Telehealth is no longer a fringe offering – by 2025 it has become a mainstream mode of care delivery. In the wake of the pandemic, virtual visits stabilized at levels far above the pre-2020 baseline.

Roughly one in four patients now use telehealth services, compared to only about 5% before the pandemic. Healthcare organizations have embraced this “new normal,” with 86.9% of US hospitals offering telehealth. However, behind every telehealth service is a complex web of credentialing and compliance requirements.

Below, we explore key utilization trends, the multi-state licensing landscape, evolving regulations, and credentialing hurdles, and highlight opportunities to streamline operations in this dynamic environment.
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Telehealth Utilization Trends in 2025‍

Telehealth usage saw an unprecedented surge in 2020 and has since settled into a sustained high plateau. Patients have grown comfortable with virtual care for everything from routine primary care to behavioral health. In fact, over 20% of adult patients had a telehealth visit, and Medicare reports a 63-fold increase in telehealth use since 2019. Key trends shaping telehealth in 2025 include:

• Broad Adoption Across Care Settings: Hospitals, clinics, and specialty practices continue to integrate telehealth. Nearly 87% of hospitals nationwide now connect with patients via telemedicine. Mental health services lead telehealth utilization, but chronic care check-ins and even post-surgery follow-ups are commonly done virtually. This broad adoption underscores that virtual care is here to stay as a core part of healthcare delivery.
• Hybrid Care Models: Providers increasingly blend in-person and virtual visits. A patient might see their physician in person for an annual exam, then use telehealth for follow-ups or minor issues. This hybrid approach improves access and convenience while maintaining quality. Provider operations teams must credential practitioners for both modalities seamlessly.
• Technology & Integration: Advances in telehealth technology (high-quality video platforms, remote monitoring devices, AI-driven triage) have made virtual visits more effective. Integration with electronic health records (EHRs) is improving, so telehealth encounters feed directly into patient records. These tech trends don’t change credentialing fundamentals, but they do expand the volume and types of providers (e.g. remote patient monitoring staff, tele-specialists) that need to be credentialed and onboarded efficiently.

Telehealth’s growth has proven its value in improving access and patient satisfaction. But this growth also shines a spotlight on operational challenges – particularly the credentialing process required to onboard and authorize telehealth providers across multiple settings and states.

Multi-State Licensing and Regulatory Landscape

One of the biggest telehealth hurdles in 2025 remains state licensing. Healthcare is regulated at the state level, which means a provider offering telehealth across state lines must be licensed in each state where patients are located. COOs and ops leaders managing national telehealth services face a patchwork of state rules. Key developments include:

• Interstate Licensure Compacts: Efforts to streamline cross-state practice have gained momentum. The Interstate Medical Licensure Compact (IMLC) now has 42 member states (plus D.C. and Guam) by 2025, providing an expedited path for physicians to obtain licenses in multiple states. Similarly, the Nurse Licensure Compact covers over 40 states for RN and LPN/LVN licenses. These compacts significantly reduce the burden on providers who want to practice nationally, effectively creating a wider pool of “multi-state ready” clinicians. However, not all states participate fully, so gaps remain.
• Expiration of Pandemic Waivers: During COVID-19, emergency waivers allowed easier cross-state telehealth practice and flexible credentialing. Many of those waivers are expiring or have expired. For example, certain telehealth flexibilities for Medicare were set to expire in March 2025 without congressional action. Provider organizations that benefited from relaxed rules now must ensure full compliance with standard licensing and credentialing regulations again. This regulatory whiplash requires careful attention in 2025 – no one wants to be caught with providers practicing unlawfully across state lines once temporary policies sunset.
• Evolving Federal Policies: On the positive side, regulators are making some telehealth gains permanent. Medicare has extended telehealth reimbursement parity for many services through September 30, 2025, including allowing patients’ homes as the originating site and covering mental health telehealth indefinitely. Marriage and family therapists and mental health counselors can now permanently bill Medicare for telehealth. These changes, along with ongoing lawsuits challenging restrictive state licensure laws, reflect a shift toward more telehealth-friendly regulations. The direction is toward flexibility, but for now, organizations must juggle varying rules across different jurisdictions.

