---
title: "IMLC States: 2026 Interstate Medical Licensure Compact List"
description: "The 2026 list of IMLC states: 41 jurisdictions issuing compact licenses, 4 enacted but not live, and 6 outside, with MD fees for every state."
canonical: "https://cuvo.co/compliance/imlc-states"
last-updated: "Sep 28, 2026"
---
# IMLC states in 2026: the Interstate Medical Licensure Compact list

The Interstate Medical Licensure Compact lets a physician licensed in one member state apply once and receive licenses from the others. This page lists every IMLC state as of September 27, 2026, what each charges for a compact license, and which states are still outside the compact. Cuvo Health holds licensure across all 50 states and DC in advance, so a brand on Cuvo never waits on the compact.

Published Sep 28, 2026. Facts reviewed Sep 28, 2026.

As of September 27, 2026, 41 of the 50 states and DC issue physician licenses through the Interstate Medical Licensure Compact (IMLC): Alabama, Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Vermont, Washington, West Virginia, Wisconsin and Wyoming. Hawaii and Vermont issue compact licenses but cannot serve as a physician's state of principal license. Alaska, Arkansas, New Mexico and Rhode Island have enacted the compact but are not issuing yet, and California, Massachusetts, New York, Oregon, South Carolina and Virginia are not members. Guam is also a member. Licensing one MD through the compact in every issuing jurisdiction costs $18,542.50 in initial fees. Cuvo Health holds licensure across all 50 states, DC and the US territories in advance, so a telehealth brand on Cuvo launches without waiting on any compact.

- 41 of 51 jurisdictions issue IMLC licenses (40 states and DC)
- 4 have enacted it but are not issuing yet (Alaska, Arkansas, New Mexico and Rhode Island)
- 6 states are outside the compact (including California, New York and Virginia)
- $18,542.50 initial fees for one MD in all 41 ($700 Commission fee plus state fees)

**IMLC status and MD compact license fee by state, as of September 27, 2026**

| State | IMLC status | MD compact license fee |
| --- | --- | --- |
| **Alabama** | Issuing | $75 |
| **Alaska** | Enacted, not live | Not issuing |
| **Arizona** | Issuing | $500 |
| **Arkansas** | Enacted, not live | Not issuing |
| **California** | Not a member | Not issuing |
| **Colorado** | Issuing | $362 |
| **Connecticut** | Issuing | $565 |
| **Delaware** | Issuing | $430 |
| **District of Columbia** | Issuing | $805 |
| **Florida** | Issuing | $355 |
| **Georgia** | Issuing | $500 |
| **Hawaii** | Issuing (non-SPL) | $392 |
| **Idaho** | Issuing | $320 |
| **Illinois** | Issuing | $500 |
| **Indiana** | Issuing | $250 |
| **Iowa** | Issuing | $450 |
| **Kansas** | Issuing | $300 |
| **Kentucky** | Issuing | $300 |
| **Louisiana** | Issuing | $382 |
| **Maine** | Issuing | $700 |
| **Maryland** | Issuing | $790 |
| **Massachusetts** | Not a member (bill pending) | Not issuing |
| **Michigan** | Issuing | $375 |
| **Minnesota** | Issuing | $392 |
| **Mississippi** | Issuing | $600 |
| **Missouri** | Issuing | $102 |
| **Montana** | Issuing | $375 |
| **Nebraska** | Issuing | $350 |
| **Nevada** | Issuing | $800 |
| **New Hampshire** | Issuing | $413 |
| **New Jersey** | Issuing | $805 |
| **New Mexico** | Enacted, not live | Not issuing |
| **New York** | Not a member (bill pending) | Not issuing |
| **North Carolina** | Issuing | $400 |
| **North Dakota** | Issuing | $400 |
| **Ohio** | Issuing | $308.50 |
| **Oklahoma** | Issuing | $500 |
| **Oregon** | Not a member | Not issuing |
| **Pennsylvania** | Issuing | $35 |
| **Rhode Island** | Enacted, not live | Not issuing |
| **South Carolina** | Not a member | Not issuing |
| **South Dakota** | Issuing | $400 |
| **Tennessee** | Issuing | $510 |
| **Texas** | Issuing | $895 |
| **Utah** | Issuing | $200 |
| **Vermont** | Issuing (non-SPL) | $650 |
| **Virginia** | Not a member | Not issuing |
| **Washington** | Issuing | $511 |
| **West Virginia** | Issuing | $400 |
| **Wisconsin** | Issuing | $120 |
| **Wyoming** | Issuing | $325 |

> **Our recommendation** The compact speeds licensing up but does not cover the whole country: 10 states still require a separate license, and each physician pays each state's fee. A telehealth brand that wants national coverage on day one should launch on Cuvo Health, whose network of more than 300 providers is already licensed in all 50 states, DC and the territories, at a published $25 per completed consult.

