Occupational Therapy License from Maryland to Missouri: Does It Transfer? (2026)
Can I use my Maryland occupational therapy license in Missouri?
Yes, for working in Missouri — both Maryland and Missouri are active members of the Occupational Therapy Licensure Compact (OT Compact). If Maryland is your primary state of residence and your Maryland license is active and unencumbered, you can buy a compact privilege to practice in Missouri without a second license. A privilege is not a license transfer: if you are moving your residence to Missouri, you will need a Missouri license once Missouri becomes your home state.
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Verdict
Compact privilege — work there without a second license
Because Maryland and Missouri are both issuing privileges, you may not need a Missouri license at all, provided Maryland stays your home. An OT or OTA living in Maryland with an active, unencumbered Maryland license can practice in Missouri on a compact privilege. That changes if you relocate: living in Missouri makes it your home state, and the privilege gives way to a Missouri license from the Missouri Board of Occupational Therapy (Division of Professional Registration).
What's different between Maryland and Missouri
Computed from both states' verified data rows, in both directions, and from the route every other origin gets into Missouri. Exam notes are our summary of each board's published rules, with sources below.
- Route, each way
Maryland to Missouri (this page): Compact privilege — work there without a second license.
Missouri to Maryland (the reverse move): Compact privilege — work there without a second license.
The route is the same in both directions.
- Does coming from Maryland matter?
Coming from Maryland matters here: only 10 of 50 origins (the other 49 states and DC) get this result for a move into Missouri.
The others get: licensure by endorsement (40).
- OT Compact membership
Maryland and Missouri are both OT Compact member states.
A compact privilege lets you practice in Missouri while Maryland is your home state; it is not a license, and a move to Missouri needs a Missouri license.
- Application fee
Missouri lists $40 for an out-of-state applicant and Maryland lists $200 for the reverse move; neither may be the full cost.
- Processing time
Missouri lists 3–4 weeks; Maryland has no verified processing-time figure on file, so the two cannot be compared here.
- Exam rules on record
Missouri and Maryland carry different exam notes (our summaries, below); any state law or jurisprudence exam is listed with each state's requirements.
- Missouri (this move): The NBCOT certification exam is not retaken. On the reciprocity application (MO 375-1095, 10-2026), the applicant lists NBCOT OTR credentials and has the certifying entity send verification of credentials directly to the Board; copies of certificates or wallet cards are not accepted. The form does not require current NBCOT certification. Missouri also requires its open-book Jurisprudence Exam, returned with the application.
- Maryland (the reverse move): The NBCOT certification exam is not retaken. Maryland asks for verification of INITIAL NBCOT certification or examination; screenshots from NBCOT's verification site are accepted. Current NBCOT certification is not required. An applicant who is not currently NBCOT-certified submits a Continuing Competency Requirement Compliance Report showing 24 contact hours in the preceding 24 months. Every applicant must also complete the Maryland jurisprudence exam, an open-book exam on Health Occupations Article Title 10 and COMAR 10.46, answered on paper or online.
What changes, Maryland → Missouri
| Maryland (current) | Missouri (destination) | |
|---|---|---|
| OT Compact status | Licensure by endorsement · OT Compact privilege (not a license) | Licensure by endorsement · OT Compact privilege (not a license) |
| Application fee | $200 (Application for initial licensure is $200 (COMAR 10.46.05.01B). It is non-refundable and includes a first temporary license. The fingerprinting vendor fee is extra; the Board does not state the amount. NOT the OT Compact privilege fee: Maryland's privilege costs $125 (COMAR 10.46.05.01M) plus the $75 Commission fee.) | $40 (OT reciprocity application fee from form MO 375-1095 (rev. 10-2026; $20 for an OTA or a limited permit). Paid by check or money order to the Missouri Board of Occupational Therapy. Fingerprint fees are paid to the vendor (IdentoGO), not the Board; the amount is not stated. Other states may charge fees for license verifications. NOT the OT Compact privilege fee: the Board says Missouri charges $40 for OTs ($20 for OTAs) plus a $75 administrative fee, while the Commission's table lists $30 / $10.) |
| Processing time | The Board publishes no processing timeframe | 3–4 weeks (The Board's FAQ (last revised 2021) says licensure takes 'an average of 3-4 weeks' once the completed application, fee and Jurisprudence Exam are in and the NBCOT Verification of Certification and state verifications have been requested. An application with a 'yes' answer or past discipline goes to the Board's quarterly meetings (February, May, August and November).) |
| Licensing authority | Maryland State Board of Occupational Therapy Practice | Missouri Board of Occupational Therapy (Division of Professional Registration) |
The destination column is what you must satisfy — Missouri sets the rules for this move.
