Interstate Medical Licensure Compact: A New Era of Physician Mobility

By: N. Adam Brown, MD MBA, CMO Radiant Healthcare

The process of securing medical licenses across state lines has been a study in frustration for decades. Each state maintained its own forms, fees, and verification process, creating a maze of bureaucracy that hindered physicians from reaching more patients.

The Interstate Medical Licensure Compact (IMLC) addresses this inefficiency. It gives physicians a faster, more practical way to serve patients across multiple states.

Instead of repeating the entire process for each new state, eligible doctors can now leverage their primary license to apply in other states through a central, coordinated pathway.

Here’s how it works.

What is the IMLC?

At its simplest, the IMLC is an agreement among participating states that streamlines multi-state licensure.

A physician who meets the eligibility criteria in their State of Principal License can apply once and then extend that approval to other compact states.

The process still requires verification, but it’s managed through a single system that substantially reduces the administrative burden.

Some 42 states plus the District of Columbia and Guam now participate in the agreement, which means about 80% of U.S. physicians are eligible for expedited licensure.

Why Credentialing Teams Care

Licensure is often the slowest part of credentialing. Every hospital and staffing agency knows the frustration of hiring an excellent clinician only to lose weeks to verification and documentation.

The IMLC accelerates this process. In 2024, 37.4% of all initial licenses were issued via the IMLCC pathway, up from 31% percent in 2022.

That growth translates into something tangible for credentialing teams: faster onboarding, better workforce flexibility, and fewer gaps in coverage. 

Expanding Access Through Rural and Telehealth Networks

Rural and remote communities (where physician shortages are most pronounced) stand to benefit most. With fewer barriers to cross-state practice, hospitals can fill vacancies sooner and draw from a wider pool of credentialed clinicians.

Telehealth providers also benefit. Physicians can continue treating established patients across state lines and deliver follow-up or specialist consultations without extended licensing delays.

The result is a more accessible healthcare ecosystem where geography is less of a barrier to access.

Costs and Eligibility

The compact makes licensing faster, but not necessarily easier.

Physicians must pay a non-refundable $700 IMLC application cost in addition to state-specific license fees. In Alabama, for example, the fee is $75. For those who want to practice in Maryland, the fee is a more substantial $790.

Physicians must also meet clear eligibility requirements: an unrestricted license in a participating state, board certification, completed graduate medical education, and a clean professional record.

Confirming eligibility early can prevent wasted time and fees, especially since the IMLC application fee is non-refundable.

Remaining Limitations

While the IMLC is a major step forward, a handful of states remain outside the compact and others are still developing legislation.

Note that the compact does not override state authority. Each state maintains control over renewals, investigations, and disciplinary actions, which means compliance monitoring remains critical.

Credentialing teams must also maintain internal processes to track renewals, verify continued eligibility, and stay informed about any state-specific telehealth laws that affect licensed physicians.

The Path Forward

The IMLC represents a modern approach to an outdated system. While it’s not perfect, it reduces repetition, lowers administrative effort, and helps healthcare organizations deploy talent where it’s needed.

Full adoption is the next step. As the remaining states join, the compact’s efficacy will only increase. For physicians, this means less waiting and more working. For patients, it means timely access to care that may otherwise have been out of reach.

References

https://gmedical.com/blog/interstate-medical-licensure/

https://imlcc.com/wp-content/uploads/2025/07/IMLCC_New-License-Volume-Report-for-June2025-7-3-2025-FINAL.pdf

https://imlcc.com/what-does-it-cost/