How to Get Your Maryland Occupational Therapist License (2026 Guide)

Maryland requires a license from the Board of Occupational Therapy Practice before any individual may practice occupational therapy or use protected OT titles. The Board operates under Title 10 of the Maryland Health Occupations Article and its implementing regulations at COMAR 10.46. Applicants must meet educational requirements, pass the NBCOT examination (or another Board-approved national credentialing exam), complete a fingerprint-based criminal history records check, and pass the Maryland Board of Occupational Therapy Jurisprudence Examination.

One of Maryland’s more distinctive licensing features is that all applicants — including those applying by endorsement from another state — must successfully complete the Maryland Jurisprudence Examination. This examination tests knowledge of Maryland’s OT practice laws and regulations and is required before a license can be issued. Additionally, Maryland offers a temporary license for applicants who have completed all requirements except the NBCOT examination, permitting practice under Board-established conditions while awaiting exam results.

Maryland is an OT Compact member state. The Board’s fee schedule includes a separate $125 interstate compact fee, and the Board’s home page references the OT Compact as offering eligible OTs an alternative pathway for providing services in other compact member states without a separate license in each state.

Maryland OT Licensing Pathways

Initial Licensure (Examination): The standard pathway for applicants who have graduated from an ACOTE-accredited occupational therapy program, completed at least 6 months of supervised full-time fieldwork, passed the NBCOT exam (or another Board-approved national credentialing exam), completed fingerprinting, and passed the Maryland Jurisprudence Examination. The application fee is $200.

Endorsement (Out-of-State Licensure): For applicants who are currently licensed or have been licensed in another state or country. COMAR 10.46.01.02 requires applicants to provide verification of all prior out-of-state credentials, along with verification of passage of the NBCOT examination (or another Board-approved national credentialing examination), completion of the Maryland Jurisprudence Examination, and a criminal background check. Note: applicants applying by endorsement who have had a lapse in practice of 3 or more years are subject to additional requirements under COMAR 10.46.04.

Temporary License: Available to applicants who have met all licensure requirements except completing the required NBCOT certification examination. The temporary license fee is included in the $200 initial application fee. A temporary license permits practice under the conditions established by the Board while the applicant awaits examination results per COMAR 10.46.01.02.

Second Temporary License: A second temporary license may be issued under specific Board-approved circumstances. The fee for a second temporary license is $50, paid separately.

Maryland Jurisprudence Examination

All applicants for Maryland OT licensure — regardless of pathway — must successfully complete the Maryland Board of Occupational Therapy Jurisprudence Examination as part of the application process. This examination tests knowledge of Maryland OT law and regulation under COMAR 10.46. Verification of successful completion must be submitted with the application. Notably, the jurisprudence exam also counts as 1 contact hour of continuing competency credit (1 hour OT Principles/Procedures) if completed during a renewal cycle per the Board’s CCR Reference Guide.

Maryland OT Licensing Timeline

1. Graduate from an ACOTE-accredited (or Board-recognized equivalent) occupational therapy program
2. Complete a minimum of 6 months of supervised full-time fieldwork experience
3. Pass the NBCOT examination (or another Board-approved national credentialing exam)
4. Complete fingerprinting for the state and national criminal history records check
5. Pass the Maryland Board of Occupational Therapy Jurisprudence Examination
6. Submit application through Maryland OneStop with all required documentation and the $200 fee
7. Receive Maryland Occupational Therapist License

If you have not yet taken the NBCOT exam at the time of application, you may be eligible for a temporary license — see the Temporary License pathway above.

How to Apply for a Maryland OT License

1. Apply online through Maryland OneStop, or download and submit a paper application from the Board’s Forms page.
2. Complete the fingerprint-based criminal history records check as required by COMAR 10.46.01.02.
3. Submit verification of NBCOT exam passage or current NBCOT certification.
4. Submit verification of successful completion of the Maryland Jurisprudence Examination.
5. If previously licensed in another state or country, submit verification of all prior credentials.
6. Pay the $200 application fee by electronic payment, check, or money order. All fees are non-refundable.

Applications that remain incomplete are administratively closed after 6 months per COMAR. Processing time is not published by the Board. Contact the Board at 410-402-8556 or mdotboard.user@maryland.gov for current processing timelines.

