Occupational Therapy Compact (OT Compact)

The Occupational Therapy Licensure Compact lets occupational therapists (OTs) and occupational therapy assistants (OTAs) practice across member states under one compact privilege. The compact is in active operational rollout — many states have enacted it and member portals are coming online progressively.

Who can apply

The OT Compact is open to OTs and OTAs holding an active, unencumbered license in a member state. The applicant declares one member state as their home state and pays a per-state privilege fee for each additional member state.

Applicants must have passed the NBCOT exam, have no current disciplinary action or license restriction, and have no disqualifying criminal history. Practice scope (which procedures and supervision arrangements are permitted) is set by each state — the compact extends geographic reach, not scope.

Member states

The OT Compact currently has 24 member jurisdictions. Several additional states have enacted the compact but are still standing up their privilege-issuance portals.

Members: Iowa, Indiana, Kentucky, Louisiana, Maryland, Maine, Minnesota, Missouri, Mississippi, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, Ohio, South Carolina, South Dakota, Tennessee, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia.

last_verified: 2026-05 · sourced from data/compacts.json

How to apply

Applications go through the OT Compact Commission's portal. You verify your home state license, complete a federal/state criminal background check, and request privileges in the member states where you want practice rights.

Apply via the OT Compact →

Fees and processing time

The compact privilege fee varies by state (typically $50-$200). Processing time varies as the compact is still in early operational rollout — some states issue privileges within days, others are still launching their portals. Confirm current fees and timing directly with the OT Compact. last_verified: 2026-05.

How TeleVerify uses the OT Compact

When your NPI lookup returns an OT, OTR, OTR/L, OTA, or COTA credential, TeleVerify auto-detects OT Compact eligibility and asks you to confirm your home state and the member-state privileges you've activated. Once confirmed, sessions where the patient is in one of your privileged states are tagged compliant_compact. Because the compact is mid-rollout, we recommend quarterly profile updates to add newly available states.

Frequently asked questions

Can an OTA hold a compact privilege?
Yes. Both OTs and OTAs are covered. OTA privileges require supervision arrangements per each member state's rules.
What if my home state hasn't started issuing privileges yet?
Even if your home state has enacted the compact, you cannot request a privilege until your state's licensing board has launched its issuance process. TeleVerify tracks rollout status per state.
How is the OT Compact different from the PT Compact?
They are separate compacts with different member-state lists, separate fees, and separate eligibility checks. A practitioner with dual PT/OT credentials would enroll in both.
Does telehealth count as practice for OT Compact purposes?
Yes. A compact privilege grants the right to practice in the privileged state, which includes telehealth where the state permits OT delivered remotely. State-specific telehealth rules (consent, supervision for OTAs, documentation) apply on top.
How does TeleVerify know I have a privilege?
You confirm in your provider profile which member states you've activated. We attest the list at signup and on every profile update; the privilege is verifiable via the OT Compact Commission's public verification portal.
Is California an OT Compact member?
No. California, Florida, Texas, New York, and several large states are not yet OT Compact members as of 2026-05. Check otcompact.gov for the latest enacted-and-issuing list.
What if I move my home state of residence to a non-member state?
Your compact privileges end. You must obtain individual state licenses for any cross-state practice. If you later move back to a member state, you can re-enroll.
⚖️ Reference information — not legal advice. Always confirm current requirements with your compliance officer, state licensing board, or a telehealth attorney before relying on this for clinical or business decisions.

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