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Can you practice telemedicine in a state different from your license?

A reader posed the following question: Can a nurse provide education over the phone (telemedicine) to an insurance company member who does not live in the state where the nurse is licensed?

Dear Nancy,

I work for an insurance company as a disease case manager. This includes members not living in the state where I am licensed.

While this member has his policy with a plan in my state, he lives outside of the state. Would doing education with this member over the telephone via telemedicine be outside my scope of practice due to not having a license from the state where this member resides?


Nancy responds about telemedicine:

Dear Frank,

The general rule with nursing practice that crosses state boundaries is if you are practicing nursing in any state, you need a license in that state. Patient education is most certainly included in the scope of practice of an RN, so without knowing more, you would need a license in the state in which the insured lives.

The exception to this rule is when a nurse has a multi-state/compact license because the nurse legally resides in a state that is a member of the Nurse Licensure Compact and the nurse has declared the state as the nurse’s primary state of residence.

If your state is a member, and you have declared your state as your home state, and you have a multi-state/compact license issued by your home state, you can practice nursing in any state that is a member of the compact. The home state multi-state/compact license is accepted as a privilege to practice in other compact/party states.

If you do not know if your state is a member of the compact, go to the National Council of State Boards of Nursing’s website and click on the Nursing Regulation tab. A drop-down menu will allow you to get a wealth of information, including which states are members of the compact.

If you know your state is part of the compact, contact your board of nursing for instructions on declaring your state as your primary state of residence. Your license also must be in good standing.

After meeting these requirements, you then will have a multi-state/compact license. Remember, though, the state in which the insured lives also must be a member of the compact  for you to practice nursing there.


Take this course related to telemedicine:

Telemedicine: Virtual Visits With Patients
(1.5 contact hrs)
Telemedicine is any kind of interactive healthcare work done from a distance; it is a growing facet of the modern healthcare landscape with more than half of American hospitals supporting some form of telemedicine. This can be the sharing of electronic data, video conferencing, or a simple phone call. Telemedicine is a supplement to face-to-face visits rather than a replacement for them. Although certain specialties or allied health clinicians may work exclusively via video conference and other virtual tools, the patient still must be assessed regularly in person by a provider. According to the U.S. Health Resources & Services Administration, telemedicine and telehealth are different in that telemedicine includes only clinical interactions and telehealth also includes meetings, continuing education for clinicians, and clinical training. This module provides healthcare providers with information about telemedicine, including types of telemedicine, clinical usage, and supporting technologies.

By | 2018-12-28T16:46:39-05:00 October 15th, 2014|Categories: Nursing Careers and Jobs|0 Comments

About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

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