Home state is non-compact	License for each state you work in
Working in non-compact state	That state’s individual license
Telehealth to non-compact patients	License where patient is located
Travel nursing to non-compact states	Each state’s license

When You Don’t Need Multiple Licenses

If your primary residence is in an NLC compact state, your multistate license lets you practice in all 43 compact states without additional licenses.

Costs of Multiple Licenses

State Type	Initial Cost	Annual Renewal Cost
Average single state	$100-200	$50-100/year
Holding 5 non-compact licenses	$500-1,000	$250-500/year
Multistate (NLC) license	$100-200	$50-100/year for ALL compact states

Important Considerations

• Primary residence rules: NLC requires you declare one primary residence
• Renewal tracking: Each license has different expiration dates
• CE requirements: Some states have unique CE requirements
• Background checks: Most states require separate fingerprinting
• Address changes: You must notify each state board

Strategic Approach

For nurses working in multiple states, consider:

1. Establish residency in an NLC compact state
2. Obtain a multistate license covering 43 states
3. Get individual licenses only for non-compact states you need (CA, NY, etc.)

See our Nurse Licensure Compact guide for the current list of member states.

Transferring your nursing license through endorsement typically costs $150-$350 total, including application fees ($75-$200), license verification ($20-$50), and background check ($50-$100). Processing time varies from 2-12 weeks depending on the state.

Endorsement Cost Breakdown

Fee Type	Typical Range	Notes
Endorsement application	$75-200	Varies by state
License verification (Nursys)	$30	Most states use Nursys
Background check/fingerprinting	$50-100	LiveScan or state-specific
Jurisprudence exam	$0-50	Some states require
Total	$150-350	Plus CE if deficient

State-by-State Examples

State	Endorsement Fee	Processing Time
Texas	$186	2-4 weeks
California	$100	4-12 weeks
Florida	$110	2-4 weeks
New York	$143	4-8 weeks

Hidden Costs to Consider

Cost	Amount	When Required
Transcript fees	$10-25	If school verification needed
CE courses	$0-200	If state requires specific topics
Expedited processing	$50-150	If you need faster results
Temporary permit	$25-75	To work while waiting

Money-Saving Tips

1. Check if compact applies: If moving to/from NLC states, you may not need endorsement
2. Use e-Notify: Free license monitoring
3. Bundle applications: Some states offer discounts for multiple license types
4. Verify CE before applying: Avoid delays and resubmission fees

When Endorsement Is Free

If you hold an NLC multistate license and move to another compact state, you can convert your license for the cost of the new state’s license fee only—no endorsement application needed.

The NLC 60-day rule requires nurses to apply for a license in their new state within 60 days of establishing a new primary residence. If you move from one compact state to another, your existing multistate license converts to single-state status after 60 days if you haven’t applied for a new license.

How the 60-Day Rule Works

Scenario	What Happens
Move to new compact state	60 days to apply for new multistate license
Don’t apply within 60 days	Multistate privilege revokes; single-state only
Move to non-compact state	Old license becomes invalid; must get new license

Timeline Example

Day 1: Move from Texas (compact) to North Carolina (compact) Days 1-60: Can practice in NC under Texas multistate privilege Day 60: Must have applied for NC multistate license After Day 60: If no application, Texas license reverts to single-state

What “Primary Residence” Means

Per the NLC, your primary residence is where you:

• Have a driver’s license
• Are registered to vote
• File state income taxes
• Declare as your legal domicile

You can only have ONE primary residence at a time.

Common Mistakes to Avoid

Mistake	Consequence
Not applying within 60 days	Lose multistate privilege
Maintaining “dual residency”	NLC doesn’t recognize it
Working in non-compact state after moving	License not valid there
Not updating license with new address	Potential board action

What to Do When Moving

1. Research new state requirements before moving
2. Apply for new license within first 30 days (gives buffer)
3. Update driver’s license to establish residency
4. Notify old state board of address change
5. Track application status closely

See NLC compact member states for current participation list.

It depends on the Nurse Licensure Compact (NLC). If you hold a multistate license from an NLC member state, you can practice in all 43 compact states without additional licenses. If your license is from a non-compact state, you need a separate license for each state where you practice.

