Maryland OT Licensing and the Compact

Maryland gives out-of-state occupational therapists two routes. If your home state issues OT Compact privileges, you can obtain a Maryland privilege; Maryland began issuing them on April 15, 2026, according to otcompact.gov, and its state fee is $125 for OTs and OTAs alike. Otherwise, you apply for a Maryland license from the Maryland Board of Occupational Therapy Practice, which requires its own open-book jurisprudence exam, fingerprints for a criminal history records check, verification of every other license, and proof of current NBCOT certification or recent continuing competency.

How does a Maryland compact privilege work?

Under the Commission's Before You Apply rules, you need a home state where you primarily live, that is a compact member and that issues privileges; an unencumbered license there; and an FBI criminal background check completed through your home-state board. You create your own account in CompactConnect, apply and pay: the $75 Commission fee plus Maryland's $125. The Commission states that "employing agencies, third party affiliates, and/or other representatives may not legally complete the application on behalf of licensees."

Check the Commission's Before You Apply table for whether a Maryland jurisprudence requirement applies to your privilege at the time you apply; the table is the controlling source and is updated as states open. A privilege expires with your home-state license, and you must purchase a new one each time you renew that home license. See the OT Compact hub and jurisprudence requirements for compact privileges.

What does a Maryland license application require?

COMAR 10.46.01.02E lists the documents:

1. the completed application;
2. verification of initial NBCOT certification or examination;
3. proof of fingerprinting for a criminal history records check;
4. the application fee, which the board's 2026 form lists as $200 for an initial or temporary license;
5. verification of licensure, registration or certification from any other state or country where you are or were authorized to practice;
6. verification that you passed the Maryland Board of Occupational Therapy Jurisprudence Examination;
7. documentation of current NBCOT certification or completed continuing competency activities; and
8. additional requirements for applicants with three or more years' lapse in practice.

On item 7, the 2026 application form spells out the alternative: if you do not maintain current, active NBCOT certification, you document 24 contact hours completed within the preceding 24 months and send a Continuing Competency Requirement Compliance Report.

The six-month clock

Maryland gives you six months from the date you start an application to submit every required document. If an applicant fails to provide the required documentation within six months, "the Board may administratively close the application," and you reapply from scratch (COMAR 10.46.01.02C and D). Fingerprint results, verifications from other boards and the NBCOT document all have to land inside that window. Order them in the first week. See license verifications between OT boards.

What is on the Maryland jurisprudence exam?

The board's 2026 jurisprudence exam is 35 yes-or-no questions on COMAR 10.46, the board's regulations. It is open book, and you return only the answer sheet by mail, fax or email. The board emails you if any answers are incorrect. Topics include OTA supervision, aide tasks, physical agent modality training, continuing competency, temporary licenses and renewal timing. Read the regulations, especially Chapter 01, before you start; several questions turn on definitions that differ from other states. More in state jurisprudence exams.

Which Maryland rules surprise OTs from other states?

Periodic supervision of OTAs is defined precisely

Maryland defines periodic supervision as face-to-face supervision by a licensed OT for each client an OTA treats, at least once every 10 therapy visits or once every 30 calendar days, whichever comes first, and it includes chart review and treatment discussions (COMAR 10.46.01.01B(20)). The OT and OTA jointly maintain formal documentation, cosigned with credentials. An OTA "may not analyze or interpret evaluation data" (10.46.01.03B(4)). See OTA supervision rules that trip up a move.

Temporary licenses require on-site supervision

A temporary license is available to an applicant who has met every requirement except the certification exam. A temporary licensee practices "with on-site supervision," meaning a supervisor immediately available on the premises (10.46.01.04C and D). Temporary licensees cannot serve as supervisors themselves. The regulations allow a second temporary license if the first expired before you completed the exam.

Title use

Maryland specifies the credentials licensees use to show licensure status: OT/L for a licensed occupational therapist, OTA/L for a licensed OTA, and OT/LT or OTA/LT for temporary licensees (10.46.01.07).

Renewal ends June 30

An initial license is valid for two and a half years or less, and renewal applications postmarked or confirmed after the June 30 expiration date are not accepted (10.46.01.02B). At renewal you attest to current NBCOT certification or completed continuing competency activities.

Should you choose a privilege or a license?

If you live in another issuing state and will keep living there, a privilege is usually the quicker path, at $200 in combined fees at current rates. It ends when your home license expires and must be repurchased each home-state renewal. If you are moving to Maryland, you need a Maryland license, which then becomes your home license for privileges in other issuing states. See endorsement or the compact.

How can we help in Maryland?

For a license, our License by Endorsement service is $599 for an OT and $499 for an OTA. We manage the six-month document clock, fingerprints and verifications, and our Jurisprudence and State Law Exam Support ($249) prepares you for the exam you complete yourself. For a privilege, our OT Compact Readiness Review ($149) and Compact Privilege Concierge session ($299) confirm eligibility and guide you while you submit and pay for the application yourself. See our Maryland requirements page.