Maryland licenses occupational therapists and occupational therapy assistants through the Maryland Board of Occupational Therapy Practice in the Maryland Department of Health. Everything below comes from the board's own pages and rules, checked October 18, 2026. Fees and rules change, so confirm on the linked pages before you pay.
Check with your board. OT Ticket is a study aid, not clinical or legal guidance. Not affiliated with, endorsed by or connected to the National Board for Certification in Occupational Therapy (NBCOT), AOTA, ACOTE, the OT Compact Commission or any state board; NBCOT, OTR and COTA are their marks, used here only to name the exam.
Maryland at a glance
Occupational therapist (OT)
OT assistant (OTA)
Exam
NBCOT OTR exam (180 questions, 4 hours), $540 to NBCOT
NBCOT COTA exam (190 questions, 4 hours), $540 to NBCOT
Board fees
$200 application, non-refundable, includes the first temporary license (COMAR 10.46.05.01)
$200
Law exam
Board jurisprudence exam with answer sheet
Same
Background check
State and FBI Criminal History Records Check; prints valid 30 days
Same
Temporary license
With NBCOT's confirmation of exam registration and eligibility; a second one is $50
Same
OT Compact
Member, accepting applications since April 15, 2026. An OT or OTA who lives in and is licensed in another member state that is open can apply for a Maryland privilege to practice through the OT Compact (not through this board). (OT Compact, checked October 18, 2026)
Maryland, step by step
Maryland Board of Occupational Therapy Practice (Maryland Department of Health)
Application and fee: a completed application and the $200 fee, mailed to the office (a scanned payment is not accepted). It is non-refundable and covers your first temporary license.
Criminal history records check: required since February 1, 2018, State and FBI. Fingerprint results are valid only 30 days, so submit your application within 30 days of being printed.
Jurisprudence exam: complete the board's jurisprudence exam and answer sheet (on the board's forms page).
NBCOT: verification of your NBCOT certification (a screenshot from NBCOT's verification site is accepted). For a temporary license, send NBCOT's confirmation of examination registration and eligibility to examine instead.
Keep it: renewal is $270 (OT) or $210 (OTA). Maryland opened OT Compact privilege applications on April 15, 2026.
Every state licenses occupational therapists and OT assistants on NBCOT certification: an ACOTE-accredited degree with its Level II fieldwork, then NBCOT's exam (the OTR exam for OTs, 180 questions in 4 hours; the COTA exam for OT assistants, 190 questions in 4 hours; 450 on a 300-600 scale passes; $540 to apply online). NBCOT certification is not a license: you apply to your state board separately, and NBCOT sends the board your score (the Score Transfer is free if you add it when you apply for the exam, $35 later). The full walk-through: How to get your OT license.