Top Telemedicine States for IMLC Doctors in 2025

Introduction

Telemedicine has exploded in the past few years, becoming a crucial component of healthcare delivery. For physicians, the Interstate Medical Licensure Compact (IMLC) offers a streamlined pathway to practice across multiple states, unlocking more telehealth opportunities than ever before.

But not all IMLC states are created equal. Some boards process licenses faster, some states offer higher reimbursement rates, and others have removed regulatory barriers to make telemedicine more flexible. Knowing where to focus your licensing efforts can make a big difference in both income potential and career flexibility.

This guide highlights the top telemedicine-friendly IMLC states in 2025 and offers practical advice for clinicians looking to maximize their reach.

Fastest IMLC Processing States

Time is money in telemedicine, and some states are known for their rapid licensing turnaround:

• Iowa (IA) – Average LOQ to license issuance: 10–12 days. Iowa’s board is streamlined and responsive, making it a favorite for physicians onboarding quickly.
  
• Colorado (CO) – Known for its efficient online verification and minimal additional documentation requirements.
  
• Arizona (AZ) – The state board has reduced verification steps and processes LOQs quickly, ideal for physicians entering telehealth contracts.
  
• Idaho (ID) – Small board with fast processing, particularly for applicants who have already prepared their documents.
  

Physicians applying through these states often experience fewer delays, allowing them to start telehealth roles faster than in other IMLC states.

Highest Telehealth Reimbursement States

Revenue potential is another important factor. Telemedicine reimbursement varies by state and payer:

• Maryland (MD) – Maintains parity with in-person visit rates for telehealth.
  
• Illinois (IL) – Offers high reimbursement for telehealth in multiple specialties, including psychiatry and primary care.
  
• Texas (TX) – Growing demand and favorable Medicaid telehealth policies increase earning potential.
  
• Washington (WA) – Telehealth is reimbursed at near in-person parity, especially for chronic care management and specialty consults.
  

Focusing licensing and job applications in these states can maximize income for physicians practicing remotely.

Compact-Friendly Telemedicine States

Some states have actively reduced telemedicine restrictions, making it easier for IMLC physicians to practice without cumbersome regulations:

• Arizona, Colorado, and Wisconsin – No requirement for physical presence in the state for patient care.
  
• Utah and Iowa – Streamlined telehealth consent and documentation requirements.
  
• North Carolina – Allows telemedicine practice as long as the physician holds an active license in the state.
  

Physicians who select these states strategically can cover multiple patient populations without unnecessary administrative burden.

How DirectShifts Helps Physicians Capitalize

Licensing is only half the equation; the other half is finding the right telehealth roles. DirectShifts helps physicians:

• Track LOQ status and coordinate with multiple boards simultaneously
  
• Pre-verify documents to avoid licensing delays
  
• Match with telemedicine contracts in compact states immediately after license issuance
  

This coordination allows physicians to maximize revenue while minimizing downtime between assignments.

Tips for Choosing Your States

When deciding which IMLC states to target for telemedicine:

1. Consider turnaround times: States with faster LOQ-to-license timelines reduce idle waiting periods.
   
2. Evaluate reimbursement policies: Choose states where telehealth is reimbursed at parity or above average rates.
   
3. Check telemedicine regulations: Some states still require in-person visits before telehealth care.
   
4. Align with demand: States with physician shortages often offer higher compensation for telehealth coverage.
   
5. Plan for renewals: Multiple states mean multiple renewal deadlines — track them carefully to avoid lapses.
   

Combining these factors ensures that your licensing strategy translates into real work opportunities, not just paperwork.

FAQs

1. Can I practice telemedicine in a state that isn’t part of IMLC?
No. You must hold an active license in that state to legally provide telehealth services.

2. Do all compact states allow telemedicine without in-person visits?
Not yet. While many have relaxed restrictions, some still require an initial in-person exam. Check state-specific telemedicine regulations before practicing.

3. How quickly can I start telehealth work once licensed?
With proper preparation, physicians can start in as little as a few days after license issuance, especially when using platforms like DirectShifts.

4. Do I need a separate DEA registration for each state I practice telemedicine in?
Yes. Prescribing controlled substances across states requires a DEA registration per state. Some states may allow a multistate registration if eligible.

5. Which states offer the highest telehealth demand for specialists?
Texas, Florida, and Illinois have strong demand for psychiatry, primary care, and chronic disease management telehealth roles.

6. Can I work in multiple states simultaneously with one IMLC license?
You hold separate licenses per state through the compact. You can work in multiple states once all licenses are active.

Conclusion

Telemedicine is growing rapidly, and the IMLC provides physicians with an unprecedented opportunity to practice across multiple states with minimal bureaucracy. By focusing on states with fast processing, high reimbursement, and flexible telehealth regulations, physicians can maximize both their professional reach and financial gain.

DirectShifts helps streamline this process from start to finish, providing licensing support and matching clinicians with high-value telehealth assignments immediately after license activation. With careful planning, IMLC physicians in 2025 can turn multi-state licensing into a competitive advantage in the telemedicine landscape.