The healthcare industry moves fast, and if you're stuck in one state, you're limiting your reach—and your revenue. Expanding your licensing footprint opens doors to high-demand telehealth roles, leadership opportunities, and a scalable career. This course gives you the exact framework to secure 25-30 state licenses efficiently, with minimal headaches. We’ll walk through the strategic steps, cost-effective methods, and critical compliance insights you need to go from single-state provider to multi-state expert.

Learning Objectives

After completing this course, you will:

• Understand the career advantages of multi-state licensing.

• Learn how to prioritize states based on telehealth demand and reimbursement rates.

• Master the streamlined licensing process using FCVS and other tools.

• Identify compliance risks and avoid costly licensing mistakes.

• Create a personalized roadmap to achieve 25+ state licenses efficiently.
  

Tips from AIR's Licensor

In this module, you’ll hear directly from AIR’s Licensor, Amy Weber, who has helped countless physicians successfully navigate the multi-state licensing process. This expert interview covers real-world strategies, common mistakes to avoid, and insider tips for streamlining your licensing experience.

Many physicians waste time and money due to avoidable delays, paperwork errors, and misunderstanding state requirements. AIR’s Licensor breaks down what actually works, what doesn’t, and how to simplify the entire process.

Key Takeaways from AIR’s Licensor

Understanding the Realities of Multi-State Licensing

• Licensing is a time investment, not just a checkbox.
• The biggest delays happen when physicians underestimate the paperwork required.
• State processing times vary widely—some take weeks, others months.
• IMLC isn’t always the fastest option—some states still require additional steps.

Key Tip: Start the licensing process sooner than you think you need to. Some states require fingerprinting, background checks, or additional board review, which can take 2-3 months.

Common Licensing Mistakes & How to Avoid Them

• Applying for too many licenses at once without a strategy
  Instead, prioritize high-value states first (reimbursement rates, demand, and ease of approval).
• Not keeping a copy of submitted paperwork
  Always save a PDF of every application and confirmation email.
• Using outdated or incorrect addresses for past employment verification
  State boards will contact old employers—make sure contact details are accurate.
• Not realizing FCVS can take 6-8 weeks to process
  Set up FCVS before applying to any states.

Key Tip: AIR’s Licensor recommends organizing all documents in a digital folder before applying—this cuts down application time by 50%.

Strategies for Speeding Up Licensing Approvals

• Use FCVS to store and verify credentials once, rather than submitting documents individually.
• IMLC can be a great shortcut—but only if your home state is a participating member.
• Some states allow you to “pre-load” applications before all documents are ready.
• Follow up with state boards every 2-3 weeks—some applications stall due to missing details that aren’t communicated.
• Use AIR Licensing Services for step-by-step guidance tailored to your needs.

Key Tip: If a state has slow processing times, apply during off-peak months (summer & early fall) to avoid seasonal backlogs.

How to Approach Licensing Renewals & Compliance

• Every state has different renewal cycles (annual, biennial, triennial).
• CME requirements vary—some require proof at renewal, others don’t.
• DEA registrations are often required per state for controlled substances.
• License tracking is critical—use spreadsheets, Mockingbird, or AIR Licensing Services to stay ahead.

Key Tip: Set renewal reminders at least 6 months in advance so you can complete any CME requirements on time.

Improving Patient Access and Reducing Care Gaps

Why Multi-State Licensing Matters More Than Ever

The demand for telehealth is skyrocketing, but there’s a bottleneck: most providers are only licensed in one or two states. Patients in rural and underserved areas face longer wait times, limited provider options, and higher healthcare costs—all due to licensing restrictions.

A physician licensed in multiple states is in a prime position to:

• Serve larger patient populations without being restricted by geography.

• Secure higher-paying contracts with telehealth companies that prioritize multi-state providers.

• Increase appointment volume, as patients in multiple states can schedule with them.

____________________________________________________________________________________________________________

The Data Behind Multi-State Licensing

• 92% of healthcare visits can be conducted via telemedicine. (Source: American Telemedicine Association)

• Nearly 40% of rural areas lack adequate provider coverage.

• Telehealth companies pay 25-50% more for multi-state licensed providers because they can fill more appointment slots.

____________________________________________________________________________________________________________

Key Benefits of Multi-State Licensing

• Higher Income Potential – More states = more job offers and better negotiation leverage.

• Expanded Career Options – Gain access to multiple job boards, networks, and contracting opportunities.

• Improved Patient Access – Reach patients who need care the most, regardless of location.

