What you need to know about the Occupational Therapy Licensure Compact

The demand for occupational therapists is projected to increase by 11% through 2033 as patient demands skyrocket and working occupational therapists leave the workforce. This may leave some patients without care—but that’s where the Occupational Therapy Licensure Compact (OT Compact) comes in.

What is the OT compact?

The Occupational Therapy Licensure Compact allows occupational therapists across the country to work in 37 states with their existing license—if they are already licensed in a compact member state and that state is considered their home state. This also applies to occupational therapy assistants.

In order to work under the compact, OTs and OTAs need to be licensed in good standing in a member state. For example, if your primary residence is in Illinois—which is not a member state—you may not join the compact, even if you also hold a license in Wisconsin, which is a member state. To be eligible, the state of your primary residence must be a member of the compact and you must hold a license for that same state.

The definition of good standing currently means no disciplinary action within the past two years. If you are licensed and in good standing in one member state, you can then travel and work in any of the other compact member states.

The compact is no longer just pending. It began issuing compact privileges in January 2026, and as of September 2026, eight states are actively accepting applications: Indiana, Maryland, Minnesota, Ohio, Tennessee, Virginia, West Virginia, and Wisconsin. Instead of needing to acquire a new state license, OTs whose home state is one of these eight can apply to work with a "compact privilege," which is the equivalent of a formal license, in any other state that is also actively issuing.

Which states are involved in the OT compact?

As of September 2026, 37 states have enacted the Occupational Therapy Licensure Compact:

Of these, only eight are actively issuing and accepting compact privileges: Indiana, Maryland, Minnesota, Ohio, Tennessee, Virginia, West Virginia, and Wisconsin. Enacting the compact and issuing privileges are two different steps—a member state must also integrate its licensing system with the compact's CompactConnect database before privileges become available there.

In addition, Illinois, Massachusetts, and New York currently have legislation pending to join the OT Compact.

How does the OT compact work?

If you're an OT and licensed in one of the eight states actively issuing privileges—Indiana, Maryland, Minnesota, Ohio, Tennessee, Virginia, West Virginia, or Wisconsin—you can apply now through CompactConnect, the OT Compact's shared database that verifies your licensure information across states. Other enacted states haven't opened applications yet; check the compact's "Before You Apply" page for each state's specific go-live date. Once you submit your application and it's approved, you'll receive the compact privilege, provided you meet all requirements, including a background check and a valid, unencumbered license in your home state.

What are the specific requirements for an OT compact privilege?

Along with being licensed and in good standing, OTs and OTAs will need to meet the following requirements:

• Have a Social Security Number or a National Provider Identifier.

• Pass an FBI fingerprint-based criminal background check.

• Pay any fees for the compact privilege.

• Have both your home state and destination state be actively issuing compact privileges, not just enacted members.

What is the timeline for OT compact implementation?

The OT Compact began issuing privileges in January 2026, starting with Ohio, Minnesota, and West Virginia, followed by Indiana, Maryland, Tennessee, Virginia, and Wisconsin through spring and summer 2026. Additional member states are actively working to integrate their licensing systems with CompactConnect and are expected to begin issuing privileges on their own timelines throughout 2026 and beyond. Check the OT Compact website for the latest status before assuming a state is ready.

Interested in travel therapy? The OT Compact makes working as a travel OT easier without the need to acquire additional licenses. Check out our travel OT jobs.

How can I get ready to join the Occupational Therapy Licensure Compact?

The main requirement for being part of the OT Compact is that your home state’s license is valid, your home state is a member of the compact, and you’re in good standing. So, it’s a good time to make sure your license is up to date and won’t expire any time soon.

If your primary residence is in a state that isn’t part of the OT Compact, there is something you can do to help. Urge your state legislators to join the compact by contacting them. There’s still plenty of time to join, and the OT Compact means more occupational therapists for all member states.

Also, keep an eye on the OT Compact website, where they’ll post updates on application timing as well as new member states.

CompHealth can help you find a travel therapy job wherever you want to work, with or without the OT Compact. See our open occupational therapy positions or contact us at 800.453.3030 to learn more.