AlliedLicenseGuide.com covers occupational therapist licensing requirements for 25 states across the U.S. Each state guide covers initial licensure, renewal requirements, continuing education, fees, and OT Compact membership status. This content is editorially reviewed by an ARDMS-credentialed sonographer as part of AlliedLicenseGuide.com’s allied health licensing database.
How OT Licensing Works in the United States
Every state requires occupational therapists to hold a current state license before practicing. While the core requirement — passing the NBCOT examination — is uniform across all states, the specifics vary considerably: application fees range from $30 (Missouri) to over $400 (Nevada), renewal cycles are typically biennial but expire on different dates, and CE requirements range from 18 to 30 hours per cycle. A growing number of states have joined the OT Compact, which allows eligible licensees to practice across member states under a single home state license.
The NBCOT OTR examination is the standard national credentialing exam accepted by all 50 states. Some states additionally require a state-specific jurisprudence or law exam — including Oregon (Law/Ethics Exam), Wisconsin (Statutes and Administrative Code Exam), and Missouri (Jurisprudence Examination) — before a license can be issued.
The OT Compact — What You Need to Know
The Occupational Therapy Licensure Compact (OT Compact) is an interstate agreement allowing eligible OTs to obtain compact privileges to practice in other member states without obtaining a separate full license in each state. As of June 2026, the compact is in active implementation. Of the 25 states covered in this database:
OT Compact Status — ALG Coverage States
| Member States (compact privileges available) | Non-Member States |
| Ohio, Pennsylvania, Texas, California, Florida, New York, Georgia, Illinois, North Carolina, Arizona, Michigan, New Jersey, Washington, Colorado, Virginia, Massachusetts, Tennessee, Minnesota, Maryland, Indiana, Nevada, Wisconsin, Missouri, South Carolina | Oregon (2025 legislation did not pass) |
Compact privilege availability and implementation status may vary. Not all member states are actively issuing compact privileges — as of June 2026, states actively issuing privileges include Indiana, Ohio, Maryland, Minnesota, Tennessee, Virginia, West Virginia, and Wisconsin. Always verify current compact procedures directly with the relevant state board or at otcompact.gov before relying on compact privileges for practice decisions.
Occupational Therapist Licensing Guides by State
Select a state below to view complete initial licensing and renewal requirements, including fees, CE hours, exam requirements, and OT Compact status.
Frequently Asked Questions
What exam do I need to become a licensed occupational therapist?
All states require passage of the NBCOT OTR examination (National Board for Certification in Occupational Therapy) as a condition of initial licensure. Some states also require a state-specific jurisprudence or law exam — including Oregon, Wisconsin, and Missouri. No state administers a separate clinical competency exam beyond NBCOT.
What is the OT Compact and does it apply to my state?
The Occupational Therapy Licensure Compact allows eligible OTs holding an active, unencumbered home state license to apply for compact privileges to practice in other member states without obtaining a full separate license. Of the 25 states covered here, 24 are OT Compact members — Oregon is the only non-member. Compact privilege availability and procedures vary by state and implementation stage; always verify current status at otcompact.gov or with the relevant state board.
How many CE hours are required to renew an OT license?
CE requirements vary by state. Within our coverage area, requirements range from 18 continuing competency hours (Indiana) to 30 CE points (Oregon) per biennial cycle. Several states — including Maryland and Oregon — waive CE requirements entirely if the licensee holds current NBCOT certification. Most states use a 2-year renewal cycle; expiration dates vary from birthday-based (rare) to fixed calendar dates.
Is there a national OT license?
There is no single national OT license. Each state issues its own credential. The NBCOT OTR certification is a national professional credential, not a government license — it is required for initial licensure in all states but is distinct from a state license. The OT Compact creates a pathway for practicing across multiple states, but it still requires a home state license as its foundation.
How do I transfer my OT license to a new state?
Most states offer endorsement or reciprocity pathways for OTs already licensed elsewhere. Requirements typically include verification of your current license, NBCOT certification verification, and sometimes a state-specific exam. If both your current and destination states are OT Compact members, you may be able to obtain compact privileges instead of applying for a full new license — check otcompact.gov for current compact privilege procedures.
Page History
- 2026-06-10 — Hub page created. 24 of 25 state guides live. South Carolina in production.
- 2026-06-10 — South Carolina added. All 25 state guides now live. OT Compact footnote updated to clarify implementation status — member states not yet actively issuing privileges include South Carolina and others; verify at otcompact.gov. Compact member list updated to include South Carolina.