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 Massachusetts generally means you need authority to practice in Massachusetts — via compact privilege or a Massachusetts license. See telehealth: patient in another state.
The law that governs this in Massachusetts
Caring for a patient located in Massachusetts is practice in Massachusetts, so it is Massachusetts’s own nurse practice act that defines what you may do and the Massachusetts Board of Registration in Nursing that applies it. That act is Mass. Gen. Laws ch. 112, §§ 74–81C.
The compact itself is separate law. Massachusetts adopted it at Mass. Gen. Laws ch. 112A, which is what allows a multistate license issued elsewhere to reach Massachusetts at all — the practice act still decides what you may do once it does.
Compact status is not the only consideration
Even where a multistate license reaches Massachusetts, your employer and the Massachusetts Board of Registration in Nursing 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 Massachusetts
Massachusetts has enacted the compact (November 20, 2024) but has not finished implementing it, so privilege is not active here yet. Either way the practical answer for caring for patients located in Massachusetts is the same today: a multistate license from another state does not authorize it, and you generally need a Massachusetts license from the Massachusetts Board of Registration in Nursing. Re-check before a start date rather than assuming — this is precisely the fact that changes.