Understanding Compact Licenses for Travel PT, Travel OT and Travel SLP

It has now been over three years since our original article on therapy compact licensure, and in that time much progress has been made! The PT Compact has been up and running for many years now and has made life significantly easier for many Travel PTs. Before we get too in depth, let’s start with a overview of what compact licenses are and why they’re important for travel therapists.

What is a Therapy Compact License?

For American healthcare workers, an inter-state licensure compact facilitates inter-state healthcare practice. It is an agreement which allows those who meet certain requirements to more easily practice in other states which are in the compact agreement, without having to go through the full process to get a new license in that state. Nursing already has this type of agreement, and now the different therapy disciplines are starting their own licensure compacts.

Having access to a compact licensure agreement improves access to care and providers for patients in various states by reducing the barriers for clinicians to practice across state lines. It increases portability for military spouses, traveling healthcare professionals, and those clinicians who live close to the border of two neighboring states. It also assists with improving access to telehealth services in various states.

Currently, physical therapists in eligible states are already benefiting from the PT Compact, and occupational therapists and speech language pathologists in eligible states will soon be able to participate in their own respective compact licensure agreement, as each organization continues to develop the OT Compact and the ASLP Compact.

How Does Compact Licensure Compare to Standard State Licensure?

Traditionally, healthcare practitioners in most disciplines must apply for an individual license to practice in each different state. Each state regulates the practice of the healthcare discipline, with its own rules and regulations, and thus, its own application progress. Typically if healthcare practitioners would like to practice in a different state than their home state, they must apply directly to the new state to obtain a license there.

This process may include an application, a fee, often a jurisprudence exam on the state laws for that discipline, original transcripts from your educational institution, original passing scores for your national board exam, verification of good standing for any state in which you’ve previously held a license, and more. As you can see, this process can often be lengthy, daunting, and expensive.

Many practitioners may only require getting one or two state licenses in their lifetime, so this process isn’t much of an issue for most. However, for traveling healthcare providers, military spouses or others who may move often for their spouse’s work, or those living on a border of two or more states, this can be a big hassle. This is where having access to a compact licensure can save a significant amount of time, effort, and money.

Eligibility for Therapy Compact Licensure

Compact licensure is different for each healthcare discipline, but as it pertains to travel therapists, we will focus on the PT, OT, and SLP Compacts. Currently (as of September 2022) the PT Compact is the only one in operation, but based on the information available on the OT and ASLP Compact websites, the processes should be similar to the process for the PT Compact. Therefore, I will focus here on explaining how the PT Compact works, and we will assume for now that the others will be the same or similar.

The first and most important factor to understand about the PT Compact (and this will likely be the same for the OT and SLP Compacts), is that you are only eligible if your home state is participating in the compact. I repeat, you are ONLY eligible if your HOME state is participating. Do not pass Go, do not collect $100… if your home state isn’t participating, you are NOT eligible.

The PT Compact defines your home state as the state where you currently hold an active driver’s license. If your home state, where you have an active driver’s license, is not participating, then you are NOT eligible. You CANNOT ‘make yourself eligible’ by applying for a regular license in a compact state. You could, theoretically, make yourself eligible by moving your permanent residence to a compact state and obtaining a driver’s license there. But, this is a big hassle, and in most cases not recommended just to get access to the compact. More on this later as it pertains to travelers and your tax home.

In addition to having an active driver’s license in the compact state to prove that this is your residence, you must also hold an active therapy (PT/PTA, OT/OTA, SLP/SLPA) license, which is maintained in good standing, in your home state. This will be your primary state license (obtained the traditional way) on which all compact licenses/privileges will be based.

Which States Are Participating in the PT Compact?

As of September 2022, there are 25 US states that are participating in the PT Compact, and are actively issuing ‘compact privileges’ to members in those states. Additionally, there are 8 other states which have ‘enacted legislation’ to approve the PT Compact in their state, however they are still working out the details and have not yet started issuing compact privileges to their members yet.

In terms of determining your eligibility for the PT Compact, you will need to check the current map and list of participating states, and your home state must be currently ‘issuing and accepting compact privileges for you to be eligible. (Your home state must be DARK BLUE on the map to be currently eligible).

You can check the map for the most up to date status of all the states here.

Once you have determined that you are in fact eligible to participate based on your home state being DARK BLUE on the map, you can then look at all the other states that are actively participating (also in DARK BLUE) to see the other states in which you could quickly and easily obtain a compact privilege to practice.

