Expanding Your Reach: How to Get Licensed in Multiple States as a Psychologist

Cross state licensure has become a major area of interest for psychologists, due in large part to the exponential growth of teletherapy. Our Cross-State Licensure Survey found that 70% of clinicians surveyed in 2023 planned to maintain an entirely virtual practice, an almost 71% increase from the previous year.

The combination of teletherapy and cross-state licensure allows psychologists to find clients that best align with their practice goals and philosophy of care, and to retain clients who are moving out of state — an experience reported by 70% of clinicians.

For clinicians who split their time between two or more states, gaining cross-state licensure allows them to practice wherever they may be located. And for those who happen to have a growing social media presence, cross-state licensure empowers clinicians to help more of their followers.

While the benefits are clear, getting licensed in additional states is not easy, and can come with several barriers to entry.

Clinicians surveyed by Alma have described the process as confusing, frustrating, overwhelming, and bureaucratic. Additional barriers listed by clinicians include time, cost, vagueness in the application process, and uncertainty that they’ll be able to find enough clients in additional states.

Wondering if getting licensed in one or more additional states is worth the time and money? We’re here to help you weigh the pros and cons — and take the next steps, when you’re ready.

Cross-State Licensure Q&A

What is multi-state or cross-state licensure for psychologists?

Multi-state licensure is a legal process that enables a psychologist who is already licensed to practice in one state to expand their practice to one or more additional states.

How long does cross-state licensure take?

According to Alma’s Cross-State Licensure Survey, 25% of clinicians waited between four and six months to get a license in an additional state. Eleven percent waited seven months to a year.

How much does cross-state licensure cost?

While the potential to increase revenue with an additional state license can be a real benefit, the costs can also be significant. A second license can cost anywhere from $250-1,000 with the majority falling somewhere between $250-500.

How difficult is the cross-state licensure application process?

Although there are some ways to streamline a cross-state licensure process (see the section on PSYPACT® below), each state has slightly different requirements. This can make it arduous to apply for a license in multiple states. Lack of information about the process is a top barrier for 53% of survey respondents.

Is cross-state licensure worth it?

There is no guarantee that the time, money, and effort you put into obtaining cross-state licensure will in fact pay off, which is a real concern for many of the folks we talked to. Clinicians worry that they may not be able to establish enough clients in an additional state to make licensure worthwhile.

If this is a concern for you, joining a nationwide platform like Alma can lower your risk. Alma surfaces your profile to thousands of people seeking therapy across all the states in which you’re licensed to practice.

Practicing across state lines with PSYPACT

Despite several barriers, there are ways to make the process of gaining multiple licenses easier. We’ve pulled together up-to-date resources so you can make an informed decision about what’s right for you and move forward with confidence.

How to apply to PSYPACT®

Psychologists have an advantage over other clinicians when it comes to accessing licensure across states thanks to PSYPACT®. The Psychology Interjurisdictional Compact is an interstate agreement allowing psychologists in participating jurisdictions to practice across state lines without having to get licensed.

The organization is currently working on new legislation to bring more states into the agreement.

For all participating states, the process for practicing via telepsychology has two requirements. You will need to:

• Apply for and obtain an E.Passport from the Association of State and Provincial Psychology Boards (ASPPB) ($400 application fee plus a $100 annual renewal fee)
• Apply for and obtain an Authority to Practice Interjurisdictional Telepsychology (APIT) from the PSYPACT Commission ($200 application fee plus $50 annual renewal fee)

While the cost is still high, becoming part of PSYPACT typically helps reduce the time and effort you will put into applying to get licensure in each state.

If you choose to bypass the PSYPACT route or want to obtain a license in a non-participating state, there are more steps involved.

Applying for a license in individual states

According to the American Psychological Association, these are the basic steps for getting licensed as a psychologist in any given state:

• You need a doctoral degree in psychology, obviously. This could be a PhD or a PsyD.
• You need to have a certain number of supervised internship hours, which varies by state––ranging from 1,500 to 6,000 hours.
• You have to pass the Examination for Professional Practice in Psychology (EPPP). Some states require that you also pass additional exams.
• Once the above steps are complete, you must receive approval by a state licensing board that all licensing requirements are met.

There are additional nuances state by state. Some states are easier than others and several states have reciprocity agreements in place that make it easier to transfer licensure if you hold a license in another state.

It’s important to check requirements with each state’s governing board vs. relying on information in published guides, as requirements can and do change.

The Association of State and Provincial Psychology Boards provides state by state links to each of the psychology boards where you can find the most up-to-date licensing requirements.

More things to consider before seeking cross-state licensure

While gaining additional state licenses is the first step in expanding your practice, it’s not the only consideration when growing your business across state lines. It’s also important that you check each state’s requirements for scope of practice and continuing education in order to maintain compliance in each state where you hold a license.

Each state may also have its own insurance requirements, such as liability or malpractice insurance. Last but not least, expanding your practice means making sure you are fulfilling your tax requirements in each of the states where you practice. It’s always best to consult with professionals to ensure you are checking all the boxes and keeping your practice compliant.

Ready to expand your practice? Alma is here for you!

At Alma, we believe when clinicians have the support they need, the system gets better for everyone––this includes supporting you through cross state licensure. As one of the only platforms serving all fifty states, we can help you make an informed decision about expanding your practice.

We also offer Alma members tools and resources that make it easy to network with therapists in other states, accept major insurance plans, keep your clients on track with sessions and progress, streamline your continuing education, and so much more.Ready to open the doors to new opportunities? We are here to help.

*All data within this white paper is attributed to Alma’s 2023 Cross-State Licensure Survey unless otherwise specified or attributed.