What’s New with the PT Interstate Licensure Compact?

In theory, a PT patient who needs help with low back pain should receive the same care in Alaska as they do in Hawaii. After all, PTs across the country should have equivalent skills. It should follow that a licensed Alaskan PT could move to Hawaii and immediately treat patients—right? Wrong. Each state has its own individual licensure requirements that do not cross state lines, which means that in order to treat in a new state, PTs must go out and get a shiny new PT license.

Some national PT organizations—like The Federation of State Boards of Physical Therapy (FSBPT)—are trying to change that. They’re attempting to unify the industry by pushing the PT compact. 

What is the PT compact? 

The physical therapy licensure compact is an interstate agreement that allows participating PTs and PTAs to provide physical therapy services across state lines. Basically, PT compact states recognize that if you earned a PT or PTA license in North Dakota, you’re skilled enough to provide care in Louisiana. This makes it easier for providers to work across state lines, opening up patient access to medical care.

What’s the history of the PT compact?

In 2010, during an annual Federation of State Boards of Physical Therapy (FSBPT) meeting, a representative from the FSBPT Delegate Assembly posed the idea of creating an interstate agreement that would allow PTs to provide care across state lines. Members of the FSBPT and the Delegate Assembly continued to discuss the idea until 2014, when the FSBPT created an interstate compact taskforce to tackle the project.

That same year, the taskforce partnered with the Council of State Governments’ National Center for Interstate Compacts (CSG) to craft the language of the PT compact that would be presented to state legislative bodies. That same interstate compact language is used today!

Who recognizes the PT compact?

Though the number of participating states is growing, there are states that have yet to enact the PT compact. As of May 2022, the compact member states are: 

• Washington, 
• Oregon, 
• North Dakota, 
• Nebraska, 
• Colorado, 
• Utah, 
• Arizona, 
• Oklahoma, 
• Texas, 
• Iowa, 
• Missouri, 
• Delaware,
• Maryland,

• Montana,
• Arkansas, 
• Louisiana, 
• Mississippi, 
• Kentucky, 
• Tennessee, 
• West Virginia,
• Virginia,
• North Carolina, 
• New Hampshire, 
• Georgia, and
• Ohio.

Additionally, some states have passed the PT compact legislation—but have not yet begun issuing (or accepting) compact licenses. These are: 

• Alabama,
• South Dakota, 
• Wisconsin, 
• Indiana,
• South Carolina, 
• New Jersey, 
• Kansas, and 
• Pennsylvania.

Michigan, Massachusetts, and Rhode Island have all introduced PT compact legislation, although none have passed through both houses of the respective state legislatures yet.  

What are the benefits of joining? 

While joining the PT compact might not be the right move for every physical therapist, there are some who could seriously benefit from getting an interstate license. If a therapist lives really close to the border between two states, for instance, he or she could open up practice on both sides of the state line. According to the PT compact site, a compact license is typically cheaper than a traditional license, which means enterprising therapists could save money by getting one traditional license and one compact license instead of two traditional licenses. Additionally, the PT compact site notes that a compact license doesn’t have any continuing education requirements. 

How can I obtain a PT compact license? 

Before you can join the PT compact, you must fulfill a handful of eligibility criteria. You must hold an active PT or PTA license in your state, for instance, and you cannot have “any active encumbrances or any disciplinary action against your license for a period of two years.” Additionally, your home state (and any other state in which you wish to be licensed) must be active PT compact participants. Finally, if the state you wish to practice in requires a jurisprudence exam, then you must take one before applying for your compact license. Most jurisprudence exams are accessible online, but ultimately, you’ll have to do a little digging to figure out how and where you can take the exam.  

If you meet all that criteria, then follow these instructions:

1. Navigate to the PT Compact website. 
2. Log in with your FSBPT ID and password.
3. Select the button that says “Purchase.”
4. Complete your user profile.
5. Select the states for which you want a compact license.
6. Attest that you’ve finished your jurisprudence exams as applicable.
7. Pay for your compact privileges. 

To see how much it costs to get compact privileges in a certain state, refer to this table. 

What’s new about the compact?

In a September 2021 update from the Medicare Learning Network, CMS announced that it would fully recognize compact licenses as meeting the standard of federal licensure. Previously, Medicare Administrative Contractors (MACs) could deny enrollment applications that listed interstate licenses. 

Telehealth Implications

For the duration of the current public health emergency (a.k.a. the COVID-19 pandemic), CMS is allowing PTs, OTs, and SLPs to provide telehealth therapy services to their Medicare patients—and it’s paying for those services. Because CMS also now recognizes the PT compact, that means compact therapists could, in theory, provide telehealth to Medicare patients located in different compact states. To determine specific telehealth requirements, we recommend compact license holders consult the rules and laws for the state in which they intend to provide these services.

Telehealth services—whether they’re provided in-state or otherwise—could open doors of therapeutic care accessibility to patients who live in rural or underserved areas, allowing them to get the specialized care they need without traveling long distances. But, that accessibility will be short lived if CMS fails to make its temporary telehealth expansion permanent—which gives rehab therapists even more reason to take immediate action on the advocacy front. (Check out this page to learn how.)  

So, there you have it. That’s the PT compact in a nutshell! Have more questions for us? Feel free to drop them below, and we’ll do our best to find you an answer.