50-State Physician Guide

Licensure, practice ownership, and APC supervision rules — state by state. Click any state for the full breakdown.

States

AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

District of Columbia

DC

Territories

GU MP PR VI

Comparison Table

State IMLC FCVS In-State Requirement NP Independent PA Independent Physician PC Max NP:MD Max PA:MD License Renewal Cycle Annual Cost
Alabama Yes Accepted Strict: Must be resident & practicing in AL. No No Yes 9 9 $375 $150 Annual $150
Alaska No Accepted None (Telehealth-friendly). Yes Yes No No Limit (FPA) No Limit $825 $400 Biennial $200
Arizona Yes Accepted None (Telehealth-friendly). Yes Yes No No Limit (FPA) 4 $500 $500 Biennial $250
Arkansas Yes Accepted Ready availability; no strict residency. Yes (6,240h) No No No Limit 3 $220 $300 Biennial $150
California No Accepted Ready availability; physical presence not required. Yes (3 yrs) No Yes (51%) 4 8 $805 $1,206 Biennial $603
Colorado Yes Accepted Telecommunication availability only. Yes Yes No No Limit (FPA) No Limit $450 $327 Biennial $164
Connecticut Yes Accepted Resident/Practicing MD (For first 3 years/2,000 hours of NP practice) Yes (3 yrs) Yes (3 yrs) Yes No Limit (FPA) No Limit $565 $565 Annual $565
Delaware Yes Accepted MD must be licensed/available. Yes Yes No No Limit (FPA) 4 $312 $344 Biennial $172
District of Columbia No Accepted Must be licensed in DC. Yes No No No Limit (FPA) No Limit $414 $714 Biennial $357
Florida Yes Accepted MD must be licensed in FL; residency not required. Yes (Primary) No No No Limit 4 $955 $705 Biennial $353
Georgia Yes Accepted Strict: MD must be in-state or within 50 miles. Principle place in practice. GA narrowing in on telehealth. No No No 8 4 $500 $300 Biennial $150
Guam No Required Must be licensed in Guam. No No Yes N/A N/A $300 $300 Biennial $150
Hawaii Yes Accepted None (MD license only). Yes Yes No No Limit (FPA) No Limit $500 $360 Biennial $180
Idaho Yes Accepted None. Yes Yes No No Limit (FPA) No Limit $600 $300 Biennial $150
Illinois Yes Accepted MD must be "readily available." Yes (4,000h) No Yes No Limit 7 $700 $450 Triennial $150
Indiana Yes Accepted MD must be licensed in IN. No No No No Limit 4 $250 $200 Biennial $100
Iowa Yes Accepted None. Yes Yes No No Limit (FPA) 5 $450 $450 Biennial $225
Kansas Yes Accepted MD must be licensed in KS. Yes No Yes No Limit (FPA) No Limit $300 $330 Annual $330
Kentucky Yes Required MD must be licensed/practicing in KY. No No No No Limit 4 $300 $300 Annual $300
Louisiana Yes Required MD must be "comparable specialty" in-state. No No No No Limit 8 $382 $350 Annual $350
Maine Yes Required None. Yes Yes No No Limit (FPA) No Limit $600 $500 Biennial $250
Maryland Yes Required MD must be licensed in MD. Yes (18 mo) No No No Limit (FPA) No Limit $790 $512 Annual $512
Massachusetts Pend Required MD must be licensed/practicing in MA. Redily Available during the 18-month "mentorship" period. Yes (2 yrs) No Yes No Limit (FPA) 4 $600 $600 Biennial $300
Michigan Yes Accepted MD must be licensed in MI. No Yes Yes No Limit No Limit $367 $308 Triennial $103
Minnesota Yes Accepted None. Yes Yes (2,080h) No No Limit (FPA) No Limit $425 $384 Biennial $192
Mississippi Yes Accepted Strict: MD must be within 75 miles of site. 80 hours a month and 20 hours a week in state in person. Never approve excemptions purely telehealth based. No No No 4 4 $600 $600 Biennial $300