What are the Statuses of the OT Compact and the ASLP Compact?

As of September 2022, neither the OT Compact or the ASLP Compact are fully operational yet, so no members are currently eligible to begin participating. Both compacts have had more than 20 states enact the compact into law, however they are both still in the process of developing and implementing infrastructure needed for to begin actual operation of the respective compact licensures. This can be a long process as it is a new organization and they must get everything in order.

Per the OT Compact website, they anticipate another 12-18 months needed following their August 2022 meeting in order to get the infrastructure in place to become operational. That would put them in late 2023 to early 2024 before occupational therapy members can begin participating and using the compact privileges. For more information regarding the OT Compact, visit their website here.

Per the ASLP Compact website, as of September 2022, they anticipate another 6-12 months in order to become fully operational. They state that they anticipate members becoming eligible for participation in 2023. For more information regarding the ASLP Compact, visit their website here.

The Process of Applying for a Compact License

So, once you are eligible to participate (based on your home state’s status in the compact), how do you actually obtain a compact license privilege in order to practice in another compact state?

For the PT Compact, the process of applying to use your compact privilege happens via the PT Compact website. This is very important to note, as unfortunately we have heard of therapists who were confused and applied directly via the state’s website, not the PT Compact website, resulting in them actually just applying for a full licensure in that state. This caused significant hassle as they just went through the normal licensing process, rather than actually getting to use their compact privilege. So be sure to start at the PT Compact website.

The process for obtaining a PT Compact privilege in a new state is very fast, and in many cases you can obtain the privilege the same day with a quick and easy process and small fee on the PT Compact website (as opposed to taking several weeks to several months obtaining a state license the traditional way). The only exception is for compact states which require a jurisprudence exam.

It’s very important to note that if the compact state where you are applying for compact privileges requires a jurisprudence exam, you must complete this BEFORE going to the PT Compact website to apply for your compact privilege in that state. The timeframe for the jurisprudence exam will vary by state, taking a few days to a few weeks depending on if it needs to be scheduled at a testing center. Check the list of states that have jurisprudence requirements for more information.

Overall, the process for getting your compact privilege to practice in another compact state is significantly easier, faster, and cheaper than applying for state licensure the typical way.

How do you Renew & Maintain CEU Requirements for Compact License?

Another benefit of using compact privileges to practice in other states is that the CEU requirements are significantly streamlined vs. maintaining multiple state licenses the traditional way. For travelers in particular who have several state licenses, you typically have to keep up with a variety of different CEU requirements and report to each state per their rules. However, with the PT Compact, you only have to maintain your CEUs for your home state, and you have no requirements for maintaining CEUs for any states where you practice using the compact privilege.

You do however have to renew your compact privilege. The expiration date is the same as when your home state license expires. So when you go to renew your home state license the traditional way via the state’s website, you will also need to go to the compact website to renew any compact privileges if you want to continue having compact privileges in that state or states. You can learn more about the PT Compact renewal process here.

Compact Licensure Specifics for Travel Therapists

Here are some key points for understanding compact licensure as it pertains to travel therapists:

Does having the compact make it easier to be a travel therapist?

Absolutely. Those who are eligible will have easier access to taking jobs in any of the compact states, without having to wait to go through the full licensure process. This can make your life easier in general because you don’t have to go through the long application process for compact states.

It also makes the job search process a lot easier, because you can essentially apply for any job that pops up in any compact state without worrying if you already have a license there. In contrast, for most travel therapists who are going through licensure the traditional way, it’s not recommended to apply for jobs in a state unless you already have the state license. Most travel jobs need someone ASAP and can’t wait for you to get the license. There are some exceptions in states where the licensure process is quicker and for jobs that are more desperate and willing to wait on you to get the license. But sometimes standard licensure can take several weeks to several months, so in general you usually don’t apply for jobs without having a license.

So, say your dream job pops up in Colorado, but you don’t have the license yet. Normally you’d have to pass it up because they’ll take someone who is already licensed. But if you’re compact eligible, you could go ahead and apply, and if you get the job, you can easily and quickly get the compact licensure within a few days.

But, one other thing to consider with the increased access to the compact states, is that there could also be increased competition for the jobs in these states. But, as time goes on and more and more states are participating in the compact, this competition will even out.

Do all facilities accept the compact licensure?

