Choose a compact privilege when you live in a state issuing privileges, the target state issues them too, and no license you hold is encumbered. Choose endorsement when any of those fails, when you are moving rather than working across a line, or when you want a license that does not depend on your home license.
Choose an OT Compact privilege when three things are true: you live in a state that is issuing privileges, the state where you want to practice is issuing them too, and no license you hold is encumbered. Choose a license by endorsement when any of those is false, when you are moving rather than adding work across a line, or when you want authority that does not depend on your home license. Many OTs end up with both: privileges for some states, licenses for others.
How do the two compare side by side?
| Compact privilege | License by endorsement | |
|---|---|---|
| Where it works | Only between states issuing privileges (10 as of October 2026) | Every state |
| Depends on where you live | Yes: your home state is your primary residence and must be issuing | No |
| Government fees | $75 Commission fee plus the state fee ($4 to $200 for OTs among issuing states) | Board application and license fees, $35 NBCOT score transfer, verification fees |
| Documents | Home license on record, FBI check through home board, jurisprudence where required | Application, score transfer, verifications from every board, usually fingerprints, any state exam |
| Who files | You, personally; the Commission bars third parties from completing it | You, or a service acting for you |
| How long it lasts | Until your home license expires; repurchased at every home renewal | Its own renewal cycle, independent of other licenses |
| Continuing education | Home state only | Each state's own rules |
| Practice rules | The remote state's | That state's |
The ten issuing states are Minnesota, Ohio, West Virginia, Indiana, Virginia, Maryland, Tennessee, Wisconsin, Arkansas and Mississippi. Twenty-seven more have enacted the compact but are not issuing; enactment alone grants nothing. See which states are issuing privileges.
Which five questions decide it?
1. Is your home state issuing privileges?
Your home state is where you primarily live and hold your license, and the Commission says it must be a member and accepting applications. If you live in Kentucky, Pennsylvania or any other enacted-but-not-issuing state, or in a non-member state such as Texas or California, the compact cannot help you yet, however many privileges other states issue. See your home state and the OT Compact.
2. Is the target state issuing?
Same test on the other end. Non-members (California, Connecticut, the District of Columbia, Florida, Hawaii, Idaho, Nevada, New Jersey, New Mexico, Oregon and Texas) always need a license.
3. Is your record clean enough?
The compact requires "no encumbrance on any State license" and, after any adverse action, that you have paid all fines, completed all requirements and waited two years from completion (OT Compact, Section 4.A). Endorsement routes vary: Florida's MOBILE Act excludes discipline in the last five years, but other routes stay open. See disclosing past discipline.
4. Are you moving, or working across a line?
A privilege is for practicing in a state you do not live in. If you move to another member state, that state becomes your home state, and you need a home license there. The compact provides a process for that: you apply for a new home state license "by virtue of a Compact Privilege," and the new state verifies you through the Commission's data system "without need for primary source verification," except for an FBI check if not already done, any other background check it requires, and its jurisprudence requirement. Your former home license then converts to a privilege (Section 5.B). A move to or from a non-member state means a regular license application.
5. How long will you work there?
Privileges are cheaper per state but must be bought again after every home renewal, and each one ends early if your home license lapses. For a state you will work in for years, a license may cost less in effort over time and protects you if your home license runs into trouble.
How does it work out in real cases?
- An OT living in Ohio who picks up per diem shifts in Indiana. Both issue privileges. A privilege is the obvious choice: $75 plus Indiana's $25, the home-board FBI check, and Ohio CE only.
- An OT living in northern Kentucky working in Cincinnati. Ohio issues privileges, but Kentucky does not yet, so this OT has no compact home state. Ohio license by endorsement.
- An OT moving from Virginia to Tennessee. Both issue privileges, but Tennessee will be the new home state, so the OT needs a Tennessee home license through the compact's change-of-residence process, then can hold a Virginia privilege if still needed.
- An OT living in Texas taking telehealth clients in Maryland. Texas is not a compact member, so the OT needs a Maryland license, whatever Maryland's compact status.
- An OTA living in Wisconsin working in Minnesota. A privilege works, but the OTA must be supervised by an OT licensed or holding a privilege in Minnesota (Section 4.D). See the OT Compact for OTAs.
Does either path let you skip the state's own rules?
No. Under a privilege, you "shall function within the laws and regulations of the Remote State" (Section 4.C); under a license, the state's practice act applies directly. Advanced practice approvals, modality certifications, dry needling registrations and OTA supervision rules all apply either way. Jurisprudence exams apply too: the Commission flags them for Kentucky, Maryland, Missouri, North Carolina, North Dakota, Ohio and Wisconsin for privileges, and states such as Texas require one for a license.
Who can help with each path?
This is where the paths differ for us as a service. For endorsement, we can prepare and file the application with you. For a privilege, the Commission says "employing agencies, third party affiliates, and/or other representatives may not legally complete the application on behalf of licensees," and licensees "should create their own accounts, complete the application, and make the payment themselves." So we never complete or pay for a privilege application. We do everything around it: the eligibility review, the home-board FBI check, jurisprudence preparation, and a guided session while you complete and submit the application yourself. See can someone else apply for my privilege?
Prices: the OT Compact Readiness Review is $149 and tells you which path fits each state; the Compact Privilege Concierge is $299 for the first privilege and $149 for each additional one; License by Endorsement is $599 per state for OTs and $499 for OTAs. Government fees are separate. Browse states in the license index or the compact hub.
Common questions
- Is an OT Compact privilege cheaper than a license?
- Usually per state: $75 plus the state's fee, with no score transfer or verifications. But you buy it again at every home renewal, and it ends if your home license lapses.
- Can I use a compact privilege if I am moving to another compact state?
- Not for long. The new state becomes your home state, so you apply for a home license there through the compact's change-of-residence process, which relies on the Commission's data system.
- Can a licensing service file my compact privilege?
- No. The Commission says third parties may not legally complete the application. You create the account, complete it and pay; a service can prepare you and guide the session.
- I live in Kentucky. Can I use the compact to work in Ohio?
- Not yet. Kentucky has enacted the compact but was not issuing privileges as of October 2026, so you need an Ohio license.
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