Is There an Optometry Licensure Compact? No, and Here Is Why

No. As of October 2026 there is no interstate licensure compact for optometrists, and AOA's own work group found no nationwide push to build one. An optometrist who wants to practice in a second state applies to that state's board for a full license, and in states such as Ohio and Tennessee that is true of telehealth care as well. That surprises people who have watched nurses, physical therapists and psychologists gain compact privileges, and it shapes how any optometrist who moves or practices in several states should plan.

What did AOA's compact work group conclude?

The American Optometric Association convened an Interstate Licensing Compact Work Group, which issued its recommendation on Jan. 15, 2023. Its conclusion: "there is not a unanimous need nor an urgent nationwide desire for an interstate licensing compact within the profession of optometry at this point in time." The memo also stated the situation plainly: "Currently, there are no interstate licensing compacts within the profession of optometry, so licenses for Doctors of Optometry may be obtained: via conventional application to each state regulatory board individually; via reciprocity in states that authorize it; and/or via licensure by endorsement in states that allow for it."

The work group listed the concerns it heard most: scope of practice differences from state to state, possible opposition if practice acts were opened in legislatures, the cost to create and run a compact, and "unintentionally promoting any inappropriate use of telehealth that might endanger patient safety." On cost, it noted that building a compact typically runs upward of $500,000 for legal, consulting and educational work, with up to $1 million more for operations. It recommended that state affiliates gauge their own interest and that AOA survey them; it suggested more formal work only if at least 8 to 10 affiliates were strongly committed.

Why do so many people assume one exists?

Partly because so many other health professions have one. The AOA memo itself listed the active compacts as of June 2022: the Enhanced Nursing Licensure Compact with 39 states, the psychology compact with 31, the Interstate Medical Licensure Compact with 29, the Physical Therapy Compact with 25, the Emergency Medical Technician Compact with 21, and the audiology and speech-language pathology and occupational therapy compacts with 15 each.

Partly because optometry already has one national exam series. NBEO describes its exams as "universally accepted for optometric licensure in the United States," so your Part I, II and III scores travel with you. The scores do; the license does not. Each board still decides whether you need years of practice, which law exam you sit, and which scope tier you may practice under.

Is the CELMO certificate a stand-in?

No. ARBO's Council on Endorsed Licensure Mobility for Optometrists issues a certificate that some boards accept as evidence when reviewing an endorsement application. ARBO answers its own question "Is this a form of national optometric licensure?" with "No," and adds that "There is no guarantee that the individual state boards will automatically grant a license by endorsement." It can shorten a file in the states that recognize it, such as Connecticut, Iowa, Arizona and Wyoming, and does nothing elsewhere. See CELMO certificates: what they do and where they count.

Do universal licensing laws work like a compact?

They help, but each one still ends in a full license from that state, on that state's terms. Arizona's universal recognition law (A.R.S. § 32-4302) serves new residents who hold an Arizona driver license and have at least one year of licensure elsewhere. Ohio's optometry statute (ORC 4725.18) licenses out-of-state optometrists under Chapter 4796, which by default looks for one year of licensure and practice in one of the last five years. West Virginia's universal licensing law (W. Va. Code 30-1-27) is tied to new residency or a military spouse's posting. None of them lets you practice in the state on your home license.

Can you see another state's patients by telehealth without a license there?

Usually not. Ohio's board rules define telehealth services as care by a professional licensed in Ohio. Tennessee's rules require the patient to be physically in Tennessee and the optometrist to be licensed there. North Dakota requires an active North Dakota license, and the first patient relationship must start with an eye exam by a licensed optometrist with a physical location in the state. North Carolina treats telehealth as practice at both locations, so a home office used for telehealth must be licensed as a main or branch office.

A few states offer a registration short of a license. Florida's out-of-state telehealth provider registration (s. 456.47) is open to optometrists with an active, unencumbered license elsewhere, no discipline in five years, a Florida registered agent and liability coverage. Delaware offers an Optometry Interstate Telehealth Registration for $50. Our post on which state licenses tele-optometry requires goes state by state, and White Glove Telemedicine lists telehealth registration states across professions.

What should a multi-state optometrist do instead?

Treat each state as its own project and sequence them. Start with the states that license on NBEO scores and set no years of practice, such as Texas, Illinois, New York and Pennsylvania, because those files are usually the lightest. Put annual-exam states on the calendar early: Oklahoma's State Board Exams happen once a year, and North Carolina examines in February and August. Confirm your scope tier qualifies in each state, since Illinois, Arizona and South Carolina all check it. And keep every renewal date in one place, because the cycles differ: New York renews every three years, Florida every two, Arkansas every year.

That is the work we do. A license on NBEO scores or by endorsement is $699 per state, a state that gives its own exam or interview is $799, and the Tele-Optometry Package covers three licenses from $1,899 per optometrist. We prepare and track; you answer, sign, pay the board and sit any exam. See the pricing page, the out-of-state licensing hub, or start with how optometrists get licensed in another state.