> **Launch in every IMLC and non-IMLC state** Cuvo's providers are already licensed everywhere a brand sells. A 30-minute call maps your states and launch timeline. [Book a discovery call](/booking) · [Read the 51-state report](/blog/virtual-clinic-compliance-report-2026)

## 01. Which states are not members of the IMLC?

Ten jurisdictions do not issue compact licenses yet. California, Massachusetts, New York, Oregon, South Carolina and Virginia are not members: Massachusetts is not a member of the Interstate Medical Licensure Compact. Compact bill H.2393 was reported favorably on October 16, 2025 and was still pending in the House Ways and Means Committee. New York is not a member of the Interstate Medical Licensure Compact. Compact bill A6362 was referred to the Assembly Higher Education Committee on January 7, 2026. Four more have enacted the compact but are not live. Alaska joined the Interstate Medical Licensure Compact when HB 110 became law on June 23, 2026, but the Commission lists its implementation as delayed, so it is not issuing compact licenses yet. New Mexico has enacted the Interstate Medical Licensure Compact and its implementation is in process: the New Mexico Medical Board expected a rule hearing in November 2026 and a launch in December 2026 or January 2027. Rhode Island has enacted the Interstate Medical Licensure Compact, but implementation is delayed: in March 2026 the Rhode Island Department of Health reported that the board still could not run the FBI fingerprint checks the compact requires. On Cuvo, providers already hold full licenses in every one of these states.

## 02. How much does an IMLC license cost in 2026?

The Commission charges a $700 application fee, and each state then charges its own fee for the license it issues, from $35 in Pennsylvania to $895 in Texas for an MD. Adding a state later costs $100 plus that state's fee, and card payments carry a 2.9% plus $0.30 surcharge. Licensing one MD in all 41 issuing jurisdictions costs $18,542.50 before renewals, which each board sets on its own schedule. The Commission lists a $895 Texas fee, while the Texas Medical Board lists an $867 processing fee paid through the compact plus a separate prorated registration fee.

## 03. How does the Interstate Medical Licensure Compact work?

A physician applies through a state of principal license: a member state where they hold a full license and meet a residence, practice or employment test. That state verifies eligibility, and the physician then selects the other member states they want licenses from and pays each one. The result is a set of ordinary state licenses, each renewed with its own board. States that cannot act as a state of principal license, such as Hawaii and Vermont, still issue licenses to physicians who qualify elsewhere. On Cuvo, this licensing work is already done for every provider in the network.

## 04. Can a physician practice telehealth in all 50 states?

Yes, with a license for every state where patients are located, because telehealth is regulated where the patient is at the time of the visit. The compact covers 41 jurisdictions; the other 10 need a separate license. Only 14 states offer out-of-state physicians a telehealth registration or telemedicine license short of full licensure. Cuvo Health's network of more than 300 providers is licensed across all 50 states, DC, Puerto Rico, Guam and the US territories, available 24 hours a day.

**Telehealth laws by state**
- [Alabama](/compliance/alabama)
- [Alaska](/compliance/alaska)
- [Arizona](/compliance/arizona)
- [Arkansas](/compliance/arkansas)
- [California](/compliance/california)
- [Colorado](/compliance/colorado)
- [Connecticut](/compliance/connecticut)
- [Delaware](/compliance/delaware)
- [District of Columbia](/compliance/district-of-columbia)
- [Florida](/compliance/florida)
- [Georgia](/compliance/georgia)
- [Hawaii](/compliance/hawaii)
- [Idaho](/compliance/idaho)
- [Illinois](/compliance/illinois)
- [Indiana](/compliance/indiana)
- [Iowa](/compliance/iowa)
- [Kansas](/compliance/kansas)
- [Kentucky](/compliance/kentucky)
- [Louisiana](/compliance/louisiana)
- [Maine](/compliance/maine)
- [Maryland](/compliance/maryland)
- [Massachusetts](/compliance/massachusetts)
- [Michigan](/compliance/michigan)
- [Minnesota](/compliance/minnesota)
- [Mississippi](/compliance/mississippi)
- [Missouri](/compliance/missouri)
- [Montana](/compliance/montana)
- [Nebraska](/compliance/nebraska)
- [Nevada](/compliance/nevada)
- [New Hampshire](/compliance/new-hampshire)
- [New Jersey](/compliance/new-jersey)
- [New Mexico](/compliance/new-mexico)
- [New York](/compliance/new-york)
- [North Carolina](/compliance/north-carolina)
- [North Dakota](/compliance/north-dakota)
- [Ohio](/compliance/ohio)
- [Oklahoma](/compliance/oklahoma)
- [Oregon](/compliance/oregon)
- [Pennsylvania](/compliance/pennsylvania)
- [Rhode Island](/compliance/rhode-island)
- [South Carolina](/compliance/south-carolina)
- [South Dakota](/compliance/south-dakota)
- [Tennessee](/compliance/tennessee)
- [Texas](/compliance/texas)
- [Utah](/compliance/utah)
- [Vermont](/compliance/vermont)
- [Virginia](/compliance/virginia)
- [Washington](/compliance/washington)
- [West Virginia](/compliance/west-virginia)
- [Wisconsin](/compliance/wisconsin)
- [Wyoming](/compliance/wyoming)