Missouri No Accepted Strict: MD must be within 75 miles of site. (CHANGED THEIR LAW ON THIS - telehealth) No No No 6 6 $300 $260 Biennial $130
Montana Yes Accepted None. Yes Yes No No Limit (FPA) No Limit $500 $500 Biennial $250
Nebraska Yes Accepted MD must be licensed in NE. Yes No No No Limit (FPA) No Limit $300 $200 Biennial $100
Nevada Yes Accepted (DO Requires) MD must be licensed in NV. Yes Yes Yes No Limit (FPA) No Limit $600 $800 Biennial $400
New Hampshire Yes Required None. Yes Yes No No Limit (FPA) No Limit $600 $300 Biennial $150
New Jersey Yes Accepted MD must be licensed in NJ. No No Yes No Limit No Limit $328 $620 Biennial $310
New Mexico Yes Accepted None. Yes Yes (3 yrs) No No Limit (FPA) No Limit $700 $400 Triennial $133
New York No Required MD must be licensed/practicing in NY. Yes (3,600h) No Yes No Limit (FPA) 4 $735 $600 Triennial $200
North Carolina Yes Required MD must be "readily available". Physician must be reachable at all times during patient care. No Yes (4,000h) Yes No Limit 4 $440 $250 Annual $250
North Dakota Yes Accepted None. Yes Yes No No Limit (FPA) No Limit $200 $200 Annual $200
Northern Mariana Islands No Accepted Must be licensed in CNMI. No No Yes N/A N/A N/A N/A Biennial N/A
Ohio Yes Required MD must be practicing in similar field in-state. No No Yes No Limit 5 $305 $305 Biennial $153
Oklahoma Yes Accepted MD must visit monthly (DO) or be available (MD). No Yes (6,240h) No No Limit 2 $500 $300 Annual $300
Oregon No Accepted None. Yes Yes No No Limit (FPA) No Limit $575 $634 Biennial $317
Pennsylvania Yes Accepted MD must be licensed in PA. MD must be available on a "regularly scheduled basis" No No No No Limit 6 $360 $360 Biennial $180
Puerto Rico No Accepted Must be licensed in PR. No No Yes No Limit No Limit $500 $400 Triennial $133
Rhode Island Yes Required MD must be licensed in RI. Yes Yes Yes No Limit (FPA) No Limit $1,090 $570 Biennial $285
South Carolina Yes Required Strict: MD must reside/practice in SC. No No No 6 6 $580 $320 Biennial $160
South Dakota Yes Accepted None. Yes No No No Limit (FPA) No Limit $400 $200 Annual $200
Tennessee Yes Accepted MD must be within "reasonable" distance. Once annual site (11 virtual, 1 in-person). Board advisory ruling, can take place for telehealth. Location for telehealth for site visit, can be a site mutually agreed upon. NP doesn't have to b present. No No No No Limit 4 $510 $400 Biennial $200
Texas Yes Accepted MD must be licensed in TX; monthly meetings. No No Yes 7 7 $817 $500 Biennial $250
U.S. Virgin Islands No Required Must be licensed in USVI. No No Yes N/A N/A $350 $350 Biennial $175
Utah Yes Required None. Yes Yes No No Limit (FPA) No Limit $200 $183 Biennial $92
Vermont Yes Accepted None. Yes No No No Limit (FPA) No Limit $650 $550 Biennial $275
Virginia No Accepted MD must be "regularly practicing" in VA. Yes (3 yrs) No Yes 6 6 $310 $337 Biennial $169
Washington Yes Accepted None. Yes Yes No No Limit (FPA) No Limit $491 $996 Biennial $498
West Virginia Yes Accepted MD must be licensed in WV. No No No No Limit 5 $400 $400 Biennial $200
Wisconsin Yes Accepted MD must be licensed in WI. No No No No Limit No Limit $75 $412 Biennial $206
Wyoming Yes Required None. Yes Yes No No Limit (FPA) No Limit $600 $300 Annual $300

Data compiled from state medical board websites, FSMB, and regulatory filings. Last updated June 2026. Report corrections.