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CompactStates

Telehealth nursing and the compact license

Telehealth raises a simple but important question: which state’s license do you need? The answer usually follows the patient.

Which state license do I need for telehealth nursing?

For telehealth, nurses are generally considered to be practicing where the patient is located at the time of service — not where the nurse is sitting. So you need to be licensed (or hold compact privilege) in the patient’s state. If both your home state and the patient’s state are compact states and you hold a multistate license, that single license generally covers the encounter.

Nurse Licensure Compact FAQ ↗Last reviewed 2026-06-17

How the “patient location” rule plays out

Because the patient’s location controls, a multistate license is especially useful for telehealth nurses who serve patients across several states.

  • Patient in a compact state + your active multistate license = generally covered under privilege.
  • Patient in a non-compact state = you generally need that state’s license, even if you never leave home.

Don’t forget non-compact patient states

This is where telehealth nurses get caught out: serving a patient in a non-compact state usually requires that state’s license by endorsement. Map out every state your patients are in, and check each one with the compact state checker.

Confirm before you practice

Telehealth rules can carry extra conditions, so verify your license type in Nursys and confirm telehealth requirements with the board in the patient’s state.

Before you accept a telehealth role

  • Confirm your license type in Nursys — single-state or multistate.
  • Check the status of the state where the work (or the patient) is located.
  • For telehealth, remember you’re generally licensed where the patient is.
  • Ask the employer or agency exactly which license they require.
  • Confirm any state-specific requirements with that board of nursing.
  • Keep documentation of your residency and license status.

Frequently asked questions

No. For telehealth you’re generally licensed where the patient is. Your compact license covers patients in compact states; patients in non-compact states generally require that state’s license.

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