What is the PA Licensure Compact? 

What is the PA Compact?

The PA Compact is an interstate occupational licensure compact for physician assistants (PAs). Interstate compacts are a constitutionally authorized, legally binding, legislatively enacted contract among participating states.

States joining the compact agree to recognize a valid, unencumbered license issued by another compact member state via a compact privilege. Licensed PAs utilizing the compact can obtain a privilege in each compact member state where they want to practice. PAs using a compact privilege to practice in another state must adhere to laws and regulations of practice in that state and are under the jurisdiction of the state’s regulatory board in which they are practicing. 

For a history of the development of the PA Compact and the methodology used, please see our compact history page.

How the PA Compact Works

1. PAs licensed in a participating state

  • A PA with an active, unencumbered license in a compact state wants to practice in another participating state.
  • The PA notifies the compact commission that they want a compact privilege in another state (remote state).

2. Background check

  • The PA submits information for an FBI background check.

3. Application reviewed

  • The PA’s license and eligibility are verified.
  • The PA completes jurisprudence requirements (if required).

4. Compact privilege issued

  • The commission issues the compact privilege on behalf of the remote state.
  • The practitioner now has legal authorization to practice in the remote state where they hold a compact privilege.

Who Can Use the PA Compact?

A PA is eligible to participate in the compact if they: 

  • Have graduated from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc. or other programs authorized by the 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.
  • Hold an unrestricted license issued by a participating compact state to provide medical services as a PA.
  • Have no limitation or restriction on any state license or compact privilege in the previous two years.
  • Notify the compact commission of their intent to seek the compact privilege in a remote state.
  • Meet any jurisprudence requirements in the remote state and pay any fees.
  • Report to the commission any adverse action taken by a non-member state within 30 days after the action is taken.

Other requirements may apply. Practitioners should refer to the model compact legislation for a comprehensive list of requirements.

PA Compact Benefits

Benefits for PAs:

  • Facilitates multistate practice by reducing the burden of maintaining multiple licenses.
  • Expands employment opportunities into new markets.
  • Improves continuity of care when patients or providers relocate.
  • Supports relocating military spouses. 

Benefits for State Regulators:

  • Reduces application processing time.
  • Facilitates cross state licensure board cooperation on investigations and disputes.
  • Enhances public safety through a shared data system.
  • Allows states to charge a fee for a compact privilege/license in that state.
  • Preserves the current state-based licensure system.

Benefits for States:

  • Promotes workforce development and strengthens labor markets.
  • Expands consumer access to highly qualified practitioners.
  • Preserves state sovereignty.
  • Increases collaboration among states.
  • Facilitates practitioner mobility during public health emergencies.

Timeline

Interstate compacts take time to develop and implement because of the coordination necessary among state legislatures, state regulatory boards and the compact commission. 

Summer 2019

Compact project started.

Fall 2019

FSMB convenes meeting with state regulatory boards to discuss outline of compact.

November 2022

Compact legislation finalized and made available for state adoption.

Fall 2024 (projected)

Compact Commission holds inaugural meeting.* 

Fall/Winter 2025 (projected)

Compact Commission begins granting compact licenses.* 

*Contingent upon compact activation in the first half of 2024. 

What’s Next?

The compact legislation has been reviewed by stakeholders in the profession, adapted based on their feedback, and is ready for state adoption. States legislatures must enact the compact model legislation to become participating states.