____________________________________________________________________________________________________________

What You’ll Learn in This Module

• How your licensing footprint impacts patient access and your earning potential.

• Which states to prioritize based on demand, reimbursement rates, and need.

• The financial and business case for obtaining 25-30 licenses strategically.

Framework for Multi-State Licensing

How to Approach Licensing the Right Way

If you apply for one license at a time without a strategy, you’ll waste months—if not years—getting fully licensed. Instead, use a structured roadmap to efficiently obtain multiple licenses in parallel.

Your Two Routes to Licensing

When it comes to obtaining licensure, you have two main options:

1. Direct Application to Each State:

   • Requires manually managing separate applications, timelines, and requirements.

   • Suitable if you prefer a hands-on approach but can be time-intensive.

2. Licensing Specialist Assistance (Recommended):

   • Specialists handle the paperwork, streamline communication with state boards, and ensure accuracy.

   • Reduces the risk of delays and eliminates the administrative burden.

____________________________________________________________________________________________________________

Step 1: Identify Your Target States

Not all states are created equal. You need to prioritize strategically based on:

1. Telehealth Demand – States with large populations and a strong telemedicine industry (e.g., Texas, California, Florida).

2. Reimbursement Rates – Some states pay significantly higher for telemedicine visits.

3. Licensing Speed – Some states have faster processing times than others.

4. IMLC Eligibility – If you qualify for the Interstate Medical Licensure Compact (IMLC), you can fast-track licenses in multiple states.

____________________________________________________________________________________________________________

Step 2: Plan for Costs & Timelines

Licensing isn’t free, and costs can add up quickly. Here’s what you should budget for:

• State License Fees: $300 to $1,000 per state.

• DEA Registration: ~$888 per state for controlled substances.

• FCVS Credential Verification: $375 initial setup + $95 per additional state.

• Renewal Fees: Vary by state, averaging $200-$500 per year.

Time Commitment:

• Some states process applications in 2-4 weeks, while others take 3-6 months.

• Avoid bottlenecks by applying in batches—start with 10 key states, then move to the next set.

____________________________________________________________________________________________________________

Step 3: Streamline Your Paperwork

Every state asks for the same core documents, so get organized early:

• Medical school diploma & transcripts.

• Residency and work history verification.

• Board certifications.

• Malpractice insurance & claims history.

• Background checks & fingerprinting.

____________________________________________________________________________________________________________

Key Considerations

1. Targeting the Right States

Before applying, assess each state using these criteria:

• Reimbursement Rates – Some states pay 30-40% more per telehealth visit than others.

• Licensing Speed – Some states approve applications in 4 weeks, while others take 6+ months.

• Ease of Renewals – Some states have heavy ongoing compliance requirements, while others are more physician-friendly.

Strategic Approach:

• Start with IMLC states if eligible (faster approval process).

• Prioritize reimbursement-friendly states for higher-paying opportunities.

• Balance fast and slow-processing states to keep your application pipeline moving.

____________________________________________________________________________________________________________

2. Understanding the Licensing Costs & Time Commitment

Applying for 25-30 licenses requires financial planning and a structured timeline. Here’s what to expect:

Cost Breakdown:

• State License Fees: $300–$1,000 per state

• DEA Registration (if needed): ~$888 per state

• FCVS Setup: $375 initial setup + $95 per additional state

• Renewal Fees: Varies, average $200-$500 per year

Time Commitment:

• Some states process applications in 2-4 weeks, while others take 3-6 months.

• Expect to dedicate 2-4 hours per state application, depending on requirements.

____________________________________________________________________________________________________________

3. Structuring Your Application Process for Maximum Efficiency

Instead of submitting one application at a time, use a batch approach:

• Batch 1: 10 high-priority states (fastest processing & highest demand).

• Batch 2: 10 states with strong pay rates but longer processing times.

• Batch 3: Remaining states based on long-term career goals.

Grouping applications this way ensures a steady flow of approvals over time without overwhelming your workload.

Pro Tip: Use FCVS (Federation Credentials Verification Service) to store and send these documents automatically (covered in the next module).

Introduction to FCVS

How FCVS Saves You Time & Reduces Licensing Delays

For physicians looking to secure 25+ state licenses, one of the most frustrating parts of the process is the repetitive documentation requests from different state medical boards. The Federation Credentials Verification Service (FCVS) simplifies this by creating a centralized credentialing profile that you can send to multiple states at once.

Without FCVS, you would have to manually submit diplomas, transcripts, board certifications, work history, and identity verification to every state, one by one. With FCVS, you upload everything once, and they store, verify, and transmit your credentials whenever a state board requests them.

