Based on AOTA's October 5 announcement, the OT Compact Commission's current application table and governing documents, and Mississippi's official licensure notice.
An occupational therapist considering an Arkansas assignment or a Mississippi patient now has another licensure route to examine. Both states began issuing OT Compact privileges on October 5, AOTA announced, expanding the operational network to ten states. For eligible OTs and OTAs, the opening makes another cross-state job or service possible through a state-specific privilege. The application still has to be approved before care begins.
In brief
- Arkansas and Mississippi join Indiana, Maryland, Minnesota, Ohio, Tennessee, Virginia, West Virginia, and Wisconsin in issuing privileges.
- The published state and compact fees add up to $79 for an OT privilege in Arkansas and $275 in Mississippi; OTA totals are $78 and $225.
- Eligibility depends on the clinician's qualifying home state. Each privilege expires with the home-state license, with no grace period.
The opening reaches clinicians in both directions
Arkansas and Mississippi residents with qualifying home-state licenses can seek privileges in the other operational states. Eligible clinicians whose home states were already issuing privileges can now seek permission to practice in Arkansas or Mississippi. Mississippi's health department separately confirms the October 5 start.
AOTA reports 37 compact member states. Each has to connect its licensing system to CompactConnect before applications can open. The commission's current state table is the practical reference for a clinician comparing an assignment, a new patient, or a move. A state marked as awaiting applications still requires its traditional licensing route.
Budget for the destination state's privilege
The commission lists a $75 compact fee alongside each state's charge. Arkansas's state portion is $4 for an OT and $3 for an OTA, producing totals of $79 and $78. Mississippi lists $200 and $150, producing totals of $275 and $225. Those figures combine the listed privilege charges; any separate background-check cost needs its own place in the budget.
Someone planning privileges in both states would therefore budget $354 as an OT or $303 as an OTA for those listed charges. An employer offering to cover licensure costs should specify which fees it will reimburse and what happens when the home-state license renews. Check the current table and the amount displayed at payment before committing to an assignment.
Home-state eligibility comes first
The compact starts with the state where the clinician primarily resides and holds a qualifying license. Its governing language requires a home-state license, no encumbrance on any state license, the required criminal background check, and compliance with other eligibility conditions, including those concerning prior adverse actions. Clinicians should review the full requirements against their own record.
The application guidance directs the background check through the home-state licensing board. It also requires clinicians to complete their own accounts, applications, attestations, and payment. A staffing agency can help a worker plan the assignment and reimbursement, but the commission says an employer or other representative may not complete the application on the licensee's behalf.
Match the permission to the patient's location
The compact places practice in the state where the patient is located during the encounter. A telehealth clinician therefore needs permission appropriate to that location, even while working from an office elsewhere. Remote-state law continues to govern the care, and an OTA practicing under a privilege must be supervised by an OT who is licensed or holds a privilege in that state.
For a hiring manager, this means checking the specific destination privilege before putting a clinician on the schedule. The licensing change also leaves payer enrollment, employer credentialing, and service-coverage questions to be resolved for the actual role. A job offer should make clear who handles those steps and when the clinician can begin seeing patients.
Put renewal on the same calendar as the assignment
A privilege expires when the home-state license expires. The commission's no-grace-period policy, effective September 10, uses that expiration date even when the home state permits a later grace period. The application guidance says clinicians must purchase new privileges after renewing the home-state license. Complete both steps before resuming practice under a privilege.
Before accepting cross-state work, compare the assignment dates with the home-state expiration date and save the approved privilege record. Employers should track that date alongside their coverage schedule. Arkansas and Mississippi have widened the available map; keeping permission current is what makes the new route usable for the next patient.