Why Multistate Licensure Matters for Telehealth Startups
In telemedicine, your product isn’t just software — it’s medical care. And to legally deliver that care, your physicians need to be licensed in the patient’s state. That makes multistate licensure a foundational requirement for any virtual care startup, no matter how niche or ambitious.
What Is the IMLC and Why Is It Useful?
The Interstate Medical Licensure Compact (IMLC) streamlines the process of obtaining medical licenses across 35+ U.S. states. Instead of filing redundant applications with each board, the IMLC allows you to get verified once and then request licenses in bulk — saving time, money, and administrative overhead.
How Does This Apply to Startup Teams?
If your provider network includes physicians, they’ll need to:
- Be licensed in every state where patients are located
- Comply with telehealth-specific regulations in each jurisdiction
- Maintain active licenses and CME compliance
The IMLC accelerates this process — especially if you're building a multistate or nationwide platform.
When Should Founders Act?
Before launch. Many startups delay licensing until they’re live — but without state licensure, your physicians can’t legally practice. This results in last-minute delays, launch region restrictions, or even legal risk. Build licensing into your roadmap early.
Use Cases Where the IMLC Is Essential
- Direct-to-consumer telehealth platforms (e.g., urgent care, mental health)
- Employee wellness or B2B virtual clinics
- Remote second-opinion networks
- Asynchronous care (e.g., dermatology, contraception, hair loss)
In each case, licensure is tied to where the patient is — not the provider or company HQ.
How Long Does It Take?
The IMLC process takes 3–6 weeks on average:
- 1–2 weeks to get the Letter of Qualification (LOQ)
- 1–7 days per state license thereafter
Start early, and submit fingerprinting right after application to stay on track.
Should All Physicians Use the IMLC?
If they meet the eligibility criteria — yes. It’s the fastest way to scale coverage across multiple states. Not all physicians qualify (see IMLC eligibility), but for those who do, it’s a no-brainer.
What’s the Cost?
- $700 application fee for the IMLC
- $100–$500 per state license (varies)
- $50–$100 for fingerprinting/background check
Some companies choose to absorb these costs for early-stage clinicians or reimburse them after a probation period.
What About PAs and NPs?
The IMLC is only for physicians (MDs and DOs). Other provider types must apply to each state separately or use the Nurse Licensure Compact (NLC) or upcoming APRN Compact where available.
Final Thoughts
Licensing isn’t a “legal thing to figure out later” — it’s a core part of your clinical infrastructure. Without it, your business can’t legally operate in most states. If you’re building a telemedicine platform, make the IMLC part of your strategy from day one. It’s not just compliance — it’s scale.