Occupational Therapy License Reciprocity by State (2026)

The pathways, applied to occupational therapy

Compact privilege (both states must be issuing)

You qualify when your home state is your primary residence, it issues OT Compact privileges, and your license there is active and unencumbered; the state where you want to work must also be issuing. You apply through the commission, complete an FBI background check through your home-state board, show no adverse action on any license in the previous two years, and pay the $75 commission fee plus the remote state's own fee. Some remote states also require their jurisprudence exam. The privilege covers practice in that one state for as long as your home license stays current.

Licensure by endorsement (the default for most moves)

Endorsement gets you the destination state's own license. The board verifies your NBCOT certification exam result by Score Transfer or Verification of Certification, checks every license you have held, confirms your ACOTE-accredited education, and usually requires fingerprints. Some boards add a laws-and-rules exam; some ask for current NBCOT certification while others only want proof that you passed. This is the path for any state outside the issuing group and for anyone changing where they live.

Enacted but not yet issuing

A state that has passed the compact but has not opened applications is, for practical purposes, a non-member. Its endorsement process is unchanged, a privilege from elsewhere does not reach it, and therapists who live there cannot buy privileges out of it. This site marks those states separately so the difference stays visible, and updates them as boards go live.

Relocating inside the issuing group

A privilege lets you work away from home; it does not follow you when home changes. If you move your primary residence from one issuing state to another, you need a license in the new state. The compact provides a conversion route for privilege holders (Ohio, for one, publishes a "Conversion of a Privilege to Practice" application); otherwise you apply by endorsement. Keep your old license active until the new one issues.

Three facts move over time and are date-stamped on every page: which enacted states have started issuing privileges, each state's privilege fee and jurisprudence rule, and each board's endorsement fee and processing time. Many states license occupational therapy through a combined or umbrella board (Ohio's board also covers physical therapy and athletic training, Virginia's is its Board of Medicine), so the state pages name the body that actually issues the OT license. OTA licensure mirrors the OT process, and the compact covers assistants on the same terms.