However, while FCVS is a huge time-saver, it’s not a one-size-fits-all solution—some states require additional documents or direct submissions even if you use FCVS.

____________________________________________________________________________________________________________

Key Considerations: Setting Up FCVS for Maximum Efficiency

What FCVS Does (And Doesn’t Do)

FCVS Verifies:

• Medical school diploma
• Transcripts
• Postgraduate training (residency & fellowships)
• Board certifications
• Work history

FCVS Submits:

• Credential package directly to state medical boards for easier approval
• Primary source verification of education and training

FCVS Does NOT Replace:

• Individual state licensing applications
• State-specific forms, fees, and additional requirements (such as background checks or fingerprinting)
• The need for separate DEA registrations in each state

Pro Tip: Even if you use FCVS, you still need to track additional state-specific requirements to avoid delays.

____________________________________________________________________________________________________________

How to Set Up FCVS Correctly (to Avoid Delays)

Many physicians make the mistake of waiting too long to register for FCVS, only to find that verification takes weeks—sometimes months. To ensure the fastest processing, follow this step-by-step guide:

Step 1: Register at www.fsmb.org/fcvs and create an account.
Step 2: Gather and upload the following required documents:

• Medical school diploma
• Transcripts
• Residency verification
• Board certifications
• Government-issued ID

Step 3: Pay the setup fee ($375 for the first profile, $95 per additional state).
Step 4: Track verification status and correct any missing or incorrect documents.
Step 5: Once completed, select states where you want to send your verified credentials.

Common FCVS Mistakes & How to Avoid Them:

• Incomplete document submissions → Always double-check that everything is uploaded.
• Misspelled or mismatched information → Ensure consistency across all documents.
• Waiting until you’re ready to apply → FCVS verification can take 6-8 weeks, so set it up before submitting applications.

Which States Accept FCVS?

FCVS is widely accepted, but not all states use it the same way. Before relying on FCVS, check:

States that accept FCVS for full credentialing: Most IMLC states, California, New York, Texas, and Florida.
States that require additional direct verifications: Some states still require direct submission of additional documents, even if you use FCVS (e.g., Illinois, Georgia, and Massachusetts).

Action Step: Set up your FCVS profile now—don’t wait until you're ready to apply for licenses.

Applying for the Interstate Medical Licensure Compact (IMLC)

What is the IMLC?

The Interstate Medical Licensure Compact (IMLC) is an agreement between 39 U.S. states & territories that allows physicians to fast-track licensing in multiple states.

Instead of applying separately to each state board, IMLC-approved physicians can submit a single application and quickly obtain multiple licenses.

____________________________________________________________________________________________________________

Who Qualifies for IMLC?

• You must hold an unrestricted license in an IMLC-participating state.

• You must have no history of disciplinary actions.

• Your primary state must be an IMLC member.

If you meet these requirements, you can apply for multiple state licenses in weeks instead of months.

____________________________________________________________________________________________________________

IMLC vs. Traditional Licensing: What’s Faster?

• IMLC License Processing: 2-3 weeks

• Standard State Licensing: 2-6 months

How to Apply for IMLC Licensing

• Step 1: Check if your state of residence is an IMLC member (IMLC Map).

• Step 2: Apply for an IMLC Letter of Qualification (LOQ)—this confirms you meet eligibility criteria.

• Step 3: Select additional states where you want to be licensed.

• Step 4: Pay fees for each additional state (varies per state).

____________________________________________________________________________________________________________

Key Considerations for Using IMLC

• Best for physicians expanding into multiple states quickly.

• Not all states participate, so check the IMLC map before applying.

• Some states still require additional forms or background checks, even with IMLC approval.

Action Step: If your home state is in IMLC, use it as a fast-track option for multi-state licensing.

Tools & Resources for Streamlining Licensing

How to Track Licenses, Stay Organized, & Maintain Compliance

Once you hold licenses in multiple states, keeping track of renewals, CME requirements, and compliance rules is critical. The easiest way to manage this is through a simple tracking system, licensing management tools, or outsourcing to a licensor.

Tracking Licenses: DIY vs. Automated Tools

Option 1: DIY Licensing Spreadsheet (Simple & Free)

For independent physicians who aren’t super tech-savvy but want to track licenses manually, a basic spreadsheet is a great option.

How to Set Up Your Licensing Tracker in Google Sheets (or Excel)
Create a spreadsheet with the following columns:

Set Up Reminders:

• Use Google Calendar or Outlook to create alerts 6 months before renewal deadlines.

