Occupational Therapy License from Tennessee to Maryland: Does It Transfer? (2026)
Can I use my Tennessee occupational therapy license in Maryland?
Yes, for working in Maryland — both Tennessee and Maryland are active members of the Occupational Therapy Licensure Compact (OT Compact). If Tennessee is your primary state of residence and your Tennessee 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
Tennessee and Maryland both issue OT Compact privileges, so this move has two versions. Working in Maryland while you keep living in Tennessee: buy a Maryland privilege through the commission ($75 plus Maryland's fee), meet any Maryland jurisprudence requirement, and keep your Tennessee 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 Tennessee 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
Tennessee to Maryland (this page): Compact privilege — work there without a second license.
Maryland to Tennessee (the reverse move): Compact privilege — work there without a second license.
The route is the same in both directions.
- Does coming from Tennessee matter?
Coming from Tennessee 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
Tennessee and Maryland are both OT Compact member states.
A compact privilege lets you practice in Maryland while Tennessee 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 Tennessee lists $135 for the reverse move; neither may be the full cost.
- Exam rules on record
Maryland and Tennessee 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.
- Tennessee (the reverse 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').
What changes, Tennessee → Maryland
| Tennessee (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 | $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).) | $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 | 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 | The Board publishes no processing timeframe |
| Licensing authority | Tennessee Board of Occupational Therapy (Tennessee Department of Health, Health Related Boards) | 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 Tennessee 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 Tennessee and your Tennessee 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 Tennessee 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)
- 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)
Reviewed by the License Reciprocity Editorial Team · verified against primary sources 2026-10-29
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