Occupational Therapy Licensure Compact: Which States Issue Privileges (2026)
Last verified: 2026-09-27 · live membership: otcompact.gov ↗
The Occupational Therapy Licensure Compact lets an occupational therapist or OTA who lives in and holds an active, unencumbered license from an issuing state obtain a "privilege to practice" in another issuing state without getting that state's license. As of 2026-09-27, 8 states are issuing privileges and 29 have enacted the compact but are not yet accepting applications. Each privilege costs the $75 commission fee plus the remote state's fee.
Membership right now
Interactive version with every compact: Compact Membership Map
Does the OT Compact cover your move?
Pick your two states — the checker applies the compact rules for you.
Who qualifies: the 6 uniform licensure requirements
A multistate license is issued only if you meet every one of these, in addition to living in a member state:
- Hold an active, unencumbered OT or OTA license in your home state, which must be your primary state of residence AND an OT Compact state that is issuing privileges
- Complete a criminal background check (FBI) through your home-state licensing board before applying
- No active encumbrance on any state license and no adverse action against any license or compact privilege in the previous two years
- The remote state where you want to practice must also be issuing/accepting OT Compact privileges
- Pay the uniform $75 OT Compact Commission fee plus the remote state's privilege fee (varies by state)
- Meet the remote state's jurisprudence requirement where one applies (e.g. Ohio requires its OT Jurisprudence Exam immediately after the privilege issues) and attest to reading that state's OT practice act
The OT Compact is active: the Commission's Before You Apply page (last updated 2026-08-18, read 2026-09-27) lists eight states currently accepting applications and issuing privileges to practice: Minnesota, Ohio and West Virginia (from 2026-01-12), Indiana (2026-03-09), Virginia (2026-03-20), Maryland (2026-04-15), Tennessee (2026-05-20) and Wisconsin (2026-05-29). A compact privilege is a PRACTICE PRIVILEGE that the Commission says is equivalent to a state license, but it is not a license transfer. It lets an OT or OTA whose home state (primary residence) is one of those eight states work in another of them while their license stays at home. The privilege expires with the home-state license and must be bought again each time the home license is renewed. Each privilege costs the uniform $75 Commission fee plus the remote state's fee. The applicant must complete an FBI background check through the home-state board, have no adverse action on any license in the previous two years, and meet any remote-state jurisprudence requirement. Twenty-nine more states have ENACTED the compact but are 'Not Yet' accepting applications as of 2026-09-27, so no privilege can be used in or from them yet: Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Georgia, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington and Wyoming. The Commission says each state opens applications at its own pace and gives no go-live dates. California, Connecticut, the District of Columbia, Florida, Hawaii, Idaho, Illinois, Massachusetts, Nevada, New Jersey, New Mexico, New York, Oregon and Texas have not enacted the compact (bills are filed in Illinois, Massachusetts and New York). NBCOT: the compact requires member states to use only a recognized national exam for licensure, which is in practice the NBCOT certification exam. The compact does not ask the practitioner to re-test. A licensee who moves permanently to another compact state converts the privilege to a license there under the compact's Section 5 rules (Ohio publishes a 'Conversion of a Privilege to Practice' application). Anyone else who relocates, or whose destination is not issuing privileges, must get licensure by endorsement.
Primary state of residence: the rule that decides everything
Everything starts from your home state, and the compact defines it as your primary state of residence. Your license must be issued there, it must be active and unencumbered, and that state must itself be issuing privileges. An OT who lives in Wisconsin and holds a Wisconsin license can buy privileges for Ohio, Minnesota and the other issuing states. An OT who lives in Texas cannot buy any, because Texas has not enacted the compact, even if that therapist also holds a Wisconsin license.
The privilege depends entirely on the home license. It expires when the home license expires, and the commission requires you to buy it again each time you renew at home. Discipline on the home license affects every privilege attached to it. The background check also runs through the home state: you complete an FBI check with your home-state board before you apply.
Practice happens where the patient is. A telehealth session with a client sitting in Maryland is OT practice in Maryland and needs a Maryland license or privilege, wherever you are logged in from. Travel OTs, school-based contractors who cross a state line, and telehealth practices are the people the compact was built for, and the ones most exposed when a state they assumed was live turns out to be only enacted.
Moving scenarios
Issuing home state to issuing remote state: buy the privilege
You live in Tennessee and are licensed there; a contract in Virginia comes up. Both states issue privileges, so you apply through the commission instead of Virginia's board, pay the $75 commission fee and Virginia's fee, and meet any Virginia jurisprudence requirement. Your Tennessee license and residence do not change.
Issuing state to an enacted-but-waiting state
You live in Ohio and want to work in North Carolina, which has enacted the compact but is not accepting applications yet. The privilege cannot reach it. You apply to the North Carolina board by endorsement like any out-of-state OT, and you keep your Ohio license and any Ohio-anchored privileges as they are.
Non-member state to issuing state
Coming from a state that has not enacted the compact, such as Florida or California, you have no privileges to use. Endorse into the issuing state, make it your primary residence, and its license becomes your home license. From there you can buy privileges for the other issuing states instead of applying for a license in each.
Moving your home between issuing states
If you relocate from Minnesota to Indiana, Indiana becomes your home state and you need an Indiana license. A privilege is not enough once you live there. Privilege holders can convert under the compact's rules where the board offers that route; otherwise you apply by endorsement. Keep the Minnesota license active until the Indiana license issues so your other privileges don't lapse in between.
Frequently asked questions
What is the Occupational Therapy Licensure Compact?
The Occupational Therapy Licensure Compact lets an occupational therapist or OTA who lives in and holds an active, unencumbered license from an issuing state obtain a "privilege to practice" in another issuing state without getting that state's license. As of 2026-09-27, 8 states are issuing privileges and 29 have enacted the compact but are not yet accepting applications. Each privilege costs the $75 commission fee plus the remote state's fee.
How do I apply for an OT Compact privilege?
Apply through the commission at https://otcompact.gov/, not the remote state's board. You need an active, unencumbered license in an issuing home state where you live, an FBI background check completed through your home-state board, no adverse action on any license in the past two years, the $75 commission fee plus the remote state's fee, and any jurisprudence requirement that state sets.
Which states can I use an OT Compact privilege in right now?
Only the 8 issuing states as of 2026-09-27: Indiana, Maryland, Minnesota, Ohio, Tennessee, Virginia, West Virginia and Wisconsin. A privilege is useful only if your home state is also on that list.
Does an enacted state count as an OT Compact state?
Not for practice. The 29 enacted states that are not yet accepting applications cannot issue privileges or honor them, so their endorsement process is unchanged. The commission gives no go-live dates; each state opens on its own schedule.
What happens to my privilege when I renew my home license?
The privilege expires with your home-state license, so it has to be purchased again after each home renewal. If the home license lapses or is disciplined, every privilege tied to it is affected.
Does the OT Compact cover occupational therapy assistants?
Yes. OTAs qualify on the same terms as OTs: an active, unencumbered OTA license in an issuing home state, the background check, the two-year no-adverse-action rule, and the commission and state fees.
Reviewed by Billy Reiner, Editor · verified against primary sources 2026-09-27
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