Locum tenens work has traditionally involved temporary in-person coverage, often supported by expedited or temporary licensing pathways designed for short-term assignments. As locum arrangements increasingly include remote or telehealth coverage, the licensing picture becomes more layered, since a temporary in-person license does not always extend cleanly to remote practice in the same state.
Temporary licenses were built for a different model
Many states offer expedited or temporary licensure specifically for locum tenens physicians filling short-term gaps at a facility. These pathways were generally designed with physical presence in mind, such as covering a rural hospital for a set period. Whether that same temporary license authorizes a physician to provide telehealth coverage from outside the state is a separate question that depends on the specific state's rules, and is not always addressed by the temporary licensure statute itself.
Compact eligibility can help, with limits
The Interstate Medical Licensure Compact offers an expedited pathway to full licensure in participating states, which can be useful for locum physicians building a multi-state telehealth practice over time. Compact licensure is generally a full license rather than a temporary one, so it involves its own application and renewal obligations, and it does not cover every state, since compact membership is limited to participating states.
A temporary license built for in-person locum coverage does not automatically authorize telehealth work in the same state.
Credentialing adds its own timeline
Locum tenens assignments, including remote ones, typically still require credentialing with the facility or platform involved, on top of any licensing requirement. Because locum assignments are often short and arranged quickly, the credentialing timeline can become the practical bottleneck even when licensure is already in place.
Coordinating multiple moving parts
Physicians and staffing agencies managing locum telehealth coverage generally find it useful to confirm, for each assignment, whether the license type held is valid for remote practice in that state, whether DEA registration covers prescribing needs for the assignment, and whether credentialing will be complete before the assignment start date.
Because temporary licensure rules, compact participation, and credentialing timelines vary by state and change over time, always confirm current requirements directly with the relevant state board or agency before making a compliance decision.