The IMLC charges a one-time $700 Letter of Qualification fee, plus $100 for each additional state you select beyond the first, on top of every state's own licence fee, which ranges from about $35 to $895 and is identical whether you apply through the Compact or directly. That means the Compact route is never cheaper in board and Commission fees alone. For one state it costs $700 more than applying directly. For four states it costs roughly $1,000 more.
The IMLC's real value is time and effort, not money: your State of Principal Licence verifies your credentials once, the Letter of Qualification is valid for 365 days, and each additional state license typically issues within days rather than the weeks to months a direct application takes because of its own separate verification. Whether that is worth $700 to $1,400 depends on how many states you need and how much your time, or a specialist's time, costs per application.
What does the IMLC actually charge, on top of a state's own fee?
A flat $700 Letter of Qualification fee the first time you apply, then $100 each time you add a state afterward, in addition to that state's own licence fee. The $700 is not charged per state; it is charged once per application cycle.
Each member state still sets and collects its own licence fee, from roughly $35 at the low end to $895 at the high end, and the Compact simply forwards that payment to the state. Applying through the IMLC does not get you a discount on any state's own charge.
So does going through the Compact save money?
No. Because every state's own fee is identical either way, the Compact is always more expensive in raw fees, by exactly the $700 LOQ fee plus $100 for each state after the first. The gap is fixed and does not depend on which states you choose.
| States needed | Compact fees on top of state fees | Direct application fees on top of state fees | Compact premium |
|---|---|---|---|
| 1 state | $700 | $0 | $700 more |
| 2 states | $700 + $100 = $800 | $0 | $800 more |
| 4 states | $700 + $300 = $1,000 | $0 | $1,000 more |
| 8 states | $700 + $700 = $1,400 | $0 | $1,400 more |
Each state's own licence fee is added on top of both columns equally, so it cancels out of the comparison. Whatever a given state charges, applying through the Compact costs that same amount plus the Compact's own fee.
The IMLC is not a discount. It is a different way of paying the same state fees, plus a surcharge for a faster, less duplicated process. Any page that frames the Compact as cheaper is describing the wrong thing. The honest comparison is time and effort against that surcharge.
If it costs more, why would anyone use it?
Because the $700 pays for verification done once instead of separately for every state, and each additional licence after that typically issues in days rather than the weeks to months a direct application takes. That is the actual trade being made.
A direct application to each state board repeats the same primary source verification independently: education, training, board certification, work history and malpractice history are all re-checked from scratch by every board. Through the Compact, your State of Principal Licence verifies all of that once, issues the Letter of Qualification, and each member state you select afterward relies on that verification rather than repeating it.
| Direct application, each state | IMLC, after the first state | |
|---|---|---|
| Primary source verification | Repeated independently by every board | Done once by your State of Principal Licence |
| Typical time to a licence | Several weeks to a few months per state, board-dependent | About 1 to 5 business days once the Letter of Qualification exists |
| Paperwork you resubmit | A full application packet per state | A state selection, not a new verification packet |
| Window to act | No shared deadline between states | 365 days from LOQ issuance to add states under it |
When does the time saved outweigh the $700 to $1,400?
Rarely for one state, usually for three or more, especially under a deadline. For a single additional state, a direct application is cheaper and the time difference is often not decisive. Once several states are involved, repeating full verification several times over tends to cost more in delay, and in a specialist's billed time, than the Compact's flat surcharge.
One state, no deadline pressure
Apply directly. You save the $700 and the time difference rarely matters if you are not racing a start date.
One state, hard deadline
The Compact can still be worth it if a direct application's board timeline will not clear in time and the LOQ route is genuinely faster for that board.
Three or more states
The Compact usually wins on both time and, once a specialist's per-state fee is counted, often on total cost too, since the heaviest work happens only once.
You already hold several state licences
Adding more through the Compact only requires the $100 per-state fee once your LOQ is current; there is no reason to repeat a direct application at that point.
Who can actually use the IMLC?
Only a physician with a full, unrestricted licence in a state that serves as a State of Principal Licence, with no pending licence discipline, criminal history or controlled-substance action. Not every member state issues a Letter of Qualification; some only accept privileges issued by another state's SPL process.
A malpractice claim alone does not disqualify you; a board action arising from one usually does. Confirm current eligibility rules and which states are live as SPL or issuing-only on the compact hub before assuming either route is available in your state.
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Juney Ham is the founder and CEO of Telesure, the marketplace that matches clinicians with independent licensing and credentialing specialists. Previously co-founder of Upside and CMO at Hired. Every regulatory figure on this page is taken from the issuing state board, compact commission or CMS and was verified on 1 October 2026. Fees and compact status change; confirm with the relevant board before relying on them.
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