Preview on pages.dev. A custom domain has not been attached. This host is not indexed.
AlliedCompassOT · PT · SLP CAREER GUIDE Gear Shop

Free to use, no sign-up.

How to become an occupational therapist

The official U.S. path is an ACOTE-accredited occupational therapy program, the NBCOT OTR exam, and a license from the jurisdiction where you will practice.

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.

  1. Education

    The official NBCOT eligibility page states: “OTR candidates must graduate with an entry-level occupational therapy degree from an ACOTE®-accredited occupational therapy (OT) program”. If you were educated in the United States, that page says you must have graduated from an ACOTE-accredited program.

    ACOTE is the accreditor for occupational therapy and occupational therapy assistant programs. Its U.S. school directory lists OT programs at the master’s and doctorate levels. On its students and public page, ACOTE states there is no mandate to move OT programs to the doctoral-degree level: institutions can transition to the doctoral level, remain at the master’s level, or offer both.

    That same ACOTE page states: “One must graduate from an ACOTE-accredited program to be eligible to take the NBCOT certification examination.” It also states that during Probationary Accreditation, programs are still accredited and graduates are eligible to take the NBCOT exam, and that there is risk in entering a program that is not fully accredited. Use ACOTE’s directory to confirm a program’s status. This site does not publish a school list.

    If you earned your degree outside the United States, NBCOT describes an Occupational Therapist Eligibility Determination (OTED) process on that eligibility page, with its own documentation rules. Confirm current OTED steps and fees there.

  2. Exam

    Apply for the NBCOT OTR certification exam. NBCOT’s Get Certified page is the official starting point. It points to the exam handbook, eligibility, a free MyNBCOT account, preparation, the exam application and ATT letter, scheduling, exam day, and next steps. That page also states: “Certification is not the same as licensure.” More detail is on our NBCOT exam page.

  3. License

    NBCOT’s page What is an OTR or COTA professional? states that OTR and COTA professionals are also state-licensed professionals. Practice rules, applications, and fees are set by the jurisdiction board. Start with the state and territory directory and confirm everything on the board site.

  4. Compact

    If you will practice in more than one state, read the official OT Compact rules. The official OT Compact homepage, in a status update of October 2026, states: “Visit the ‘Before You Apply’ webpage to learn which states are accepting OTC applications.” It also states: “You cannot practice in an OTC state under the OT Compact, even if that state has enacted OTC legislation. You can only apply when the state opens applications, deems you eligible to apply, AND your application is approved.” That update still also states: “The OT Compact is enacted in some states, meaning those states have passed legislation to be part of the compact (check out the ‘Maps’ page tabs to see which states have joined the OTC). However, the OT Compact is not yet operationalized, meaning the process to apply for and receive compact privileges is still developing.” The same homepage states: “You must apply through the OTC to receive your privileges to practice in OTC states.” It also states: “Until you receive your OTC privilege to practice, you need a license to practice in any state you wish to provide OT services. Follow that state licensing board’s traditional licensing process to obtain your license to practice.” Details stay on the compacts page, compact applications, and the official compact site.

About the OTR credential

On that same “What is an OTR or COTA professional?” page, NBCOT states that OTR and COTA professionals have completed occupational therapy education and passed a national certification exam, have agreed to follow the NBCOT Code of Conduct and to fulfill continuing professional development requirements, and that only those who maintain an Active in Good Standing status with NBCOT can use the OTR or COTA credential. It also states that the OTR professional evaluates the client, plans therapeutic interventions, and completes discharge documents, and provides clinical supervision of the COTA professional.

National certification renewal figures we have already quoted live on the directory and in Methodology & sources.

Related pages