In the beginning, there were some issues with certain insurances not recognizing the PT Compact as equivalent to the standard license, so they were not accepting billing from therapists practicing with compact licensure. Therefore, certain facilities were declining applicants who didn’t have the regular license. For the most part this has been resolved, and nearly all insurances and facilities are accepting the PT Compact license.

However, this does still come up occasionally where a travel therapist is asked to get the full license instead of the compact, so be aware if that happens to you. For OT & SLP Compacts, this could be a potential issue in the beginning, but hopefully by the PT Compact paving the way, insurances will be on board when the OT & SLP Compacts are rolled out.

Can I apply for a regular license in a compact state to get access to the compact?

No. This is one of the biggest misnomers about the compact. You can’t become eligible just by getting a license in a compact state. Your home state has to be participating for you to be eligible.

But what if I already have a regular state license in the compact state?

Same as above. Even if you already have a regular state license in a compact state, and maybe you’ve even had it for a long time, this does not make you eligible. Your home state has to be participating for you to be eligible.

New grads – where to get licensed first

Another misnomer that we’ve often heard from therapists is that they think their eligibility for the compact has to do with the state they received their FIRST license in. For example, they think that if they apply to take the board exam in a compact state and/or get their very first license in a compact state, that this will somehow make them eligible for the compact. This is not the case. It only has to do with your home state where you have a permanent residence and driver’s license.

This could be particularly confusing for someone who went to school in a compact state, but has their permanent residence and drivers license at their parents’ house in a non-compact state. In this case, unfortunately, even if you went to school in a compact state, took your board exam there, and got your first license there, you still aren’t eligible if you are keeping your permanent address at your parents’ house in a non-compact state. Now if you decide to rent or buy a place and change your drivers license and permanent address to the compact state where you went to school, then yes you could be eligible. But this gets into a whole other can of worms when we start discussing tax homes.

Home state (permanent address) vs. tax home

Are these the same? In some ways, yes, but not completely. For most people, your permanent residence is the same as your tax home. But, as far as the PT Compact is concerned, the rules for verifying your home state are very relaxed compared to the rules for maintaining a tax home. For the PT Compact, you only have to show that you have a driver’s license in the compact state to be eligible. The tax home rules are a lot more complex. If you’re unfamiliar with tax home rules and why this is important for travel therapists, I highly recommend reading this Tax Home article.

Can I move my home address to a compact state to become eligible?

Yes, you could do this if you wanted to, but in our opinion it would be much too complicated to make it worth it just to get access to the compact. Of course you would need to change your permanent address on lots of documentation and get a driver’s license in the new state to make this work. And theoretically, actually move yourself and your belongings there. But, you may be thinking, I want to be a travel therapist, so I won’t even be at this new “home address” most of the time anyways. Why not just say that my new permanent address is at my parents’, or aunts’, or friends’ house in a compact state to get all the benefits of having access to the compact?

The main reason this isn’t a good idea for a travel therapist is because it can then interfere with your established tax home situation. It’s not as easy as changing your drivers license to establish a new tax home in the eyes of the IRS. A tax home is tied more to the area where you have been earning income and conducting business. The only case where it would be more feasible to make this move of both your tax home and perm address is if you’ve just graduated from college and are re-establishing yourself back at home with your parents, where you grew up, returned for school breaks, and already had ties.

If you’re trying to move your permanent address and thus tax home to a place where you never earned any income, had any business ties, or actually lived before, you are not going to meet the tax home rules and will be at risk of not qualifying to receive tax-free stipends as a travel therapist.

If you’re considering moving your address for the compact or other reasons as a travel therapist, we highly recommend setting up a consultation with a professional tax advisor in order to make sure you’re meeting the tax home rules. We recommend TravelTax for this.

What if your home state isn’t participating but you want them to?

The best route is to contact your PT, OT, or SLP board for your home state and advocate for the importance of access to the compact. Let them know the benefits for patients to have access to care, and the benefits for clinicians. If you need help with this, first talk to the PT, OT, or SLP Compact to get some direction.

If your state has already passed legislation but has been slow to actually move forward with issuing compact privileges, contact the Compact as well as the state board to get an update.

If I’m not eligible for the compact, can I still travel?

YES! Keep in mind that the compact is VERY new. Therapists have been traveling to other states for decades without using a compact license. In fact, we have been traveling ourselves for over 7 years, starting as new grads, and have yet to use the PT Compact, even though our state did begin participating a couple of years ago. And of course OTs and SLPs currently don’t have a Compact that’s active at all, and they still travel. It does require a little bit of extra work to get licensed in each new state where you’d like to practice as a travel therapist, but it’s completely doable.

