Occupational Therapy License from Missouri to Maryland: Does It Transfer? (2026)
Can I use my Missouri occupational therapy license in Maryland?
Yes, for working in Maryland — both Missouri and Maryland are active members of the Occupational Therapy Licensure Compact (OT Compact). If Missouri is your primary state of residence and your Missouri license is active and unencumbered, you can buy a compact privilege to practice in Maryland without a second license. A privilege is not a license transfer: if you are moving your residence to Maryland, you will need a Maryland license once Maryland becomes your home state.
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Verdict
Compact privilege — work there without a second license
Missouri and Maryland both issue OT Compact privileges, so this move has two versions. Working in Maryland while you keep living in Missouri: buy a Maryland privilege through the commission ($75 plus Maryland's fee), meet any Maryland jurisprudence requirement, and keep your Missouri license active, because the privilege ends when it does. Moving to Maryland: Maryland becomes your home state and you need a Maryland license, by converting the privilege where the Maryland State Board of Occupational Therapy Practice offers that route or by endorsement.
What's different between Missouri and Maryland
Computed from both states' verified data rows, in both directions, and from the route every other origin gets into Maryland. Exam notes are our summary of each board's published rules, with sources below.
- Route, each way
Missouri to Maryland (this page): Compact privilege — work there without a second license.
Maryland to Missouri (the reverse move): Compact privilege — work there without a second license.
The route is the same in both directions.
- Does coming from Missouri matter?
Coming from Missouri matters here: only 10 of 50 origins (the other 49 states and DC) get this result for a move into Maryland.
The others get: licensure by endorsement (40).
- OT Compact membership
Missouri and Maryland are both OT Compact member states.
A compact privilege lets you practice in Maryland while Missouri is your home state; it is not a license, and a move to Maryland needs a Maryland license.
- Application fee
Maryland lists $200 for an out-of-state applicant and Missouri lists $40 for the reverse move; neither may be the full cost.
- Processing time
Missouri lists 3–4 weeks for the reverse move; Maryland has no verified processing-time figure on file, so the two cannot be compared here.
- Exam rules on record
Maryland and Missouri carry different exam notes (our summaries, below); any state law or jurisprudence exam is listed with each state's requirements.
- Maryland (this 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.
- Missouri (the reverse 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.
What changes, Missouri → Maryland
| Missouri (current) | Maryland (destination) | |
|---|---|---|
| OT Compact status | Licensure by endorsement · OT Compact privilege (not a license) | Licensure by endorsement · OT Compact privilege (not a license) |
| Application 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.) | $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.) |
| Processing time | 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).) | The Board publishes no processing timeframe |
| Licensing authority | Missouri Board of Occupational Therapy (Division of Professional Registration) | Maryland State Board of Occupational Therapy Practice |
The destination column is what you must satisfy — Maryland 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 Maryland: purchase an OT Compact privilege for Maryland through the compact commission and complete any Maryland jurisprudence requirement.
- Keep your home-state license active — every privilege lapses with it.
- If you are moving your primary residence to Maryland: apply for a Maryland license with the Maryland State Board of Occupational Therapy Practice; 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 Missouri to Maryland?
No. The NBCOT certification exam is not retaken.
Do I need a Maryland license or just a compact privilege?
A privilege is enough if you keep living in Missouri and your Missouri license stays active and unencumbered. If you move your residence to Maryland, you need a Maryland license from the Maryland State Board of Occupational Therapy Practice.
What does it cost?
A Maryland compact privilege costs the $75 commission fee plus Maryland's privilege fee. A Maryland license by endorsement, for a relocation: $200 (Application for initial licensure is $200 (COMAR 10.46.05.01B).
How long does it take?
A privilege depends on your FBI background check through the Missouri board and any Maryland jurisprudence step. A Maryland license by endorsement: The Board publishes no processing timeframe.
Sources
Primary sources only — official boards and compact commissions. Data last verified 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)
- OT Compact Commission — Before You Apply (Maryland accepting applications since April 15, 2026; $125 privilege fee; jurisprudence required) ↗ (accessed 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)
Reviewed by the License Reciprocity Editorial Team · verified against primary sources 2026-10-29
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