Physical Agent Modalities and Dry Needling

No specialty certification or separate license is required for general OT practice in Maryland. However, two scope-specific practice rules apply to certain OT services:

Physical Agent Modalities (PAMs): COMAR 10.46.06 sets forth competency requirements for OTs who apply electrical and superficial physical agent modalities. OTs using PAMs must document the required continuing education and supervised patient treatments under the Board’s PAMs competency rules. A separate PAMs Log is available from the Board’s CCR page.

Dry Needling: COMAR 10.46.09 governs dry needling by licensed OTs. The Board also maintains a Dry Needling Registry. These are practice-scope rules, not separate licenses. A position statement notes that the Board intends to develop more comprehensive dry needling regulations.

OT Compact and Maryland

Maryland is a member of the Occupational Therapy Licensure Compact (OT Compact). The Board’s home page states that the OT Compact “allows eligible licensed OTs and OTAs an alternative method for providing services in other compact member states.” Maryland’s fee schedule includes a $125 interstate occupational therapy licensure compact fee for applicable compact transactions.

For OTs licensed in other compact member states who wish to practice in Maryland, and for Maryland-licensed OTs seeking compact privileges in other states, the OT Compact framework may allow practice without a separate full state license. Compact privilege eligibility and procedures are subject to change. Verify current requirements directly with the Maryland Board of Occupational Therapy Practice before relying on compact status for practice decisions. Contact the Board at mdotboard.user@maryland.gov or 410-402-8556, or visit otcompact.org for current compact commission information.

Relevant Statutes and Regulations

• Md. Health Occupations Article, Title 10 — Occupational Therapy Practice Act
• COMAR 10.46.01 — General Regulations (Licensure)
• COMAR 10.46.05 — Collection of Fees
• COMAR 10.46.06 — Competency Requirements for Physical Agent Modalities
• COMAR 10.46.09 — Dry Needling

Related Pages

• Maryland OT License Renewal
• Virginia Occupational Therapist Licensing Requirements
• Pennsylvania Occupational Therapist Licensing Requirements
• Occupational Therapist Licensing by State — Complete Guide

Frequently Asked Questions

Is a Maryland state license required to work as an occupational therapist?

Yes. Maryland requires a current Occupational Therapist License from the Maryland Board of Occupational Therapy Practice before any individual may practice occupational therapy or use protected OT titles. This is codified in the Maryland Health Occupations Article, Title 10, and COMAR 10.46. Source: Maryland Board of Occupational Therapy Practice

Is the jurisprudence exam required for all Maryland OT applicants?

Yes. All applicants for Maryland OT licensure — including initial applicants and those applying by endorsement from another state — must successfully complete the Maryland Board of Occupational Therapy Jurisprudence Examination per COMAR 10.46.01.02. Verification of successful completion must be submitted with the application. Source: COMAR 10.46.01

What is the application fee for a Maryland OT license?

The initial licensure fee is $200, which includes the first temporary license. A second temporary license is $50. The OT Compact interstate fee is $125 when applicable. All fees are non-refundable per the Board’s published fee policy. Source: COMAR 10.46.05 — Collection of Fees

Does Maryland require a background check for OT licensure?

Yes. All applicants must complete a fingerprint-based state and national criminal history records check as required by COMAR 10.46.01.02. Proof of fingerprinting must be submitted with the application. Source: COMAR 10.46.01

Is Maryland a member of the OT Compact?

Yes. Maryland is an OT Compact member state. The Board’s home page describes the compact as offering eligible OTs an alternative method for providing services in other compact member states. The Board’s fee schedule includes a $125 interstate compact fee for applicable compact transactions. Verify current compact privilege procedures directly with the Board before relying on compact status for practice decisions. Source: Maryland Board of Occupational Therapy Practice

Can I apply for a Maryland OT license before passing the NBCOT exam?

Yes. Maryland may issue a temporary license to applicants who have met all other licensure requirements but have not yet completed the national certification examination. A temporary license permits practice under the conditions established by the Board while the applicant awaits examination results. The temporary license fee is included in the $200 initial application fee. A second temporary license is available under Board-approved circumstances for an additional $50. Source: COMAR 10.46.01.02

Can I practice in Maryland while waiting for NBCOT exam results?

Under a temporary license, yes. A temporary license may be issued to applicants who have met all licensure requirements except for completing the required NBCOT certification examination. It permits practice under the conditions established by the Board while awaiting examination results, and is included in the $200 initial application fee. A second temporary license is available under Board-approved circumstances for an additional $50. Source: COMAR 10.46.01.02