A breakdown of expenses associated with obtaining and maintaining a medical license, including examination fees, application fees, and hidden medical licensing costs.

For healthcare professionals seeking a medical career, understanding the medical licensing cost is essential. These costs differ markedly by state and the professional’s role, impacting both career choices and financial planning. Starting with the initial application fees and including periodic renewals, navigating these expenses requires careful attention.

Consider the medical licensing cost for physicians, which may include fees for tests, applications, and credential verification. These can easily pile up. Nurses, on the other hand, might face fewer initial expenses but wind up spending more over time due to frequent renewals or additional payments for specialist certifications. State medical licensing costs vary, with some states providing more efficient processes through compacts such as the Interstate Medical Licensure Compact.

This article goes into the many expenditures connected with getting and keeping a medical license, addressing not just the obvious charges but also those that are sometimes overlooked.

What to Expect When Applying for a Medical License

When seeking a state medical license, medical professionals must show detailed documentation of their educational history and postgraduate study. Examination scores, recommendations, and hospital privileges, plus any existing or former licenses, are all required as part of the medical licensure application procedure. While the specifics can vary by state, the fundamental components of these applications tend to be consistent, allowing candidates to expedite the process by reusing previously gathered materials across multiple applications.

All candidates must demonstrate successful completion of the United States Medical Licensing Examination (USMLE) by submitting all three phases. Furthermore, legal changes in numerous states have provided medical boards with increased supervision capabilities, which now include the practice of medicine beyond state lines and decision-making procedures in managed care companies. This represents an emerging regulatory framework for medical practice, emphasizing the significance of stringent professional license criteria.

Prospective licensees, especially those who apply for their initial licenses or wish to practice in multiple jurisdictions, should expect at least a two-month evaluation process. International medical graduates (IMGs) may face additional examinations, making this period longer. This time frame is required to provide medical boards with the time to undertake a thorough and equitable review of each candidate’s qualifications and professional background. These severe precautions guarantee that all healthcare personnel adhere to the high standards necessary to provide quality medical treatment.

Typical Medical Licensing Costs Associated

Many physicians in the United States incur high expenditures involved with retaining their licenses throughout their careers. State medical boards levy varying costs for first licensing applications, ranging from $35 in Pennsylvania to $1,425 in Nevada. Furthermore, all physicians who prescribe drugs must register with the Drug Enforcement Administration every three years, at a charge ranging from $731 to $3,007 depending on the category.

The United States’ system, which requires separate state licenses to practice medicine, leads to greater cumulative fees during a physician’s career, especially for those licensed in multiple states. More than 22% of physicians in the United States have licenses in at least two states, with 7% licensed in three or more. Achieving licensing in all 50 states might result in renewal fees that reach $10,000 every few years. Remarkably, only 14 doctors in the entire country maintain licensure in every state, illustrating the substantial commitment and expense involved.

medical licensing cost

Medical Licensing Examination Fees

Examination fees sometimes make up a significant amount of the initial medical licensing costs connected with getting a medical license. Key tests, including the United States Medical Licensing Examination (USMLE), the Comprehensive Osteopathic Medical Licensing Examination (COMLEX), and the National Council Licensure Examination (NCLEX), are all required and have unique prices. Additionally, physician assistants must pass the Physician Assistant National Certifying Exam (PANCE), which has a separate price structure.


The USMLE Step 1 and Step 2 Clinical Knowledge (CK) test fees are $670. Candidates should register with the National Board of Medical Examiners. The NBME Examinee Portal provides immediate access to enrollment and extra information.

The eligibility period extension requires a $70 fee.

In 2024, the application price for phase 3 is set at $925, indicating the extensive scope of this final phase. The USMLE Step 3 fee is not refundable or transferable. It is critical to confirm that you can take the exam because modifications after payment are not accepted.

USMLE Fees for IMGs

ECFMG certification is priced at $160. The registration price for Step 1 IMG testing outside of the United States and Canada is around $1,000. This fee includes the examination cost plus an international test delivery surcharge.

USMLE Step 2 Clinical Knowledge (CK) also has a $1,000 registration fee. Additional fees for arranging the exam may vary depending on some circumstances, including the testing venue, the date of the booking, and any cancellations.

The USMLE Step 3 medical licensing exam application cost is $925, which is an important investment because it is non-refundable and not transferable across applications or eligibility seasons.

