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:

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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.