• Set a quarterly review to check that all licenses are up-to-date.

Best for: Independent physicians who prefer a simple, no-cost solution to manually track licenses.

Option 2: Licensing Management Software (Automated & Scalable)

For physicians managing 10+ state licenses, software tools automate compliance tracking to prevent missed renewals.

• Mockingbird – Automatically tracks renewal deadlines & sends reminders.

• Verifiable & CertifyOS – Full credentialing & compliance automation.

• CAQH ProView – Centralized database for credentialing & licensing info.

Best for: Physicians looking for automation without needing advanced tech skills.

Should You Use a Licensing Service?

When to Consider Outsourcing Licensing

Managing 15+ licenses can become a full-time administrative burden. If you prefer to focus on patient care, a licensing service can handle renewals, applications, and compliance tracking for you.

Recommended Licensors:

• AIR Licensing Vendors – Leverage our AIR preferred vendor network for licensing. 

• Medallion – Full-service licensing applications & renewals.

• Medical Licensing Group – Licensing & credentialing with an emphasis on compliance.

Pros & Cons of Using a Licensing Service

Best for: Physicians who don’t want to manually track 15+ licenses and prefer a hands-off approach to compliance.

How to Build an Efficient Licensing System

• Use AIR Licensing Services for customized state licensing support.

• Set up a Google Sheet tracker or use Mockingbird for automated reminders.

• Store documents in Google Drive for easy access across devices.

• Set calendar alerts 6 months in advance to avoid last-minute renewals.

• If managing 15+ licenses, consider outsourcing to a professional licensing service.

Next Steps:

• Choose a tracking method: Google Sheets (manual) or Mockingbird (automated).

• Set up document storage in Google Drive or Dropbox.

• Decide whether to manage licensing yourself or use a service like AIR Licensing.

By following these steps, you’ll stay ahead of compliance deadlines and eliminate licensing headaches.

Knowledge Check (10 Multiple-Choice Questions)

Worksheets for Improvement

A. IMLC Screener/Eligibility Flowchart
B. Overview of IMLC & FCVS processes 
C. Overview of FSMB 
D. Overview of licensing processes & best practices 
E. Licensing document checklist 
F. Compliance checklist 

Research and Evidence-Based Sources

1. AMA issue brief: Telehealth licensure. American Medical Association. Published May 8, 2023. https://www.ama-assn.org/system/files/issue-brief-telehealth-licensure.pdf
2. Care Policy, Harvard Medical School, Boston, Massachusetts. Increasing Telehealth Access Through Licensure Exceptions. Vol 331.; 2024:19. 
   https://connectwithcare.org/wp-content/uploads/2024/04/jama_shachar_2023_vp_230155_1703181643.72063.pdf
3. Deyo D, Ghosh S, Plemmons A. Access to Care and Physician-Practice Growth after the Interstate Medical Licensure Compact. SSRN Electronic Journal. Published online January 1, 2023. doi:10.2139/ssrn.4629647
4. Implementing telehealth in practice. ACOG. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/implementing-telehealth-in-practice
5. Physician Information | Interstate Medical Licensure Compact. Interstate Medical Licensure Compact. Published October 14, 2022. https://imlcc.com/information-for-physicians/
6. Shachar C, Center for Health Law and Policy Innovation, Harvard Law School, Boston, Massachusetts, Tufts University, Medford, Massachusetts, Mehrotra A, Department of Health
7. Staff PFC, Staff PFC. Pursuing an Interstate Medical Telemedicine Registration Compact - Petrie-Flom Center. Petrie-Flom Center - The blog of the Petrie-Flom Center at Harvard Law School. Published September 6, 2024. https://petrieflom.law.harvard.edu/2024/09/06/pursuing-an-interstate-medical-telemedicine-registration-compact/
   

Licensing Guide

Pre-Launch Program: Licensing

The AIR Academy's Pre-Launch Licensing page offers essential guidance for physicians aiming to expand their telemedicine practice across state lines. It emphasizes the importance of multi-state licensing, outlines key considerations such as cost analysis and eligibility, and provides downloadable checklists for various states to streamline the licensing process.

To know more about it, please see this link: Virtual Academy Pre-Launch Licensing.

License Document Checklist

IMLC Screener/Eligibility Flowchart

Overview of IMLC & FCVS processes 

Overview of the Federation of State Medical Boards (FSMB)

Overview of Licensing Processes & Best Practices 

Compliance Checklist