Implication for Credentialing: Multi-state licensing complexity means credentialing teams need robust processes to verify licensure in every state a telehealth provider will serve. They must track license issuance, renewals, and compacts participation for each provider. Credentialing managers also have to stay current on each state’s telehealth laws (some states require special telehealth practice registrations or have tele-prescribing rules). Ensuring compliance amid these moving pieces is a real challenge.

Challenges in Telehealth Credentialing

Telehealth providers face all the usual credentialing requirements (verifying education, training, licenses, malpractice coverage, etc.), but operating virtually and across geographies introduces additional challenges. Some of the top credentialing challenges in 2025 include:

• Multi-State Credentialing Workloads: As mentioned, a telehealth provider often needs multiple state licenses. That means verifying and maintaining credential files for each license and adhering to each state’s board requirements. A provider who treats patients in 5 states might need 5 background checks, 5 state board verifications, and so on. This multiplies the administrative workload for credentialing teams. Without efficient tools, it’s easy to fall behind.
• Time-Intensive Onboarding: Traditional credentialing is slow, often taking months per provider. Hospitals and health systems have historically averaged 60-120 days to fully credential and enroll a physician. In telehealth, where hiring may scale rapidly to meet demand, these delays are painful. Every day a new clinician isn’t cleared to see patients is a day of lost revenue and limited service availability. We’ll quantify the financial impact in a moment, but the bottom line is that slow onboarding is costly. Telehealth companies that expand provider networks quickly have a competitive edge, putting pressure on credentialing timelines.
• Regulatory Compliance & Documentation: Credentialing in telehealth must satisfy not just one set of rules but many. Organizations need to comply with accreditation standards (like NCQA and Joint Commission), federal payer rules, and state-specific mandates. For instance, the NCQA in 2024 shortened the credentialing timeframe for health plans, expecting faster turnaround on primary source verification. The Centers for Medicare & Medicaid Services (CMS) also issued updated telehealth credentialing guidance – e.g. requiring standardized verification that providers are licensed in each state they serve. Meeting these standards requires impeccable record-keeping. Every license, certification, background check, and sanction check must be documented and up-to-date in case of audit. Managing this volume of data (often in spreadsheets or disjointed systems) is a major pain point for provider ops teams.
• Credentialing Staff Burnout: The complexity and volume of telehealth credentialing can strain even experienced teams. Coordinators often spend hours on repetitive tasks – chasing providers for documents, manually inputting data, checking primary sources – for each new hire. Under tight deadlines, it’s a recipe for burnout. In fact, constant firefighting and pressure have led many credentialing professionals to consider leaving the field. High staff turnover or fatigue in credentialing departments can further slow the onboarding process, creating a vicious cycle.
• Coordination with Payers and Facilities: Telehealth providers not only need credentials with their employer – they often must be enrolled with multiple insurance payers (for reimbursement) and possibly credentialed at partner facilities (if, say, a telehealth service is provided through a hospital system). Each payer has its own enrollment forms and timeline, which can introduce additional delays and paperwork. A lack of alignment between credentialing for practice privileges and credentialing for billing can lead to situations where a doctor is technically hired and licensed, but still can’t see patients of certain insurers due to pending enrollment. This fragmentation is another layer that ops leaders must manage carefully.

In short, telehealth credentialing in 2025 is complex, multi-dimensional, and high-stakes. Delays or mistakes not only carry financial risks but can also jeopardize patient care access and compliance status.

Opportunities and Solutions

It’s not all daunting news – with these challenges come clear opportunities to improve processes and leverage technology. Healthcare organizations are realizing that modernizing credentialing and licensing workflows is key to sustaining telehealth growth. Some opportunities and best practices include:

Embrace Credentialing Automation

Automation is transforming credentialing from a paper chase to a streamlined digital workflow. Advanced credentialing software can now auto-verify licenses, flag expirations, and even integrate with state licensing databases. The ROI is significant: hospitals using credentialing technology have reported cutting credentialing time by 30–50%. By reducing manual data entry and automatically populating forms, these tools speed up onboarding and reduce human error. For a telehealth program, that means providers start seeing patients sooner – directly translating into revenue and access gains. Automation also assists with ongoing compliance (e.g. automated monthly sanction checks), easing the burden on staff.