Additional Costs

  • Eligibility Period Extension (Step 1/Step 2 CK) costs $100 per exam.
  • Pathway Application for ECFMG Certification for 2024 Match fee is $925.
  • Medical School Transcript costs $250.
  • ERAS Token required for participation in the residency match, costing $165.
  • Electronic Transmission of USMLE Transcript for ERAS $80 per ERAS season.
  • Paper Transcripts to 10 paper copies for $70.
  • Electronic Transmission for ERAS $80 per ERAS season.


The COMLEX-USA Level 1 fee is $715.

Reschedule or Cancellation Fees

  • More than 30 days before the scheduled date: No fee
  • 6 to 30 days before the scheduled date: $85
  • 1 to 5 days before the scheduled date: $250
  • No Show Fee: $400

Examinations cannot be rescheduled, and no cancellations may be made within twenty-four hours before the planned date. All scheduling modifications must be made online using the candidate’s NBOME account.

Non-Examination-Related Fees

  • Score Confirmation Fee: $75
  • Insufficient Funds Checking Fee: $20
  • Transcript Fee: $65
  • Score Report Fee: $5

The COMLEX-USA transcript, often required by ACGME-accredited residency programs for DO applicants, has a fixed fee of $80 per application season. This fee covers the sending of transcripts to all designated programs and is charged once per season through the first program invoice. Importantly, this fee is assessed only after applying to programs and cannot be prepaid.


For those gearing up to take the NCLEX, whether it’s the PN or RN version, the registration process presents a straightforward fee in the United States of $200. Candidates in Canada face a slightly higher charge of CAD 360 for the NCLEX-RN, reflecting the additional administrative costs associated with managing the exam internationally. Furthermore, any candidate needing to switch their nursing regulatory body post-registration must account for an additional $50 fee. This charge is uniform across the United States and Canada, ensuring that all applicants are subject to the same financial adjustments if changes are necessary.

The complexity of scheduling an international test adds another layer of expense. An international scheduling fee of $150 is imposed on those who need to arrange for test administration outside their home country, adding a considerable amount to the total cost of taking the exam.

The Physician Assistant National Certifying Exam (PANCE) requires a $550 application fee. This cost is non-refundable, highlighting the necessity of establishing eligibility and preparation before applying. Shortly after the application, candidates receive an examination acknowledgment notice. This document provides essential details about scheduling the examination, moving them one step closer to certification.

Medical Licensing Application Fees

Navigating the price of first license application fees across many jurisdictions is an important step for healthcare practitioners pursuing certification. These fees vary greatly based on the state or the medical field.

Alabama $175 plus additional fees
Arkansas $500
Arizona Medical$500
Arizona Osteopathic$450
California Medical$1,151 
California Osteopathic$425 plus $200 processing fee
District of Columbia$803
Florida Medical$424
Florida Osteopathic$305
Georgia $500
Guam $400
HawaiiVaries by biennium cycle: $392 full, $221 half for MDs: $510 full, $384 half for DOs
Iowa $450
Idaho $400
Illinois $500
Indiana $250
Kansas $300
Kentucky $300
Louisiana $382
Massachusetts $600
Maryland $790 for AMGs, $890 for IMGs
Maine Medical$600 + $100 exam fee
Maine Osteopathic$350
Michigan $368
Minnesota $200
Missouri $75
Mississippi $550
Montana $500
North Carolina$400
North Dakota$400
Nebraska $350
New Hampshire $300
New Jersey$805
New Mexico $400
Nevada Medical$1425
Nevada Osteopathic$500
New York$735
Oklahoma Medical$500
Oklahoma Osteopathic$575
Oregon $375
Pennsylvania Medical$35
Pennsylvania Osteopathic$45
Puerto Rico$500
Rhode Island$1090
South Carolina$580
South Dakota$400
Tennessee Medical$510
Tennessee Osteopathic$410
Texas $817
Virgin Islands$250
Vermont Medical$650 
Vermont Osteopathic$500
Washington Medical$491
Washington Osteopathic$391
Wisconsin $60
West Virginia$400
Wyoming $400

The expenses of getting a medical license range not just by state but also by the medical profession, affecting doctors, osteopathic physicians, or physician assistants in various ways. This variety reflects the distinct regulatory requirements and perceived obligations of each function.

