Internationally educated pathways
Official routes described by NBCOT and FSBPT for people who earned their occupational therapy or physical therapy degree outside the United States. A national exam or eligibility review is not a license, a visa, or permission to work.
Quoted from official pages checked November 10, 2026. Confirm current requirements, fees, and dates on those sites. This page is not legal advice and does not guarantee eligibility, certification, or licensure.
Occupational therapy — NBCOT OTED
NBCOT’s exam eligibility page, checked November 10, 2026, states that if you were educated in the United States, you must have graduated from an ACOTE-accredited program. It also states: “If you earned your degree outside of the U.S., you must first apply to the Occupational Therapist Eligiblity Determination (OTED) process.” (That sentence uses NBCOT’s spelling on the page.)
Later on the same page, NBCOT states: “If you did not earn your entry-level master’s/doctoral degree in occupational therapy from a U.S.-accredited college/university, you must apply for the Occupational Therapist Eligibility Determination (OTED®) process. The OTED process determines if your completed education and fieldwork are comparable to current U.S. entry-level educational standards.”
To be eligible to apply for OTED, that page says you must have:
- An entry-level master’s degree in occupational therapy, or
- A bachelor’s degree in occupational therapy with a post-professional master’s or doctoral degree in occupational therapy, or
- A bachelor’s degree in occupational therapy with a master’s degree in a related field.
It also states: “Your education must include at least 960 hours of fieldwork attained through the entry-level degree granting institution, at minimum at a bachelor’s degree level.” “Additional coursework may be needed to satisfy requirements.” “Earning a post-professional master's/doctoral degree in occupational therapy in the U.S. does NOT guarantee OTED approval. OTED approvals are based on the educational comparability review of your combined education.”
As of November 10, 2026, that page listed an $850 (USD) application fee. It states: “You are eligible to apply for the OTR certification exam once you are approved through the OTED process.” “All OTED approvals are valid for 7 years from the date of approval.” It also states that you must take and pass the exam within that 7-year period, and that if you do not, you will need to reapply to the OTED process, pay the fee, and resubmit documentation for review.
The same eligibility page describes OTED as the route to apply for the OTR certification exam. It does not describe a separate COTA eligibility-determination process. Confirm current documents, fees, and any assistant-specific instructions on NBCOT’s official pages rather than assuming the OTED steps apply to COTA.
Physical therapy — FSBPT non-U.S. candidates
FSBPT’s Non-U.S. Candidates page, checked November 10, 2026, states that if you were educated outside the United States and would like to work as a physical therapist or physical therapist assistant in the United States, you must possess permission to work in the United States and a physical therapy license.
On permission to work, that page states that U.S. Citizenship and Immigration Services (USCIS) grants non-U.S. citizens permission to work in the U.S., and that to obtain a visa or permission from USCIS you may need a healthcare worker certification. It tells readers to contact USCIS and to refer to the list of organizations recognized by USCIS to issue healthcare worker certificates. The organizations named on that page are the Foreign Credentialing Commission on Physical Therapy (FCCPT) and TruMerit (Formerly CGFNS).
On licensure, the page says to contact the licensing authority where you plan to practice and ask about specific requirements. It states: “You must obtain a physical therapy license from each jurisdiction where you plan to practice. Each jurisdiction has its own set of laws and rules for obtaining a license.” It also says to ask whether credentialing is required, and defines credentialing as “a comparison of the foreign education curriculum to the current US standards, and when appropriate, to previous standards to match the year of graduation.” It states that credentialing is also required in order to obtain a healthcare worker certification, and that if credentialing is required you should contact a credentialing organization for instructions.
The same page lists organizations licensed to use the FSBPT coursework tool (CWT): the Foreign Credentialing Commission on Physical Therapy (FCCPT), International Consultants of Delaware, Inc. (ICD), and International Education Research Foundation, Inc. (IERF). Confirm current names, addresses, and instructions on the official FSBPT page.
FSBPT’s NPTE eligibility page separately states that FSBPT’s listed requirements include having a degree appropriate for the exam level from a CAPTE-accredited institution, or an education determined to be substantially equivalent by a recognized credentialing agency, and being approved by the licensing authority in the jurisdiction where you intend to be licensed. See also FSBPT’s Recommendations for Non-CAPTE page.
After eligibility
Passing NBCOT or the NPTE is not by itself a license. Apply through the jurisdiction board using the state and territory directory, and confirm immigration steps with USCIS. This page is not legal, immigration, or licensure advice.