Leverage Interstate Compacts Fully

Provider ops leaders should incorporate licensure compacts into their recruitment and credentialing strategy. If hiring a physician or nurse in 2025, check if their home state is part of a compact. A physician with an IMLC eligibility can obtain additional state licenses in a fraction of the usual time – sometimes in a couple of weeks rather than months. The IMLC’s 42-state reach is a game-changer for scaling telehealth networks. By prioritizing candidates with compact licenses (or encouraging existing staff to use the compact process), organizations can expand into new states far more quickly. This proactive licensing approach turns a potential bottleneck into a growth enabler.

Optimize Credentialing Workflow & Policy

Many organizations are revisiting their internal workflows to eliminate bottlenecks. Best practices include initiating credentialing as soon as an offer is accepted (don’t wait for the start date), maintaining a well-organized database of all provider credentials, and using checklists to ensure no steps are missed. Some are creating credentialing SWAT teams for telehealth expansion – dedicated staff who focus on multi-state onboarding projects. Others partner with credentialing verification organizations (CVOs) to offload some verification tasks. A streamlined process that runs in parallel (rather than sequentially) – for example, verifying licenses, hospital privileges, and payer enrolments concurrently – can trim weeks off the onboarding time.

Data-Driven Tracking and Management:

COOs are increasingly asking for metrics on credentialing performance. Tracking key indicators like average days to credential, number of providers in process, and any applications stuck or flagged can help identify inefficiencies. In 2025, with higher volumes, it’s critical to use dashboards or reporting tools to gain visibility. For instance, if one state’s licensing is consistently slower, you can adjust hiring plans or push that state’s applications sooner. Data also helps make the case to invest in better solutions – e.g. showing that slow onboarding cost X dollars in lost opportunity (a compelling stat for CFOs, as we’ll see in the whitepaper section).

Partnering for Compliance Expertise

The regulatory piece is complex and ever-changing. Many telehealth organizations benefit from legal or compliance partners who keep them informed on rule changes (such as new telehealth laws in certain states or updates from CMS and accrediting bodies). By staying ahead of regulatory changes – like the NCQA’s tighter credentialing timeframe requirements – provider ops teams can avoid last-minute scrambles. Building a culture of compliance and regular training for staff ensures that everyone understands the importance of proper credentialing despite the pressure to onboard quickly. In essence, speed and compliance must go hand-in-hand.

Organizations that master telehealth credentialing will be positioned to capitalize on virtual care’s opportunities. They can scale their provider network faster into new markets, offer a wider array of services, and assure quality and safety for patients. By contrast, those that neglect these challenges may find themselves unable to keep up with demand or, worse, facing compliance violations.

The Opportunity for Telehealth in 2025

Telehealth in 2025 presents a landscape of tremendous opportunity tempered by operational complexity. Utilization of virtual care is robust and growing, unlocking new revenue streams and ways to serve patients. At the same time, credentialing has emerged as a strategic function – one that can either accelerate expansion or pump the brakes on progress. COOs and Provider Operations leaders must navigate trends like multi-state practice and evolving regulations, while fixing the weak links in their onboarding processes. The good news is that solutions are at hand: from interstate compacts to credentialing software automation, organizations have more tools than ever to streamline compliance.

Credentially’s perspective is that efficient telehealth credentialing is achievable by combining modern technology and savvy process management. By adopting platforms that automate verification and track multi-state credentials, healthcare groups can cut through red tape and onboard clinicians in record time. The result is not just cost savings, but also less burnout on your staff and better care for patients who gain quicker access to providers. In a field as fast-moving as telehealth, those who turn credentialing challenges into opportunities will lead the pack. Telehealth credentialing in 2025 may be complex, but with the right strategy, it can empower your organization’s growth while upholding the highest standards of quality and compliance.

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