The PT Compact and the OT Compact Compared

The PT Compact and the OT Compact work on the same basic idea, a privilege to practice in other member states based on a home state license, but they are separate agreements with separate commissions, maps and rules. As of October 2026, the PT Compact lists 38 member jurisdictions issuing and accepting privileges, according to ptcompact.org, while the OT Compact has 10 states issuing, according to otcompact.gov. A rehab team cannot assume that a state open to its PTs is open to its OTs.

How do the two compacts compare?

OT sources: the OT Compact Commission's Before You Apply page, its practitioner FAQ and the compact model law. PT sources: the PT Compact's compact map, its process and requirements page, and its eligibility checker, all on ptcompact.org, checked October 8, 2026.

Where do the maps differ?

These are the gaps that catch dual-discipline employers.

• PT Compact members that are not in the OT Compact at all: Connecticut, the District of Columbia, Nevada, New Jersey, Oregon and Texas. A Texas clinic can bring PTs in on privileges but needs Texas licenses for every OT.
• OT Compact states that are not PT Compact members: Minnesota, which issues OT privileges, and Wyoming, which has enacted the OT Compact. The PT Compact lists both as non-members.
• States issuing PT privileges where the OT Compact is enacted but not live: most of them, including Alabama, Arizona, Colorado, Georgia, Kentucky, North Carolina, Pennsylvania, South Carolina, Utah and Washington.
• States in neither: California, Florida, Hawaii, Idaho, New Mexico and New York are not members of either compact. Illinois and Massachusetts have bills filed for both.

The states where both work today are the overlap of the OT Compact's ten and the PT Compact's member list: Ohio, West Virginia, Indiana, Virginia, Maryland, Tennessee, Wisconsin, Arkansas and Mississippi. For the OT side, see which states are issuing OT Compact privileges. For the PT side, our sister site keeps a PT Compact state list.

Why does the OT Compact have fewer live states?

The OT Compact's launch requirements are one reason. Every new OT Compact member has to fully implement FBI criminal background checks, among other steps, before it can issue privileges (OTC Rule 5.1), and the Commission adopted a separate rule for states that applied for FBI access and were refused. Each board then opens on its own schedule; the Commission's FAQ says its administrators "do not set the timeline." The first OT states began issuing on January 12, 2026. See enacted is not issuing.

Which rules are the same?

• Clean license required. Both require an unencumbered home license, and both look back two years at discipline. The PT Compact's eligibility checker says disciplinary action "within the last 2 years" makes you ineligible; the OT model law requires two years since you completed any discipline (Section 4A5).
• Remote state rules apply. Under either compact you practice under the laws of the state where the patient is.
• Home state CE. The OT Compact Commission says CE is required only in the home state; the PT Compact says you "only need to meet the continuing competence requirements for your home state license."
• Assistants are covered. PTAs in the PT Compact and OTAs in the OT Compact, each under supervision rules of the state where they work. See the OT Compact for OTAs.
• Medicare recognizes both. CMS's MLN Matters SE20008 names the physical therapy and occupational therapy compacts and treats compact pathways as valid, full licenses for enrollment.

Which differences cause mistakes?

Who applies. The OT Compact Commission says employers and third parties "may not legally complete the application on behalf of licensees." A credentialing team that manages other compact or license applications for staff should not assume the OT Compact works the same way. See can someone else apply for my OT Compact privilege?

Jurisprudence timing. Some PT Compact states let you pass their exam within 30 days after the privilege is issued. The OT Compact application has you attest that any jurisprudence requirement is already complete.

Moving. The PT Compact's eligibility checker says you "cannot practice in your new home state with a compact privilege for more than 60 days after moving." The OT model law has no equivalent grace period in its text; a move changes your home state, and the new state expects a home license. See your home state and the OT Compact.

Expiration. OT Compact privileges expire with the home license, and a Commission policy effective September 10, 2026 says home-state grace periods do not extend them. See renewing OT Compact privileges.

Can a team manage both on one calendar?

Yes, but track them as separate systems with separate logins, fees and renewal triggers. For each clinician, record the home state, the compact they use, every privilege with its expiration date (which is the home license date), and every regular license. Our sister site, White Glove DPT, explains the PT side in the PT Compact explained.

For the OTs and OTAs on your team, our OT Compact Readiness Review ($149) sorts out who can use the compact and where. Each clinician then completes and pays for their own privilege, which our Compact Privilege Concierge prepares and guides. For states outside the OT Compact, we handle licenses by endorsement. Teams with many clinicians may also want licensing for OT staffing and contract companies.