North Carolina joined the PA Licensure Compact in March 2026. According to the compact committee, compact licenses will begin being issued in early 2027.
What is the PA Licensure Compact?
The PA Licensure Compact is an interstate occupational licensure compact for PAs. The compact provided a streamlined process via a compact privilege for PAs to practice in other compact member states without the need to obtain multiple state licenses. States join the compact by legislatively enacting the model compact legislation.
The PA Compact is similar in form and function to occupational licensure compacts that North Carolina has joined for audiology and speech language pathology, occupational therapy, physical therapy, counseling, and psychology.
How does the PA Compact work?
- The PA compact utilizes a “mutual recognition” model of interstate practice, where compact member states agree to “recognize” valid licenses issued by other member states
- The PA compact will not affect scope of practice – PAs using a compact privilege to practice must abide by the laws and regulations of the state which they are practicing in at the time.
How does the Compact benefit North Carolina?
- Supports the healthcare workforce by reducing the burden of maintaining multiple state licenses – this in a win for both PAs and their patients
- Improves continuity of care when patients or providers travel or relocate
- Supports relocating military spouses
- Increases access to services for patients to meet healthcare demands by increasing availability and diversity or qualified practitioners and elevated safety standards
- States bordering North Carolina, such as Virginia and Tennessee, are currently considering or have enacted this legislation; if North Carolina joins the compact, PAs from these bordering states can easily care for patients in the state, thus increasing practitioner availability.
History of the PA Compact in North Carolina:
On February 26, 2025, the North Carolina Senate filed the PA Compact bill, SB 190: PA Licensure Compact.
The bill is sponsored by Senator Mark Hollo (R-Caldwell), a retired PA, and Senators Ralph Hise (R-Mitchell) and Amy S. Galey (R-Alamance).
In June 2025, North Carolina’s entry into the Licensure Compact for PAs was passed as part of House Bill 67. The legislation is now headed to Governor Stein’s desk for signature. This marks a major step forward in expanding and modernizing how PAs collaborate within healthcare teams across state lines.
NCAPA is proud to have championed this effort alongside legislative partners and will share additional updates as implementation moves forward.
To view other key legislation that the NCAPA is monitoring, click here for the NCAPA Advocacy Center.


