Telehealth Across State Lines for Aesthetic Groups

What “Practicing Across State Lines” Actually Means

The key legal principle is simple, though not obvious at first glance: medical care is considered to be provided where the patient is physically located at the time of the visit, not where the physician is located. This rule applies virtually everywhere in the United States. Many clinic owners intuitively assume the opposite: that the state where the practice is based matters. This incorrect assumption most often leads to problems.

The practical implication for aesthetic clinics is this: a virtual consultation, a post-operative follow-up call, or a prescription refill for a patient who is currently traveling may require a license in the state where the patient is physically located at that moment. It doesn’t matter that the patient permanently resides in another state and has been under this doctor’s care for many years. Even a brief ten-minute call is formally considered a visit in the state where the patient is currently located.

This rule applies equally across all medical specialties. Physicians, nurse practitioners, and physician assistants are all subject to the same principle regarding the patient’s physical location. However, the specific process for obtaining the right to practice in another state varies by profession.

Which States Allow Telehealth Across State Lines for Medical Providers

There are three general ways to legally provide telehealth services to a patient in another state. The first is a full license in the patient’s state. The second is an interstate compact, if one exists for a specific type of medical license. The third is a special telehealth registration offered by a specific state to physicians from other states, without requiring a full license.

The question of which states allow telehealth across state lines depends on the type of healthcare professional. The most developed compact for physicians is the Interstate Medical Licensure Compact (IMLC), which includes 44 states plus the District of Columbia and Guam; in 2025 and 2026 alone, the compact issued more than 25,000 licenses. The IMLC does not grant a single license valid for all states at once. It expedites the process of obtaining a separate, full-fledged license in each state participating in the compact. However, each state still issues, renews, and regulates its own licenses. To qualify for the expedited pathway, a physician must specify the state of their primary license and have no pending investigations against them.

For practicing nurses and physician assistants, options are more limited or still in early development. The Nurse Licensure Compact covers nurses in 43 jurisdictions. It effectively grants them a single license with the right to practice in all participating states, which differs significantly from the IMLC model for physicians. This is why you must verify which states allow telehealth across state lines for each professional and each state, rather than assuming a rule that applies to one practicing physician automatically applies to all other staff members.

We recommend checking each state individually rather than relying on a general rule. Requirements and exceptions vary by state, and what is legal in one place may be a direct violation in a neighboring one.

How This Compares to Telehealth Rules for Therapists

Mental health professionals face a similar but distinct set of rules, which provides useful context for the bigger picture.

The answer to the question, can a therapist provide telehealth across state lines, usually depends on whether the therapist is licensed in the client’s state or participates in the relevant interstate compact.

An important detail is often confused: the PSYPACT compact applies only to licensed psychologists and does not automatically extend to counselors, family therapists, or social workers. As of 2026, PSYPACT is active in more than 41 states, while a separate Counseling Compact for licensed counselors began operating in 2025 and, so far, only in a couple of states. This means the answer to whether a therapist can provide telehealth across state lines for a psychologist and, for example, a licensed counselor can be completely different even within the same state, simply because they are subject to different compacts with different scopes.

A related question worth addressing to complete the picture is: can you see a therapist out of state? The answer usually depends on whether the therapist’s license or compact extends to the state where the patient is physically located at the time of the session, rather than where the patient permanently resides. In other words, the question “Can you see a therapist out of state?” is resolved the same way it is for doctors: the current location matters, not the registered address.

Common Scenarios Multi-State Aesthetic Groups Run Into

There are several situations that aesthetic clinic networks encounter regularly:

• Traveling Patient. After a procedure, a patient wants to schedule a follow-up video call while visiting relatives in another state. Technically, this is already an out-of-state visit, even if it lasts ten minutes and concerns a simple question about healing.
• The Patient Who Has Moved. A long-time patient moves to another state and wants to continue virtual follow-up visits with their previous doctor. It’s especially easy to make a mistake here because the relationship with the doctor is long-standing and trusting. Still, legally, the situation is no different from that of a new patient in a new state.
• Multi-location network. A physician licensed in one state provides virtual consultations for a network’s sister clinic in another state, for example, on days when the local physician is on vacation. This situation is particularly common in growing networks, and without clear oversight, it often leads to unintentional violations.

Building a Compliant Multi-State Telehealth Process

The first step is to verify and document the patient’s physical location at the start of each virtual visit, rather than simply relying on the address listed in the patient’s chart. A patient’s registered address and their actual location at the time of the call are different, and confusing them is dangerous.

The second step is to compile a list of which physicians hold licenses, compact privileges, or registrations in specific states, and to keep this list up to date as staff changes and new locations open. A list compiled a year ago may no longer be current today.

Centralizing this tracking within the practice’s EMR and scheduling systems significantly reduces the risk of a virtual visit taking place without the necessary authorization. This is precisely why platforms like EmilyEMR integrate telehealth across state lines verification directly into the booking process: the system can remind an administrator or physician to verify the current license status before the visit even takes place, rather than after a problem has already arisen. Such an automated check is far more reliable than relying on an individual employee’s memory, especially when a network of clinics employs dozens of physicians with different licenses in different states. For a growing network, EmilyEMR handles the routine verification, leaving only the final confirmation to the physician and administrator.

Conclusion: Location Determines the Rules

The key takeaway is this: it is the patient’s physical location at the time of the visit, not their home address or the doctor’s location, that determines which rules apply. This simple rule underlies everything related to telehealth across state lines.

To briefly recap the entire process: review the available pathways to obtain the right to practice in each state, document the patient’s location during every visit, and keep your license records up to date. These three steps make telehealth across state lines manageable rather than a constant source of risk.

Review how your clinic network currently handles virtual visits for patients who are traveling or have relocated, and identify any gaps in the process to address in advance, rather than after a problem has already arisen.