Additionally, keep in mind that even if you are eligible for the compact, there are still several states that aren’t participating. So, for example, if you’d like to work in Alaska, Hawaii, California, or Florida as a PT, as of 2022, you have to apply for those state license the traditional way. So, the compact does make traveling easier in a lot of ways, but it’s definitely not the end all be all of being a travel therapist.

Summary

The PT Compact, OT Compact, and SLP Compact have a lot of benefits for our professions and the patients we treat, and they can be especially helpful for travel therapists! If your state isn’t participating yet, consider advocating for them adopting the compact by talking to your state board and/or contacting your compact organization. But, even if you aren’t able to take advantage of the compact license just yet, never fear. Being a travel therapist is still totally doable even without the compact! We and many others have been traveling for many years by getting licensed the traditional way!

If you’re ready to get your travel therapy journey started, reach out to us for help getting connected with great travel therapy recruiters!

Additional Resources:

Whitney Eakin headshot
Written by Whitney Eakin, PT, DPT, ATC – Whitney has been practicing as a traveling Doctor of Physical Therapy since 2015. She has educated and mentored thousands of current and aspiring travel therapists.

House Hacking to Reduce Expenses as a Healthcare Traveler

If you’ve followed this website or our blog Fifth Wheel PT for any length of time, you probably know that I have spent a lot of time learning and writing about personal finance and investing since graduating from physical therapy school in 2015. This focus on maximizing my finances led to me reaching financial independence at age 30 and retiring from full time work as a PT.

Pursuing Travel PT as a new grad to earn significantly more than at a normal permanent job was a huge part of achieving that milestone as such a young age, but even more important than that was keeping my expenses as low as reasonably possible while traveling. As a travel therapist or other travel healthcare provider, you have to look at your savings rate, which takes into account not only your income but also your expenses, to see the big picture on how to come out ahead financially.

As a traditional travel healthcare provider, traveling with a tax home in order to receive tax free stipends, often the biggest monthly expense is housing, and this was no different for me. This is because having to pay for short term housing at the travel assignment location in addition to paying for housing expenses back home can really add up quickly.

There are some ways to reduce the expense of short term housing at your travel assignment location, but for the most part options are usually pretty limited depending on the area of your travel job. On the other hand, there are a variety of ways to reduce the total cost of maintaining your permanent tax home while on assignment by house hacking. Using some of these techniques allowed me to save a lot of money over the years, so I want to share some insights with you to help you better reduce your expenses and make travel healthcare more lucrative.

What is House Hacking?

House hacking is basically utilizing a portion or all of your house to earn income or offset expenses. Chad Carson does a great job of explaining all of the various ways of house hacking in this article. Anyone that has ever lived with a roommate has done a version of house hacking in the past. Having a two bedroom house or apartment split between two people is always going to be cheaper than having a one bedroom house or apartment to yourself, due to not only being able to split the cost of the rent or mortgage, but also utilities and any additional costs/fees.

Personally, I’ve been learning about ways to “hack” my housing costs since high school. I can remember looking at duplexes for sale when I was 18 and doing calculations on how much I could reduce my expenses by buying one, living in one side and renting the other, while also having a roommate in my side. I determined that not only could I reduce my housing costs, but I could actually live for free while simultaneously paying down the mortgage on the property by doing this in my hometown. Although I never ended up doing this after graduating high school due to going away for college, followed by PT school and then travel therapy, it’s something I still think about doing in the future.

House Hacking for Travelers

There are a few different ways that a travel healthcare provider might choose to house hack their tax home to reduce costs.

The first and most simple way is by simply renting a room in a house as their tax home, instead of having an entire house or apartment. Realistically, most travelers spend very little time throughout the year at their tax home due to spending most of the year working travel assignments or traveling for fun domestically or internationally. For my and Whitney’s entire travel careers prior to COVID, we never spent more than 6 weeks at home in any given year. Having a house or apartment sit empty for most of the year seemed wasteful to us, so for the majority of that time we each chose to rent a room in our family’s house as our tax home instead. We still had a place to keep all of our stuff and stay for the short periods while we were home, but it cost much less. We also had someone to collect our mail and keep an eye on things while we were gone.

