Telehealth Nursing Licensing Guide
Navigate the licensing requirements for telehealth and remote nursing practice. Learn how to provide care across state lines legally and compliantly.
The Telehealth Licensing Challenge
Before the NLC, telehealth nurses faced a significant barrier: they needed a separate license for every state where they had patients. For a nurse triage line serving patients nationwide, this could mean 50+ licenses to obtain and maintain.
Without NLC
- Apply for license in each state
- Pay $100-$300 per state
- Wait 4-12 weeks per application
- Track multiple renewal dates
- Complete separate CE requirements
With NLC Multistate License
- One application, 43 states
- Single license fee
- Immediate practice authorization
- One renewal date to track
- Home state CE requirements only
Using the NLC for Telehealth
The Nurse Licensure Compact is the key to efficient telehealth practice. Here's how to leverage it for remote nursing:
Step 1: Establish Residence in an NLC State
To get a multistate license, your primary state of residence must be an NLC member. If you currently live in a non-compact state, consider whether relocating makes sense for your telehealth career.
Step 2: Apply for a Multistate License
Apply through your home state board of nursing. Check "multistate" on your application and meet the uniform licensure requirements (unencumbered license, SSN, background check).
Step 3: Handle Non-Compact States Separately
For patients in California, New York, Massachusetts, and other non-compact states, you'll still need individual licenses. Prioritize these based on your patient population.
Step 4: Maintain Compliance
Keep your home state license current, complete required CE, and stay informed about NLC updates. When states join or leave the compact, your coverage changes automatically.
Types of Telehealth Nursing Roles
Nurse Triage
Assess patient symptoms via phone or video, provide guidance, and direct to appropriate care levels.
Remote Patient Monitoring
Monitor vital signs and health data from patients' homes, intervening when needed.
Virtual Care Coordination
Coordinate care plans, follow-ups, and communication between patients and providers.
Telehealth NP/APRN
Provide full scope NP services via video including diagnosis, treatment, and prescribing.
Telehealth for APRNs
Advanced Practice Registered Nurses (NPs, CNMs, CRNAs, CNSs) have additional licensing considerations for telehealth practice.
APRN Compact (New)
The APRN Compact was enacted to allow multistate APRN practice similar to the RN/LPN compact. However, it requires 7 states to join before becoming operational.
Current APRN Telehealth Requirements
- RN multistate license - Covers RN scope of practice in NLC states
- Individual APRN licenses - Required for each state where you provide APRN-level care
- DEA and state prescribing registrations - For each state where you prescribe
- Collaborative agreements - Required in some states for NP practice
Telehealth Licensing Best Practices
Verify Patient Location Every Visit
Patients travel. Always confirm where the patient is physically located at the time of the telehealth encounter.
Document Licensure
Keep records showing you were properly licensed to provide care in the patient's state at the time of service.
Know State Telehealth Laws
Beyond licensing, states have varying telehealth regulations around informed consent, prescribing, and technology requirements.
Use License Tracking Software
With multiple licenses to maintain, use credentialing software to track expiration dates and renewal requirements.
Check Your License Coverage
Use our tools to verify your multistate license coverage and check reciprocity with your target states.