The governing standard, established by the Federation of State Medical Boards, dictates that a physician must hold a license or specific authorization from the state medical board where the patient is physically located during the encounter. This rule ensures that local oversight remains intact, even as digital health platforms expand their networks across dozens of states. While the digital nature of video calls can make geography feel secondary, the patient's location determines which state holds jurisdiction over the medical record and the quality of care provided.

To bridge the gap between regional licensing requirements and national patient demand, the Interstate Medical Licensure Compact (IMLC) has seen massive growth. In March 2026 alone, the compact issued 3,633 physician licenses, a stark increase from the three licenses granted during its first month in April 2017. With 44 states, Washington D.C., and Guam now participating, the infrastructure for cross-state care has scaled significantly. However, because some states remain outside the compact, patients should verify that their specific physician is authorized in their home state before beginning a consultation. Rather than assuming platform-wide coverage, experts recommend confirming that the provider holds valid, state-specific credentials, ensuring the visit complies with local medical board enforcement.