Pennsylvania Chiropractic Licensing: Reciprocity, the New Endorsement Rule and Provisional Licenses

Pennsylvania changed its rules for out-of-state chiropractors this summer. Before July 2026 the only route was licensure by reciprocity under 49 Pa. Code § 5.13, which requires a license from a jurisdiction that accepts Pennsylvania licensees on the same terms and three years of full-time practice. On July 25, 2026 the State Board of Chiropractic added § 5.13a, licensure by endorsement under the Commonwealth's general endorsement law, 63 Pa.C.S. § 3111, and § 5.13b, a provisional endorsement license. Endorsement drops the reciprocity requirement and lets you show competency by two of the last five years in practice, a SPEC passed within five years, or NBCE Parts I–IV passed within five years.

What does the endorsement rule, § 5.13a, require?

The text published in the Pennsylvania Code (56 Pa.B. 4360) requires an applicant to:

• Hold a current license in good standing in a jurisdiction whose standards are substantially equivalent to or exceed Pennsylvania's requirements for licensure by examination. You submit a copy of that jurisdiction's current licensing law or rule, with its enactment date, translated professionally at your cost if it is not in English.
• Demonstrate competency by one of: active practice in a substantially equivalent jurisdiction for at least 2 of the 5 years before filing; passing the NBCE Special Purposes Examination for Chiropractic, or a comparable exam, within the 5 years before filing; or passing NBCE Parts I, II, III and IV, or comparable exams, within the 5 years before filing.
• Have no grounds for refusal under section 506 of the Chiropractic Practice Act or § 5.81, and no discipline from the licensing jurisdiction. The board may decide in its discretion that a prior act or discipline is not an impediment.
• Pay the reciprocity or endorsement fee in § 5.6.
• Meet the professional liability insurance requirement in section 508 of the Act and § 5.41.
• Complete 3 hours of child abuse recognition and reporting training from a provider approved by the Department of Human Services.

The board may require a personal interview and more documentation, and you can ask for the interview by video for good cause.

The statutory copy requirement is unusual. Most boards compare jurisdictions themselves; Pennsylvania asks you to supply the other state's licensing law or rule. Pull the version in force now, with its enactment date, from an official source.

What is the provisional endorsement license?

Section 5.13b lets the board, at its discretion, issue a provisional endorsement license while you finish the remaining endorsement requirements. It lasts up to one year (the board may set less) and can be extended once, on written request and good cause, by up to one more year. It ends when the board grants or denies the license, when you break its terms, or when it expires. You can reapply for endorsement afterward, but the board will not issue a second provisional license. If you need to start work in Pennsylvania soon, ask for one with the application.

What does the older reciprocity rule, § 5.13, require?

Reciprocity is still on the books and still the right route for some files. It requires:

• graduation from an approved chiropractic college;
• NBCE parts by date: Parts I and II for graduates after January 1, 1968; Parts I, II and III for graduates or first licensees after December 27, 1991; Parts I–IV for graduates or first licensees after May 23, 1997;
• a current, unrestricted license obtained by examination in a U.S. state or territory or Canadian province whose standards were substantially equivalent at the time and which accepts Pennsylvania licensees for reciprocity;
• full-time active clinical practice for at least 3 years, including at least 20 months of the 2 years before applying and at least 12 months in the jurisdiction that licensed you by examination, or the part-time equivalent;
• professional liability insurance and 3 hours of child abuse training.

The 20-of-24-months rule is the one that trips people: a long leave in the last two years can disqualify an otherwise strong reciprocity file. Endorsement's two-of-five-years test is looser, which is why most new files should be evaluated under § 5.13a first.

What are the fees?

Section 5.6 sets the application fee for licensure by reciprocity or endorsement at $164 from July 1, 2026, rising to $180 on July 1, 2028. The biennial registration fee for September 2, 2026 to September 1, 2028 is $241. Adjunctive procedures certification is $115 from July 1, 2026.

Do I need a separate certificate for physiotherapy?

Yes. Under § 5.14, a Pennsylvania chiropractor may not use adjunctive procedures without board certification. The qualifying evidence includes a passing score on the NBCE Physiotherapy exam, a board-acceptable course of at least 100 hours, or passing a licensure exam that included adjunctive procedures. If you passed Physiotherapy, apply for the certificate with your license. We file it as a Scope Add-On Registration ($249). See the NBCE Physiotherapy exam for the states that require it.

How does renewal work?

Registration is biennial and expires September 1 of every even-numbered year (§ 5.17). Each renewal includes proof of malpractice insurance, continuing education under section 507 of the Act, and at least 2 hours of approved child abuse recognition and reporting training. Practicing on an unregistered license brings a penalty of $5 for each month or part of a month since expiration and possible discipline. A license inactive for more than five years needs proof of current competence to reactivate, such as passing the exams within a year or meeting the reciprocity rule.

How does White Glove handle a Pennsylvania file?

We decide with you whether § 5.13a or § 5.13 fits better, pull and date the other state's licensing law, document competency, arrange insurance proof and child abuse training, and request a provisional license where it helps. License by Endorsement is $499; board fees are separate, and the board decides every application. See the Pennsylvania page or compare routes in endorsement or the exam route.