Medical Doctors (MDs) and Doctors of Osteopathy (DOs) frequently face a variety of medical licensing costs. For example, in Rhode Island, an MD or DO may spend upwards of $1,000, but Missouri charges far lower rates. This substantial difference in medical licensing costs can influence where medical professionals choose to practice, especially when considering the financial implications throughout a career.

Physician Assistants (PAs), on the other hand, typically face lower licensing fees than their MD and DO counterparts, but this isn’t always a straightforward benefit. For example, in some states, PAs might pay a few hundred dollars less than MDs, reflecting differences in training requirements and scope of practice. However, this reduced cost can also come with varying scopes of practice and autonomy, which might influence a PA’s decision on where to practice based on the professional environment and legal stipulations of each state.

Furthermore, the timing of payments, such as biennial cycles in states like Hawaii, adds another layer of financial planning. Medical professionals must not only consider the initial fees but also how frequently they need to renew their licenses and at what cost. The fee structures often encapsulate not just the permission to practice but also contribute to state medical boards’ efforts to maintain high standards of healthcare through continuous education and vetting processes.

In addition to standard fees, there are often hidden medical licensing costs that all medical professionals must navigate. These can include expenses for background checks, document processing, and even travel costs for exams or interviews. Such expenses are seldom highlighted in basic fee structures but can significantly affect overall financial planning.

medical licensing cost

Medical Licensing Compact and Uniform Application Fees

Participating in the Interstate Medical Licensure Compact involves a set of specific fees that are essential for physicians planning to practice in multiple states. This system simplifies obtaining licenses across state lines, but it comes with its own medical licensing cost structure.

Joining the Compact requires an initial fee of $700.00. This is in addition to the fees for getting separate licenses for every compact state where a healthcare provider desires to practice. It is vital to understand that all of these medical licensing costs are non-refundable.

Each compact state has set fees for the initial licensure. For example:

  • Alabama Medical Licensure Commission: $75.00
  • Arizona Board of Osteopathic Examiners: $400.00
  • Colorado Medical Board: $273.00
  • Maryland Board of Physicians: $790.00

These fees can vary widely from one state to another, reflecting the administrative costs involved in processing applications and maintaining high standards of medical practice oversight.

The renewal fees for medical licenses under the Compact are determined by the medical boards of individual states. These fees are separate from the initial medical licensing costs and are typically disclosed by the respective state boards, ensuring transparency and allowing physicians to budget accordingly.

Medical Licensing Renewal Fees

Staying compliant and retaining the right to practice medicine requires not just an initial license but also yearly renewals. Renewing a medical license assures that a physician is still qualified to provide care under the regulations of the state where they practice. It is more than just a bureaucratic formality; it is an important compliance step that protects the general population and certifies the healthcare provider’s continued credentials.

Renewal costs can vary greatly from state to state and are frequently determined by the local medical board’s operating demands as well as state-wide health policy. These fees may cover the cost of processing the renewal, supporting ongoing education programs, and ensuring the medical board’s activities align with contemporary medical standards.

Beyond the base renewal fee, there might be additional costs associated with maintaining specialty certifications or managing extra credentials linked to a medical license. The process also involves completing a set number of continuing medical education (CME) hours.

medical licensing cost

Additional Medical Licensing Costs

Medical licensing involves managing additional costs as well, background checks, credential verifications, and other necessary processes is crucial for healthcare professionals. Understanding these medical licensing costs can help in budgeting and ensuring all regulatory requirements are met efficiently.

The Federation Credentials Verification Service (FCVS) by the FSMB simplifies the process of sending out your exam transcripts and verifying other credentials. Here’s how it works: you’ll pay a base fee of $375, which covers the creation and initial distribution of one profile. If you need to distribute your profile to additional state licensing boards later on, it’ll cost you $95 for each one.

Using the FCVS is especially advantageous for applicants applying to state medical boards that require its use, as it includes the Uniform Application at no extra charge. However, if you’re applying to state boards that don’t require the FCVS profile, the Uniform Application alone will cost you $60. This fee is non-refundable and applies to each initial application for an MD, DO, or PA license. Remember, the Uniform Application doesn’t cover credentials verification or the official transcript of your examination scores—these need to be requested separately.

