Multi-State Taxes for Traveling Locum Tenens Clinicians

In each income-tax state where you physically performed work and earned more than that state's nonresident filing threshold, you file a NONRESIDENT return reporting only the income sourced to that state. Separately, you file a RESIDENT return in your home (domicile) state that reports ALL of your income from everywhere — every assignment, every state. So a clinician who lives in Virginia and works assignments in California, Texas, and New York would file: a Virginia resident return (all income), a California nonresident return (California-earned income), and a New York nonresident return (New York-earned income). No state return is filed for the Texas income because Texas has no individual income tax. Income is sourced to the state where you physically rendered care — not where the agency or facility is headquartered, and not where you live. This is the core mechanic that drives every other rule below: nonresident returns follow your feet, the resident return follows your domicile, and the two are reconciled through a credit.

Generally no — but only because your resident state grants a credit for taxes paid to another state, not because you file fewer returns. After you file the nonresident return in the work state, your home state's resident return includes that same income but then applies a credit (on a schedule such as Virginia Schedule OSC, California Schedule S, or New York IT-112-R) for the tax the work state actually charged. Three limits matter for clinicians. First, the credit is capped at the LESSER of (a) the tax the other state imposed or (b) what your home state would have charged on that same income — so if you live in a low-tax state and work in a high-tax state, the credit is partial and you still feel the higher rate. Second, excess credit generally does NOT carry forward to a future year. Third, and most important for locums: if your resident state has NO income tax, there is no resident tax to credit, so the credit is zero. The credit prevents double TAXATION; it never removes the obligation to FILE in each state.

No. Living in a no-income-tax state does not make your locum income tax-free — it only means your HOME state collects nothing. You still owe nonresident income tax to every income-tax state where you physically worked above its threshold, and because your home state has no income tax, there is no resident credit to offset that work-state bill. A clinician domiciled in Texas who works a California assignment owes California nonresident tax in full, with no Texas credit to recover it. The no-tax states for 2026 are Alaska, Florida, Nevada, South Dakota, Texas, Washington, and Wyoming. New Hampshire belongs on that list for 2026 as well: its Interest & Dividends Tax was fully repealed effective January 1, 2025 (the final period ended December 31, 2024 at a 3% rate), so New Hampshire now has no individual income tax of any kind. Tennessee likewise has had no individual income tax since the Hall Tax was fully repealed in 2021. Note that Washington imposes a capital-gains excise tax, but it does not tax wages or self-employment earned income. Separately, federal self-employment tax (15.3% — 12.4% Social Security up to the 2026 wage base of $184,500, plus 2.9% uncapped Medicare) and federal income tax apply no matter which state you work in.

It varies widely, and there is no national standard — this is one of the most common multi-state surprises for locums. Roughly two dozen states tax nonresidents from the first day and first dollar of in-state work, including the large states locums frequently visit: California, New York, New Jersey, Pennsylvania, Massachusetts, North Carolina, Virginia, Arizona, Colorado, and Maryland. (Some of these condition the filing requirement on your total income from all sources exceeding the state's standard filing threshold, but any in-state-sourced dollar can still trigger a return.) A minority of states offer meaningful safe harbors: day-count rules (for example, Illinois, Indiana, Louisiana, and Montana require more than 30 working days; North Dakota and Utah use a 20-day test with a mutuality requirement; Alabama and West Virginia use a 30-day mutuality test), combined day-and-dollar tests (Connecticut: more than 15 days AND more than $6,000; Maine: more than 12 days AND more than $3,000), and pure dollar thresholds (Minnesota: $15,300 of Minnesota-source income for 2026; Idaho: more than $2,500; Wisconsin: $2,000; Georgia: $5,000 or 5% of wages). Dollar thresholds are inflation- and legislation-sensitive, so re-verify the current figure for any state before you file. Important caveat: state reciprocity agreements (a network of 16 states plus DC) cover W-2 WAGES only — they generally do NOT apply to 1099 independent-contractor locum income, so do not assume a reciprocity agreement exempts your earnings.

You allocate it yourself, from your own records — income is sourced to the state where you physically performed the work, not where the agency or facility sits. Many locum agencies issue a single Form 1099-NEC that lumps all your assignments together with no per-state breakdown, so the burden of reconstruction falls on you. Keep a contemporaneous log all year: assignment location, the exact dates you worked in each state, days physically present, and income earned per state. Request itemized per-state earnings statements from each agency early; if they are unavailable, reconstruct the allocation from your signed contracts, schedules, and pay stubs. Tag business expenses that relate to a single assignment to that assignment's state, and prorate genuinely general expenses across your returns. States increasingly share 1099 data and cross-reference filings, so an unfiled nonresident return can surface later as an assessment with penalties and interest. Finally, remember that estimated taxes are both federal AND state: most income-tax states want their own quarterly estimated payments, and the federal 2026 due dates are April 15, June 15, and September 15, 2026, with the fourth installment due January 15, 2027.