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Interstate Medical Licensure Compact

April 6, 2021
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WRITTEN BY Dr. Joshua Mueller

In order to practice medicine in Missouri, physicians must apply for and be granted a license by the Missouri Board of Registration for the Healing Arts. This license is valid for practice only within Missouri, and licenses from other states do not currently qualify a physician to practice in Missouri. HB 2046, passed in 2020, established licensure reciprocity, allowing physicians who hold a valid out-of-state license to apply for and receive an expedited license for practice in Missouri so long as they have been licensed for at least one year in their current state of practice. SB 300 would enter Missouri into the Interstate Medical Licensure Compact (IMLC). Under this agreement, which has been joined by 29 states as of April 2021, physicians who wish to move to a new state to practice medicine or wish to practice in multiple states are eligible for an expedited licensure process. The IMLC enacts a uniform set of requirements for license eligibility, including background checks. The IMLC would also allow out-of-state physicians who apply for licensure in Missouri to practice telemedicine across state lines. Executive Order 20-04, issued in March 2020 during the COVID-19 pandemic, temporarily allows out-of-state physicians to practice telemedicine in Missouri without a license in the state, but this order is set to expire in August 2021.


  • As of April 2021, 29 states and Washington, D.C. have entered into the Interstate Medical Licensure Compact (IMLC). More than 17,000 out-of-state licenses have been granted in IMLC states since it was first introduced.
  • There is not strong evidence that joining an interstate licensure compact increases migration of physicians or nurses to participating states.
  • The number of telemedicine visits has increased by as much as 150% nationally during the COVID-19 pandemic while interstate licensure requirements for telemedicine have been relaxed.


  • There is little quantitative research on the effects of entry into the IMLC, or on the effects of interstate licensure agreements on migration, labor supply, and wages.
  • Studies that examine migration patterns for physicians and nurses may not describe the effects, if any, on commuting across state lines or use of telemedicine.
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