Occupational Therapy License from Tennessee to Missouri: Does It Transfer? (2026)
Can I use my Tennessee occupational therapy license in Missouri?
Yes, for working in Missouri — both Tennessee and Missouri 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 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
Tennessee and Missouri both issue OT Compact privileges, so this move has two versions. Working in Missouri while you keep living in Tennessee: buy a Missouri privilege through the commission ($75 plus Missouri's fee), meet any Missouri jurisprudence requirement, and keep your Tennessee license active, because the privilege ends when it does. Moving to Missouri: Missouri becomes your home state and you need a Missouri license, by converting the privilege where the Missouri Board of Occupational Therapy (Division of Professional Registration) offers that route or by endorsement.
What's different between Tennessee 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
Tennessee to Missouri (this page): Compact privilege — work there without a second license.
Missouri 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 Missouri.
The others get: licensure by endorsement (40).
- OT Compact membership
Tennessee and Missouri are both OT Compact member states.
A compact privilege lets you practice in Missouri while Tennessee 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 Tennessee lists $135 for the reverse move; neither may be the full cost.
- Processing time
Missouri lists 3–4 weeks; Tennessee has no verified processing-time figure on file, so the two cannot be compared here.
- Exam rules on record
Missouri and Tennessee 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.
- 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 → Missouri
| Tennessee (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 | $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).) | $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 | 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 | 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 | Tennessee Board of Occupational Therapy (Tennessee Department of Health, Health Related Boards) | 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 Tennessee 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 Tennessee and your Tennessee 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 Tennessee 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)
- 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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