Does the compact cover telehealth?

Compact privilege is not limited to being physically present — if your multistate license authorizes practice in a compact state, that generally includes telehealth to patients located there. The key is that licensure follows the patient's location, so it is the patient's state that must be covered, not yours.

Does this apply to nurse practitioners doing telehealth in Puerto Rico?

No — not through the Nurse Licensure Compact. The compact covers RN and LPN/LVN licenses only. APRN authority (NP, CRNA, CNS, CNM) is separate and state-by-state, so an APRN telehealth role in Puerto Rico generally needs Puerto Rico APRN authorization regardless of compact status. See our APRN guide and confirm with the board.

CompactStates

Telehealth nursing license requirements in Puerto Rico

Telehealth licensing has one governing idea: you generally need authority where the patient is. Here is how that plays out for patients located in Puerto Rico.

Do I need a Puerto Rico license for telehealth nursing?

Generally, you need authority to practice where your patient is — so if your patient is in Puerto Rico, Puerto Rico licensure rules apply, even if you never leave home. Puerto Rico does not currently grant compact privilege, so a multistate license generally does not authorize telehealth to patients in Puerto Rico. You would typically need a Puerto Rico license by endorsement. Confirm with the Puerto Rico Board of Nurse Examiners before you take the role.

Last reviewed 2026-06-17

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 Puerto Rico generally means you need authority to practice in Puerto Rico — via compact privilege or a Puerto Rico license. See telehealth: patient in another state.

Compact status is not the only consideration

Even where a multistate license reaches Puerto Rico, your employer and the Puerto Rico Board of Nurse Examiners may impose additional requirements, and some roles carry their own rules. Compact status answers one question — it is not a blanket authorization to practise 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.

Next-step checklist

Identify where your patients are located — that generally drives licensure.
Confirm your license reads multistate on Nursys (nursys.com) if you rely on privilege.
Plan for a Puerto Rico license — privilege does not reach Puerto Rico today.
If you practise as an APRN, confirm Puerto Rico APRN authority separately with the board.

Frequently asked questions

Generally not on a compact license. Puerto Rico does not currently recognize compact privilege, so a multistate license does not authorize telehealth to patients located in Puerto Rico. You would typically need a Puerto Rico license. Confirm with the Puerto Rico Board of Nurse Examiners.