What Is the Difference Between a Healthcare License and a Certification?

Are you licensed, certified, or both? Does it make a difference? We explain the distinctions and why they matter in healthcare.

Healthcare professionals studying for a license exam.

People often use the words “license” and “certification” interchangeably. While these concepts are similar, there are key differences. Whether you hold a license or certification can determine the type of business entity you can file and whether you can employ specific individuals. Thus, if you run a healthcare business or work within the industry, you must understand the distinction.

Licensure

A license is a formal verification from a state government agency confirming that you are a professional in a specific healthcare occupation. A bachelor’s or master’s is usually required to qualify for licensure. When a state grants you a license, it’s typically limited to that geographic area. In other words, you can only practice within the border of that state unless you have multiple licenses or your profession has a multi-state license compact such as the Psychology Interjurisdictional Compact (PSYPACT).   

So, what constitutes a licensed service? Simply put, it is any service the state decides requires a license. The legislature, or occasionally the relevant state agency, enacts statutes or issues regulations establishing the profession, creating a licensing board, and setting up a licensure application process. 

Let’s use physical therapists as an example. To become a physical therapist, you must be licensed by a state body to provide physical therapy services as defined by state statute or regulation. Licensure signifies that you have satisfied the educational and training requirements and that the relevant state licensing board or governing administrative agency has authorized you to practice your profession.

Certification

To obtain a certification, you must meet a particular set of requirements for a job. In this case, the organization that establishes the requirements is typically not a state board or entity. Certification usually demonstrates excellence in a specific skill as determined by a body that sets professional standards. 

Sometimes, receiving a certification is a prerequisite to receiving your healthcare license. For instance, to be a nurse practitioner in Illinois, you must obtain a national certification from a qualifying third party, such as the American Academy of Nurse Practitioners Certification Program. You only become licensed once you submit proof of your certification to the state. 

Certification can also occur after you’ve obtained your healthcare license. A typical example would be when insurers require licensed providers to achieve certification to show that they meet industry standards. For example, licensed speech-language pathologists can obtain a Certificate of Clinical Competence (CCC) through the American Speech-Language-Hearing Association (ASHA). But first, they must fulfill the required clinical hours under supervision. Licensed speech-language pathologists can only practice independently after obtaining their CCC. Until then, a supervisor must sign off on all therapy notes for services to be covered by insurance. 

While many healthcare certifications fulfill requirements, others highlight excellence in a specific field or skill. For example, a nurse can obtain certification in Pediatric Advanced Life Support, demonstrating the ability to resuscitate children in critical situations. Nursing licensure does not depend on this certification. However, nurses may pursue the certification to serve patients better and enhance their careers.

Wellness or Coaching Credentials

The health and wellness industry is booming, with more people interested in nutrition, physical wellness, mental wellness, or other areas of the ever-expanding wellness market. As a result, there has been a surge of new certifications available for individuals who are passionate about improving the well-being of others. Many of these certifications require little or no prerequisites, making it easy to begin training and work toward completion. However, while many certifications are legitimate and well-meaning, some may be scams. 

Licensed healthcare providers must follow strict regulations for corporate governance and payment arrangements. In contrast, the wellness and coaching space is much less regulated, with low barriers to compliance with state authorities. Lured by the prospect of less oversight, many licensed individuals consider expanding their business model to include unlicensed, wellness-based services. 

However, such a move may bring legal risks and require certain disclosures. Before you leap, consult an experienced healthcare attorney who is well-versed in the complexities of broadening licensed offerings to include certified wellness or coaching services.

Get legal help. 

Licensure and certification issues are often inextricably linked to state laws or regulations. Speak to a healthcare attorney to determine how your credentials align with your goals as a business or practice owner. If you operate in one of the states where Jackson LLP has licensed attorneys, you can set up a free consultation to find out how we can help you succeed.

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. This blog should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

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