PA Licensure Compact

The PA Compact is an optional agreement between states that will allow PAs with a license in a compact member state to more easily become authorized to practice in any other member state. A state opts to become a member of the compact by adopting the PA Compact through its legislative process. The PA Compact is completely optional for licensees.

The PA Compact is the result of a joint initiative that began in 2019 between the American Academy of Physician Associates (AAPA), the Federation of State Medical Boards (FSMB), and the National Commission on Certification of Physician Assistants (NCCPA). The Council of State Governments (CSG) has provided technical assistance in the development of the compact and its consideration by states.

The PA Compact will provide a streamlined process for eligible PAs to obtain authorization to practice in other compact member states through a compact privilege, without the need to apply through each state’s licensure application process. Once the compact becomes operational after seven states have adopted the compact model legislation, eligible PAs will only need to complete a single application to receive compact privileges from each compact state in which they intend to practice.

For example, a PA with practice locations in three compact states or who delivers care through telemedicine in those three states will no longer need to apply for an individual license from each state. A PA will be able to maintain a license in one state and through a single application obtain compact privileges to practice in the additional two states. This will significantly reduce the burden of going through multiple application processes, and may reduce fees for the PA, but more importantly will reduce delays in providing patient care and increase patient access as this PA can now see patients in all three jurisdictions.

The PA Compact will be available for PAs holding an unrestricted license issued by a compact member state and meet the following requirements set forth by the compact:

• Have graduated from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or other programs authorized by the PA Licensure Compact Commission.
• Hold current NCCPA certification.
• Have no felony or misdemeanor convictions.
• Have never had a controlled substance license or permit suspended or revoked.
• Have a unique identifier as determined by the compact commission.
• Have no limitation or restriction on any state license or compact privilege in a remote state.
• Meet any jurisprudence requirements of the state where a compact privilege is being sought and pay any required fees.
• Report to the PA Licensure Compact Commission any adverse action taken by a non-member state within 30 days after the action is taken.

The compact will reduce time and cost burdens for PAs to engage in multistate practice, whether in person or by telemedicine. The compact will also establish a multistate data system that will enhance public protection by facilitating the sharing of licensure and disciplinary information across compact members states.

Furthermore, the PA Compact will allow for increased license portability, an area of particular need for PAs who travel or relocate regularly, including the military spouse community. With an active interstate PA Compact, a currently practicing PA can maintain licensure and avoid licensing-related downtime between jobs, as long as relevant states are members of the compact.

With the COVID-19 pandemic, telemedicine usage increased substantially; however, licensing requirements were not permanently changed in response. A PA – no matter how they are delivering care – must be licensed or otherwise authorized to practice in the state or jurisdiction in which the patient is located. The PA Licensure Compact would make it easier for PAs to obtain the necessary state authorization to see patients, including through telemedicine. For example, for those in rural communities, a telemedicine visit may be more feasible than a long drive to a medical office.

The PA Compact is available for state legislative enactment, but it is not yet operational and not currently issuing compact privileges. The compact will be activated and begin the process after seven states have adopted the compact model legislation. Historically the process for a licensure compact to become fully operational can take up to 24 months after its activation. Applications for compact privileges will not be available until the compact commission becomes fully operational.

To see where your state is at in the process please visit: pacompact.org.

If you would like to advocate for the compact in your state, please contact your state membership organization.