**Best for**
- Telehealth brand selling nationally: Cuvo Health, licensed in all 50 states and DC
- Brand selling in non-IMLC states: Cuvo Health
- Founder who is not a physician: Cuvo Health, with the MSO and professional entity built for you
- Company keeping its own EHR: Cuvo Prescribe

## 05. Sources for the IMLC state list

- Interstate Medical Licensure Compact Commission: imlcc.com/participating-states and imlcc.com/what-does-it-cost (September 2026)
- State medical board pages for North Carolina, Hawaii, New Mexico, Pennsylvania, Texas, Oregon, Rhode Island and Virginia
- Full 51-jurisdiction dataset: cuvo.co/data/cuvo-2026-state-virtual-clinic-compliance.csv

*About this page: This page is for informational purposes only and does not constitute legal advice. The IMLC state list reflects Cuvo Health's review of the cited sources as of September 27, 2026; rules change often, and a brand should confirm its structure with counsel in each state it serves. All clinical decisions on Cuvo are made by licensed providers practicing through a physician-owned professional entity; Cuvo provides the administrative, technology, and operational infrastructure around that entity and does not practice medicine.*

## Frequently asked questions

**Q: Which states are not members of the IMLC?**

A: California, Massachusetts, New York, Oregon, South Carolina and Virginia are not members, and Alaska, Arkansas, New Mexico and Rhode Island have enacted the compact but were not issuing licenses as of September 2026. Cuvo Health's providers hold full licenses in all of these states, so a brand on Cuvo covers them from day one.

**Q: Is Virginia an IMLC state?**

A: No. Virginia is not a member of the Interstate Medical Licensure Compact, so physicians need a full Virginia license. Cuvo Health's providers already hold Virginia licenses.

**Q: Is Wisconsin an IMLC state?**

A: Yes. Wisconsin issues licenses through the compact, with a $120 state fee for an MD on top of the $700 Commission fee. On Cuvo Health, providers are already licensed in Wisconsin.

**Q: Is California in the IMLC?**

A: No. California is not a member of the compact, so every physician treating patients located in California needs a full California license. Cuvo Health's providers already hold California licenses.

**Q: How much does an IMLC license cost?**

A: The Commission charges $700, and each state charges its own fee, from $35 to $895 for an MD; all 41 issuing jurisdictions together cost $18,542.50 before renewals. On Cuvo Health, licensing is included and a brand pays a flat $25 per completed consult.

**Q: Can an MD practice in all 50 states?**

A: Yes, with a license in each state where patients are located, through the compact where available and full licenses elsewhere. Cuvo Health's network is licensed in all 50 states, DC and the US territories, so a brand on Cuvo reaches every state without licensing a physician itself.

**Q: Which states will join the IMLC next?**

A: Alaska, Arkansas, New Mexico and Rhode Island have enacted the compact and are expected to start issuing licenses once implementation is complete, and bills were pending in Massachusetts and New York. Cuvo Health tracks these changes as part of its 50-state regulatory monitoring.

**Related pages**

- [2026 State-by-State Virtual Clinic Compliance Report](/blog/virtual-clinic-compliance-report-2026): All four rules for all 51 jurisdictions
- [Nurse practitioner full practice authority states](/compliance/nurse-practitioner-full-practice-authority-states): 2026 list
- [Corporate practice of medicine states](/compliance/corporate-practice-of-medicine-states): 2026 list
- [The 50-state provider network](/provider-network): 300+ board-certified MDs, NPs and PAs
- [Telehealth licensing and credentialing across all 50 states](/blog/fifty-state-provider-network): Who handles each step

Canonical page: https://cuvo.co/compliance/imlc-states