Step by step
- Confirm your home-state license is active and unencumbered and that your home state is your primary state of residence.
- To work in Missouri: purchase an OT Compact privilege for Missouri through the compact commission and complete any Missouri jurisprudence requirement.
- Keep your home-state license active — every privilege lapses with it.
- If you are moving your primary residence to Missouri: apply for a Missouri license with the Missouri Board of Occupational Therapy (Division of Professional Registration); a privilege does not follow you when your home state changes.
Official links
Related guides
Frequently asked questions
Do I retake the NBCOT exam moving from Maryland to Missouri?
No. The NBCOT certification exam is not retaken.
Do I need a Missouri license or just a compact privilege?
A privilege is enough if you keep living in Maryland and your Maryland license stays active and unencumbered. If you move your residence to Missouri, you need a Missouri license from the Missouri Board of Occupational Therapy (Division of Professional Registration).
What does it cost?
A Missouri compact privilege costs the $75 commission fee plus Missouri's privilege fee. A Missouri license by endorsement, for a relocation: $40 (OT reciprocity application fee from form MO 375-1095 (rev.
How long does it take?
A privilege depends on your FBI background check through the Maryland board and any Missouri jurisprudence step. A Missouri license by endorsement: 3–4 weeks (The Board's FAQ (last revised 2021) says licensure takes 'an average of 3-4 weeks' once the completed application, fee and Jurisprudence Exam are in and the NBCOT Verification of Certification and state verifications have been requested.
Sources
Primary sources only — official boards and compact commissions. Data last verified 2026-10-29.
- Missouri Board of Occupational Therapy — Applications ↗ (accessed 2026-10-29)
- Missouri Board of Occupational Therapy — Application for Licensure, Reciprocity (MO 375-1095, 10-2026) ↗ (accessed 2026-10-29)
- Missouri Board of Occupational Therapy — board home ↗ (accessed 2026-10-29)
- Missouri Board of Occupational Therapy — Fingerprinting (all applications require fingerprinting; IdentoGO code 6351) ↗ (accessed 2026-10-29)
- Missouri Board of Occupational Therapy — Frequently Asked Questions (processing time) ↗ (accessed 2026-10-29)
- Missouri Board of Occupational Therapy — Missouri OT/OTA Compact (active member since October 26, 2026; $40 OT privilege fee) ↗ (accessed 2026-10-29)
- OT Compact Commission — Before You Apply (Missouri accepting applications since October 26, 2026; jurisprudence required) ↗ (accessed 2026-10-29)
- Maryland Board of Occupational Therapy Practice — Forms (Necessary Forms for an Initial License) ↗ (accessed 2026-10-29)
- Maryland Board of Occupational Therapy Practice — Application for Licensure (2026 version) ↗ (accessed 2026-10-29)
- Maryland Board of Occupational Therapy Practice — Applicant's Checklist (2026 version) ↗ (accessed 2026-10-29)
- COMAR 10.46.05 Collection of Fees ↗ (accessed 2026-10-29)
Reviewed by the License Reciprocity Editorial Team · verified against primary sources 2026-10-29
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