Quick Answer by Scenario

Your License	Want to Work In	Need New License?
Multistate (NLC)	Compact state	No
Multistate (NLC)	Non-compact state	Yes
Single-state	Any other state	Yes
Non-compact state	Compact state	Yes

How the NLC Works

The Nurse Licensure Compact is an agreement between 43 states that allows nurses with multistate licenses to practice across state lines. You must:

• Have primary residence in an NLC member state
• Meet the uniform licensure requirements
• Hold an active, unencumbered license

States NOT in the NLC

As of 2026, these states require separate licenses regardless:

• California
• New York
• Alaska
• Hawaii
• Illinois (pending)
• Michigan
• Minnesota
• Nevada
• Oregon
• Washington (pending)

Telehealth and Remote Work

Important: For telehealth nursing, you must be licensed in the state where the patient is located, not where you are. An NLC multistate license covers telehealth to patients in all compact states.

Travel Nursing

Travel nurses benefit most from the NLC:

• One multistate license covers assignments in 43 states
• Only need additional licenses for non-compact states
• Significantly reduces licensing costs and paperwork

Check your NLC eligibility or see the full list of compact states.

The fastest path for international nurses is 12-18 months for most countries, but Canadian nurses with TN visa eligibility can start in 2-4 weeks. For others, the timeline depends on CGFNS processing, NCLEX scheduling, visa category, and country of origin.

Fastest Paths by Country of Origin

Country	Fastest Path	Timeline
Canada	TN Visa	2-4 weeks
Mexico	TN Visa	2-4 weeks
Philippines	EB-3 or employer sponsorship	18-36 months
India	EB-3 or employer sponsorship	24-48 months
UK/Ireland	H-1B or EB-3	12-24 months
Australia	H-1B or EB-3	12-24 months
Nigeria	EB-3	12-24 months

Steps to Minimize Timeline

Step	Fastest Approach	Time Saved
CGFNS	Start before finishing nursing school	2-4 months
NCLEX prep	Study while CGFNS processes	3-6 months
English test	Take IELTS/TOEFL early	2 months
State selection	Choose fast-processing state (TX, FL)	2-6 weeks
Employer match	Work with recruiting agency early	Varies

Critical Timeline Optimizations

1. Start CGFNS immediately — This is always the longest domestic step
2. Take NCLEX abroad — Available in Philippines, India, UK, Canada, Australia
3. Target compact states — More flexibility for future moves
4. Work with EB-3 employer sponsors — Some have faster processing
5. Consider premium processing — If H-1B eligible

Why Some Countries Are Slower

Factor	Countries Affected
EB-3 visa backlog	Philippines, India (multi-year waits)
Document verification	Some countries have slow institutions
English proficiency	Non-English speaking countries need testing
Credential differences	Countries with different curricula need evaluation

The Bottom Line

• Canada/Mexico: 2-4 weeks (TN visa)
• UK/Australia/English-speaking: 12-18 months typical
• Philippines: 18-36 months (visa backlog)
• India: 24-48 months (visa backlog)

Start your CGFNS application now—everything else depends on it.

CGFNS (Commission on Graduates of Foreign Nursing Schools) certification is required by most US states for international nurse licensure and provides credential verification, visa eligibility, and faster state board processing. The $445 investment opens doors that otherwise remain closed.

Key Benefits of CGFNS

Benefit	Why It Matters
State licensure eligibility	Most states require CGFNS for international graduates
VisaScreen foundation	Required for work visa issuance
Credential verification	Proves your education meets US standards
Faster processing	States trust CGFNS evaluation
One-time investment	Valid for career lifetime

What CGFNS Evaluates

Component	What’s Verified
Nursing education	Curriculum meets US requirements
License status	Active, unrestricted in home country
English proficiency	IELTS, TOEFL, or PTE scores
Secondary education	High school diploma verification
Credential authenticity	Documents verified with institutions

Which CGFNS Program Do You Need?

Program	Cost	What You Get
CGFNS Certification	$445	Full evaluation + qualifying exam
Credentials Evaluation Service (CES)	$350	Evaluation only
VisaScreen	$540	Immigration certificate

Most nurses need both CES/Certification AND VisaScreen.

States That Require CGFNS

Most states require CGFNS certification or CES, including:

• California
• New York
• Texas
• Florida
• Illinois
• Pennsylvania

Some states accept alternative evaluations—check your target state’s requirements.

Timeline and Process

Step	Timeline
Application submission	1 day
Document collection	1-4 months (varies by country)
CGFNS review	2-4 months
Qualifying exam (if required)	Schedule within 3 months
Certificate issuance	2-4 weeks after completion
Total	4-8 months typical

Tips for Faster Processing

1. Order all documents from institutions before applying
2. Use CGFNS’s secure portal for tracking
3. Follow up with institutions weekly
4. Have documents apostilled if required
5. Start English testing early (scores valid 2 years)

CGFNS is not optional for most international nurses. Start the process 12+ months before you want to work in the US.