Another way to house hack as a traveler is to buy or rent a place bigger than you’d need, and rent out rooms or get roommates to help subsidize costs. This is exactly what I had in mind when we were looking at townhouses to buy in our hometown when COVID hit and we realized we would be at home much more. We purposely bought a place with a couple of extra bedrooms so that we could have roommates or short term renters while we were out of town. By buying (or renting) an affordable place and renting out extra rooms for part or all of the year, it’s easy to make a big dent in the monthly cost of your tax home.

The last main way to house hack as a travel healthcare provider is by renting out your entire house or apartment on Airbnb, VRBO, or Furnished Finder while you’re away on assignment. This will undoubtedly offset tax home costs the most, assuming you’re able to keep occupancy relatively high, but will also lead to the most hassle. Managing a short term rental can be very lucrative but hard to manage from a distance while working. But, with a good property manager in your area that you trust, it’s certainly possible to make it work. We considered doing this when we were looking at places to buy, but ultimately decided against it due to the potential headache and issues that could arise. We also didn’t really like the idea of renting out our whole place with other people having access to our stuff. I do know a couple of travelers that have done this in the past and had a good experience along with making a decent profit though.

What About Maintaining Your Tax Home Requirements?

You may be wondering how house hacking impacts your tax home status and eligibility for tax free stipends as a travel therapist/travel healthcare provider. This is an important question to consider, and the answer depends on which of the strategies above that you choose and how you structure it.

**I do want to put the disclaimer here that I am by no means a CPA or tax professional. It’s always worth consulting a tax professional before making any decisions on your personal tax home situation. Below is my current understanding of how this works based on research I’ve done and CPAs I’ve talked to in the past. We interviewed Joe Smith from Travel Tax a couple of years ago and asked him for his advice on this as well which you can find here starting at 1:05:30 in the video.

As a quick refresher, according to the IRS, these are the rules for maintaining a tax home:

  1. You must maintain a place of permanent residence and pay expenses there (i.e. rent, own/mortgage, pay bills, pay taxes, etc.) while ALSO paying expenses at your travel location. This is called “duplicating expenses.”
  2. You must not abandon your tax home. Generally speaking, you should return there at least 30 days per year but these days don’t have to be consecutive.
  3. You must still conduct business in the area of your tax home. For example, you have a PRN job there or maintain some type of other business there.

Ideally you’d want to meet all three of these criteria but at the very least 2/3.

If you’re renting a room in a house as your tax home to house hack and save money, there should be absolutely no issue with that from a tax home perspective. Many travelers rent a room in a house or apartment from a friend or family member in their home area, keep records of payment and a lease, return to the area at least 30 days per year, and keep all of their stuff there.

If you’re renting out rooms to short term renters or roommates in a house or apartment that you own/lease, there should be no issue with this either as long as you’re keeping at least one bedroom in the house as your own. Obviously if you’re renting all of the bedrooms out in your house for the full year then this would no longer count as your tax home because you aren’t personally meeting the tax home rules above.

If you’re renting out your entire house or apartment on Airbnb, VRBO, Furnished Finder, or something similar, then that’s fine as long as you aren’t renting it out for the full year. You need to leave open time in the year for you to return home without it being rented. Something like renting out the full place for 9 months of the year while leaving a month between each assignment where you go back home and stay for a while would be ideal. Even renting a place 9 months a year on a short term basis will likely be enough to cover nearly all of the expenses of the tax home depending on your area.

Should You House Hack Your Tax Home?

House hacking your tax home is a great way to reduce your expenses while traveling to improve your financial situation more quickly. This was a key part in my own journey to achieving financial independence. With that being said, there’s undoubtedly more hassle and potential issues that go along with sharing or renting out your tax home. For that reason, it’s definitely not for all travelers. If you’re the type of traveler that gets stressed and overwhelmed easily while on assignment, then adding in extra worry back home may not be worth it. On the other hand, if you’re the type of traveler that handles potential issues well and is looking to minimize your expenses as much as possible, then house hacking could be perfect for you.

Have you ever done some version of house hacking with your tax home as a healthcare traveler? If so let me know what you did and how it went in the comments below or in an email!

As always, if you have questions about your travel healthcare journey, you can send us a message. If you’re new to travel healthcare and want to get connected with travel therapy recruiters and companies we recommend, you can fill out this form as well.

Jared Casazza
Written by Jared Casazza, PT, DPT

Jared has been a traveling physical therapist since 2015 and has helped thousands of current and aspiring travelers along their own journeys. He is also a personal finance enthusiast and has used his career as a Travel PT combined with strategic financial choices to pursue financial independence and semi-retirement early in his career.