Licensure follows the patient
The location that matters for telehealth is generally the patient’s, not yours. Sitting in one state and caring for a patient in American Samoa generally means you need authority to practice in American Samoa — via compact privilege or an American Samoa license. See telehealth: patient in another state.
The law that governs this in American Samoa
Caring for a patient located in American Samoa is practice in American Samoa, so it is American Samoa’s own nurse practice act that defines what you may do and the American Samoa Health Services Regulatory Board that applies it. That act is A.S.C.A. § 31.1002 — Health Services Regulatory Board, created; purpose.
There is no compact statute to cite for American Samoa, which is the substantive point rather than a gap in our research: American Samoa has not adopted the compact, so the practice act above is the whole of the law that applies to you here.
Compact status is not the only consideration
Even where a multistate license reaches American Samoa, your employer and the American Samoa Health Services Regulatory Board may impose additional requirements, and some roles carry their own rules. Compact status answers one question — it is not a blanket authorization to practice remotely.
APRN telehealth is separate
The compact covers RN and LPN/LVN licenses only. If you work as an APRN, your advanced-practice authority is granted state by state and is not carried by a multistate RN license — a point that catches out a lot of remote NP roles.
Why compact privilege does not reach American Samoa
American Samoa has not adopted the compact. Either way the practical answer for caring for patients located in American Samoa is the same today: a multistate license from another state does not authorize it, and you generally need an American Samoa license from the American Samoa Health Services Regulatory Board. Re-check before a start date rather than assuming — this is precisely the fact that changes.