Filipino nurses are the largest group of international nurses in the US, and the pathway is well-established: CGFNS certification, NCLEX exam, state licensure, VisaScreen, and EB-3 immigrant visa. The challenge is the 2-4 year EB-3 visa backlog for Philippines-born applicants.

Step-by-Step Requirements

Step	Requirement	Timeline
1	CGFNS certification or CES	4-8 months
2	Pass NCLEX-RN (can take in Manila)	2-4 months
3	State license application	2-8 weeks
4	VisaScreen certificate	4-8 weeks
5	EB-3 visa processing	2-4+ years

CGFNS for Filipino Nurses

The Philippines has the most established CGFNS pipeline:

• PRC (Professional Regulation Commission) verification
• Nursing school transcript verification
• English proficiency (if required)
• CGFNS qualifying exam

Common delay: PRC verification can take 2-3 months

NCLEX in the Philippines

Location	Manila Pearson VUE Center
Availability	Year-round
Registration	Through Pearson VUE
ID requirements	Valid passport
ATT	From US state board

Taking NCLEX in the Philippines saves time and travel costs.

The EB-3 Visa Backlog

Factor	Current Status (2025)
Visa category	EB-3 (skilled worker)
Priority date wait	2-4+ years for Philippines
While waiting	Can work in Philippines or other countries
Alternatives	Some nurses work in UK/Canada first

Employer Sponsorship Process

Most Filipino nurses come through direct employer sponsorship:

1. US hospital partners with recruitment agency
2. Agency handles CGFNS/NCLEX support
3. Hospital files EB-3 petition
4. Nurse waits for visa priority date
5. Consular interview in Manila
6. Arrive in US and begin work

Common Pitfalls

Pitfall	How to Avoid
Slow PRC verification	Request early, follow up weekly
NCLEX failure	Invest in quality prep (UWorld)
Recruitment scams	Use verified agencies only
Visa date retrogression	Have backup plans
Contract violations	Read employment contracts carefully

Resources

• CGFNS: cgfns.org
• PRC: prc.gov.ph
• Pearson VUE Manila: pearsonvue.com
• POEA (labor agency verification): poea.gov.ph

VisaScreen is a certificate required by US immigration for healthcare workers seeking work visas or green cards. All international nurses need VisaScreen for immigration purposes—it’s issued by CGFNS and verifies your credentials, license, and English proficiency.

What VisaScreen Verifies

Component	Requirement
Education	Nursing education equivalent to US
License	Valid, unrestricted in home country
English	IELTS/TOEFL/PTE passing scores
NCLEX	Must have passed NCLEX (or be scheduled)
Health competency	Licensed to practice profession

Who Needs VisaScreen

Visa Type	VisaScreen Required?
EB-3 (Green Card)	Yes
H-1B (Temporary Work)	Yes
TN (Canada/Mexico)	Yes
O-1 (Extraordinary Ability)	Yes
J-1 (Exchange Visitor)	Yes
Student/Tourist	No (can’t work)

Exception: Some nurses with Canadian education/licensing may be exempt.

VisaScreen vs CGFNS Certification

Feature	CGFNS Certification	VisaScreen
Purpose	State licensure	Immigration
Who requires	State nursing boards	USCIS
Includes exam	Yes (optional)	No
Cost	$445	$540
Timeline	4-8 months	4-8 weeks (after NCLEX)

Most international nurses need BOTH.

VisaScreen Process

Step	Timeline
1. Complete CGFNS credential evaluation	4-8 months
2. Pass English proficiency test	Variable
3. Pass NCLEX	2-4 months
4. Apply for VisaScreen	1 day
5. CGFNS issues certificate	2-4 weeks

English Proficiency Requirements

Test	Speaking	Listening	Reading	Writing
IELTS Academic	7.0	7.0	6.5	7.0
TOEFL iBT	26	26	22	24
PTE Academic	65	65	58	65

Validity and Updates

• VisaScreen is valid indefinitely
• Must notify CGFNS of license status changes
• Immigration may request verification
• Keep CGFNS contact information current

Cost

Component	Cost
VisaScreen application	$540
English test (if needed)	$200-300
Document shipping	$50-100
Total	~$800-1,000

VisaScreen is the final credential step before visa processing. Don’t delay—start the process while working on other requirements.