Occupational Therapy License from Missouri to Tennessee: Does It Transfer? (2026)
Can I use my Missouri occupational therapy license in Tennessee?
Yes, for working in Tennessee — both Missouri and Tennessee 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 Tennessee without a second license. A privilege is not a license transfer: if you are moving your residence to Tennessee, you will need a Tennessee license once Tennessee becomes your home state.
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Verdict
Compact privilege — work there without a second license
Because Missouri and Tennessee are both issuing privileges, you may not need a Tennessee license at all, provided Missouri stays your home. An OT or OTA living in Missouri with an active, unencumbered Missouri license can practice in Tennessee on a compact privilege. That changes if you relocate: living in Tennessee makes it your home state, and the privilege gives way to a Tennessee license from the Tennessee Board of Occupational Therapy (Tennessee Department of Health, Health Related Boards).
What's different between Missouri and Tennessee
Computed from both states' verified data rows, in both directions, and from the route every other origin gets into Tennessee. Exam notes are our summary of each board's published rules, with sources below.
- Route, each way
Missouri to Tennessee (this page): Compact privilege — work there without a second license.
Tennessee 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 Tennessee.
The others get: licensure by endorsement (40).
- OT Compact membership
Missouri and Tennessee are both OT Compact member states.
A compact privilege lets you practice in Tennessee while Missouri is your home state; it is not a license, and a move to Tennessee needs a Tennessee license.
- Application fee
Tennessee lists $135 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; Tennessee has no verified processing-time figure on file, so the two cannot be compared here.
- Exam rules on record
Tennessee and Missouri carry different exam notes (our summaries, below); any state law or jurisprudence exam is listed with each state's requirements.
- Tennessee (this move): The NBCOT certification exam is not retaken. Under Board Rule 1150-02-.05(2)(i) the reciprocity applicant must have NBCOT certification exam results sent directly to the Board (an NBCOT Score Transfer / verification of exam results). The rule asks for exam results, not proof of CURRENT NBCOT certification. Tennessee does not require a jurisprudence exam for licensure by reciprocity (the Commission also lists Tennessee's compact jurisprudence as 'Not required').
- 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 → Tennessee
| Missouri (current) | Tennessee (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.) | $135 ($125 non-refundable OT application fee + $10 state regulatory fee under Board Rule 1150-02-.06(4) as amended effective June 21, 2026 (OTA $100 + $10 = $110). The Board's online application checklist still shows the earlier $100 + $10 = $110 (OTA $85), so confirm the amount due at the end of the online application. The background-check vendor fee is paid separately. NOT the OT Compact privilege fee (Tennessee privilege: $125 OT / $100 OTA state fee + $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).) | no processing time is published; Board Rule 1150-02-.05(2)(f) says completed reciprocity files are ordinarily processed at the next Board meeting scheduled to review files, and the Board meets four times a year |
| Licensing authority | Missouri Board of Occupational Therapy (Division of Professional Registration) | Tennessee Board of Occupational Therapy (Tennessee Department of Health, Health Related Boards) |
The destination column is what you must satisfy — Tennessee 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 Tennessee: purchase an OT Compact privilege for Tennessee through the compact commission and complete any Tennessee jurisprudence requirement.
- Keep your home-state license active — every privilege lapses with it.
- If you are moving your primary residence to Tennessee: apply for a Tennessee license with the Tennessee Board of Occupational Therapy (Tennessee Department of Health, Health Related Boards); 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 Tennessee?
No. The NBCOT certification exam is not retaken.
Do I need a Tennessee 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 Tennessee, you need a Tennessee license from the Tennessee Board of Occupational Therapy (Tennessee Department of Health, Health Related Boards).
What does it cost?
A Tennessee compact privilege costs the $75 commission fee plus Tennessee's privilege fee. A Tennessee license by endorsement, for a relocation: $135 ($125 non-refundable OT application fee + $10 state regulatory fee under Board Rule 1150-02-.06(4) as amended effective June 21, 2026 (OTA $100 + $10 = $110).
How long does it take?
A privilege depends on your FBI background check through the Missouri board and any Tennessee jurisprudence step. A Tennessee license by endorsement: no processing time is published; Board Rule 1150-02-.05(2)(f) says completed reciprocity files are ordinarily processed at the next Board meeting scheduled to review files, and the Board meets four times a year.
Sources
Primary sources only — official boards and compact commissions. Data last verified 2026-10-29.
- Tennessee Department of Health — Board of Occupational Therapy ↗ (accessed 2026-10-29)
- Tennessee Board of OT — Occupational Therapist online application checklist (still lists the pre-June-2026 $100 + $10 fees) ↗ (accessed 2026-10-29)
- Rules of the Tennessee Board of Occupational Therapy ch. 1150-02, June 2026 revision (1150-02-.05(2) reciprocity procedure; 1150-02-.06 fees, amended effective June 21, 2026) ↗ (accessed 2026-10-29)
- OT Compact Commission — Before You Apply (Tennessee accepting applications since May 20, 2026; $125 OT privilege fee; jurisprudence not 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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