Glossary: the terms on a state card

Definitions are written for a reader, not a lawyer. Where a term has a legal definition that matters, the source is named.

Licensing

State medical board. The state agency that licenses and disciplines physicians (MD and, in most states, DO). Its public lookup shows licence status, expiry and board actions. The first row of every state card links it.

Osteopathic board. In a minority of states (Arizona, Maine, Nevada, Oklahoma, Pennsylvania, Tennessee, Vermont, West Virginia and a few others) DOs are licensed by a separate board with its own lookup. The card notes it where it applies.

Board of nursing. Licenses registered nurses and advanced practice nurses, including nurse practitioners, who prescribe GLP-1s in many telehealth programs. Prescriptive authority may be a separate certificate.

Board of pharmacy. Licenses pharmacies and pharmacists in the state, and licenses out-of-state pharmacies that ship into it. The second row of every state card links it; the links come from the Compounding Explained site's verified list.

Non-resident pharmacy licence. The licence a pharmacy located in one state needs in order to ship prescriptions to patients in another. Searchable on the receiving state's board of pharmacy site.

NPI (National Provider Identifier). The ten-digit federal number every US health care provider has. The public registry shows name, credential, specialty and practice address. It identifies; it does not license.

Board action, board order, disciplinary action. A formal decision by a board about a licensee: reprimand, fine, probation, restriction, suspension, revocation or surrender. Public in every state, usually on the licence record.

The compact

Interstate Medical Licensure Compact (IMLC). An agreement among 44 states, DC and Guam (Commission snapshot, information as of July 31, 2026) that gives eligible physicians an expedited route to full licences in other member states. Not a multistate licence. See the explainer.

State of principal licence (SPL). The member state where a physician's compact application starts: broadly where they live, practise, are employed or pay taxes. It issues the letter of qualification.

Letter of qualification (LOQ). The SPL's confirmation that the physician meets the compact's eligibility rules. Valid for a limited period, during which the physician can request licences from other member states.

Nurse Licensure Compact (NLC). A different compact for registered and practical nurses that does grant a multistate licence. It does not cover nurse practitioners' advanced practice licences in most states and is not shown on this site's cards.

Telehealth

Telehealth, telemedicine. Care delivered with the patient and the practitioner in different places, by video, phone or exchange of information. States define the terms in their own statutes; some distinguish them, most now use them interchangeably.

Synchronous. Real-time interaction: a video call or a phone call.

Asynchronous, store-and-forward. The patient submits information (a questionnaire, photos, records) that a practitioner reviews later, without a live interaction.

Practitioner-patient relationship. The legal relationship that must exist before a prescription is written. State law says how it may be established; the in-person question on the state card is about whether telehealth alone can establish it for a non-controlled drug.

In-person exam requirement. A rule that a practitioner must physically examine a patient before prescribing, either always or in defined situations. Rare today for non-controlled drugs, common historically, and still the federal default for controlled substances prescribed over the internet (21 U.S.C. 829(e)).

Standard of care. The level of care a reasonable practitioner would provide. Every telehealth statute we have read holds telehealth to the same standard as in-person care.

Telehealth registration, out-of-state telehealth permit. A route some states offer to physicians licensed elsewhere to treat the state's residents by telehealth without a full licence, under conditions. Florida's out-of-state telehealth provider registration is the best-known example.

Controlled substance. A drug scheduled under the federal Controlled Substances Act (and state equivalents). Semaglutide, tirzepatide and liraglutide are not controlled. Phentermine is.

Medicaid

Fee-for-service (FFS). The state pays providers and pharmacies directly under the state's own rules and drug list.

Managed care (MCO). The state pays a health plan a fixed amount per member and the plan pays providers. Most Medicaid members are in managed care. Plan formularies may differ from the state list.

Preferred drug list (PDL). The state's list of covered outpatient drugs by class, with each product marked preferred, non-preferred or not covered, plus edits. See how to read one.

Prior authorization (PA). A requirement that the prescriber obtain approval against written criteria before the drug is covered.

Quantity limit (QL), step therapy (ST), age edit. Limits on how much is dispensed per period, a requirement to try another agent first, and an age restriction, respectively.

Excludable category, weight-loss exclusion. The federal list of drug categories a state may leave out of Medicaid coverage, which includes agents used for weight loss (42 U.S.C. 1396r-8(d)(2)). The reason obesity coverage varies by state.

EPSDT. Early and Periodic Screening, Diagnostic and Treatment: the federal guarantee that members under 21 receive medically necessary care even where the adult benefit excludes it.

Compounding

Compounded drug. A drug prepared by a pharmacy for an individual patient's prescription, combining or altering ingredients. Compounded drugs are not FDA approved, are not reviewed for safety or effectiveness before sale, and are not interchangeable with brand products.

503A pharmacy. A traditional compounding pharmacy, licensed and inspected by the state board of pharmacy, compounding for identified patients under section 503A of the Federal Food, Drug, and Cosmetic Act.

503B outsourcing facility. A facility registered with FDA under section 503B, inspected by FDA, that may compound in bulk without patient-specific prescriptions under current good manufacturing practice.

Essentially a copy. The statutory phrase for a compounded drug that duplicates an approved product. Outside a shortage and narrow exceptions, pharmacies may not compound essentially a copy of an approved drug.

Drug shortage, shortage resolution. FDA's determination that demand for an approved drug exceeds supply, which opens the door to compounding copies, and its later determination that supply has recovered, which closes it. FDA declared the tirzepatide shortage resolved on December 19, 2024 and the semaglutide shortage resolved on February 21, 2025.

Enforcement discretion. A period after a shortage resolution during which FDA said it would not take action against pharmacies for continuing to compound, to allow an orderly wind-down.

Certificate of analysis (COA). A laboratory report on a specific batch of a compounded product, showing identity, potency and purity testing. The Compounding Explained site covers how to read one.