For those needing to send state license verifications, the VeriDoc service caters to around 30 participating states, with fees ranging from $10 to $60 depending on the state.

Moreover, you might need to pull records from the National Practitioner Data Bank, which costs $4 per query. This service helps to gather information about any past medical malpractice, adverse licensure actions, or convictions that are crucial for your state board applications.

Regarding criminal background checks, these typically cost between $40 and $60. Fingerprinting, required by many states, can also carry a fee. While some towns might offer this service free to residents, others might charge around $5 to $10 per fingerprint card, and it’s common for states to ask for two cards per applicant.

Hidden Costs of Medical Licensing

Navigating the hidden costs of licensing can often be as crucial as managing the explicit fees. These unexpected medical licensing expenses can impact your overall financial planning significantly if not anticipated ahead of time.

  • Transcripts and Verifications

For those states that do not accept the Federation Credentials Verification Service (FCVS), securing copies of medical school transcripts, exam results, and verification of other state medical licenses is necessary. The costs for these documents can vary widely depending on the institutions and agencies involved. Each request might entail a processing fee, which, when accumulated, can significantly add to the overall expense.

  • Notary Fees

Most medical licensing applications require at least one document to be notarized. While some can access notary services for free at their workplace or through a medical society, others may need to pay around $10 for local services like those provided by a UPS store. This fee, while small on its own, is part of a broader spectrum of small costs that add up.

  • Travel and Transportation Costs

Gas and transportation expenditures are often ignored, but they may rapidly mount up. Whether commuting to get fingerprinted, seeing a notary, or managing papers at the post office, each journey incurs expenditures that, while little, add to the total cost of the licensing process.

The accumulation of these hidden medical licensing costs can strain your budget if not planned carefully. It’s important for medical professionals, especially those early in their careers or those applying to multiple states, to account for these potential expenses when budgeting for their licensing process. Being aware of and planning for these hidden medical licensing costs ensures that you are not caught off guard and can proceed with your licensing without financial strain.

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How Medical Licensing Services Can Affect Costs

Medical licensing services provide an efficient way to navigate the challenges of getting a medical license. They serve as middlemen, coordinating the collection, confirmation, and submission of licensure-related paperwork. This centralization streamlines the process by reducing the need for candidates to contact educational institutions, previous employers, and other agencies for credentials and verifications. By managing these components, licensing services can reduce the entire time it takes to apply for a license from months to a few weeks, depending on the state and the applicant’s circumstances.

Although there is an initial cost to using such services, they tend to prove worthwhile in the long term. They assist in minimizing delays, which might lead to lost employment opportunities and increased expenses for expedited processing or late submissions. Furthermore, they limit the possibility of mistakes in application materials, which may be expensive and time-consuming to fix. Medical licensing firms frequently have established contacts with state medical boards, allowing for a more efficient and timely process.

The Value of Medical Licensing Services

Aside from the financial rewards, there are numerous significant advantages to hiring professional medical licensing services, which lead to a less stressful application procedure.

  • Stress Reduction

The licensure procedure can be difficult, particularly for recent graduates or doctors migrating across state boundaries. Licensing services manage administrative duties, enabling practitioners to concentrate on their transition or continuous professional growth without the extra stress of paperwork and deadlines.

  • Increased Efficiency

By outsourcing all the administrative chores involved with licensure, medical practitioners may make better use of their time. This might be especially helpful for busy practitioners who must balance clinical commitments with the requirements of acquiring or renewing a license.

  • Compliance Assurance

Professional licensing services are up-to-date on current regulatory standards and state law modifications. This knowledge helps to verify that applications meet current criteria, lowering the likelihood of rejection due to obsolete or erroneous information.

How MedicalLicensing.com Can Streamline Your Licensing Process

MedicalLicensing.com specializes in expediting the medical licensing procedure for healthcare professionals throughout the United States. Our experienced team will lead you from the first application to the final document submission, considerably decreasing the time and complexity required.

We help you avoid avoidable charges like late fines and paperwork mistakes, guaranteeing an efficient and cost-effective licensing process. Our solid contacts with state boards speed up the approval process, reducing delays and additional expenditures.

You may rely on us to keep you in compliance with the newest rules, lowering the chance of application rejection and relieving stress. Our service is tailored to the demands of all medical professionals, including MDs, DOs, and PAs, and it adjusts to different state legislation to provide specific solutions.