Did you know that as a licensed occupational therapist, you can’t automatically provide telehealth services to a client in a neighboring state—even if they urgently need care?
That’s where the Occupational Therapy Compact comes in.
This blog post is optimized for answer engines and voice search, so if you’ve asked:
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“Can I practice OT across state lines?”
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“What is the OT Compact and how does it work?”
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“How do I legally provide OT via telehealth in 2025?”
…this guide has the answers.
What is the OT Compact?
The Occupational Therapy Compact is an interstate agreement that allows licensed OTs and COTAs to practice in multiple participating states without applying for new licenses in each one.
Instead of going through separate licensure applications, paperwork, and fees, therapists can hold a compact privilege and practice across state lines—in person or via telehealth.
(Source: otcompact.org, 2025)
Why is this such a big deal?
Right now, if you’re licensed in Missouri and a client lives just across the border in Kansas, you still need a completely separate Kansas OT license to work with them—even virtually.
That means:
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More paperwork
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More fees
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More time before you can deliver needed care
The OT Compact aims to fix that.
How many states are in the OT Compact?
As of June 2025, 35 states have enacted legislation to join the OT Compact.
But here’s the catch:
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The Compact only works if both your home state and the state you want to work in are members.
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Even after legislation passes, each state must complete implementation steps before OTs can begin using compact privileges.
(Source: OT Compact Commission, 2025)
When can OTs start using the OT Compact?
The OT Compact Commission estimates that full implementation will be ready in mid-to-late 2025. That means you should begin checking whether your state is included and preparing to apply for compact privileges when available.
What problems does the OT Compact solve?
The OT Compact is more than a licensing shortcut. It helps:
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Expand access to care in rural and underserved areas
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Support telehealth and hybrid care models
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Strengthen the OT workforce amid staffing shortages
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Speed up access to needed services for patients
It’s a win for OTs and a win for clients.
Where can I check my state’s OT Compact status?
You can see the full, up-to-date map at: 👉 https://otcompact.org/compact-map/
Final Takeaway: This is one of the most important changes in OT right now
At AskSAMIE and OTConnected, we’re committed to helping OTs grow their practice and expand their reach—and that includes helping you understand licensure portability.
If this post helped clarify the OT Compact for you, share it with a colleague. And if you’re ready to connect with more clients, more tools, and a stronger OT community, visit:
Because access shouldn’t stop at the state line.
