Career path
A map from school to license for occupational therapists, occupational therapy assistants, physical therapists, physical therapist assistants, speech-language pathologists, and speech-language pathology assistants. Each role has its own page. Program length, tuition, and pay are listed only when an official source we checked states them.
How to become an OT
ACOTE-accredited occupational therapy program, NBCOT OTR exam, then a jurisdiction license.
How to become an OTA/COTA
ACOTE-accredited occupational therapy assistant program, NBCOT COTA exam, then a jurisdiction license.
How to become a PT
CAPTE-accredited Doctor of Physical Therapy program, NPTE, then a jurisdiction license.
How to become a PTA
CAPTE-accredited physical therapist assistant program, NPTE, then a jurisdiction license.
How to become an SLP
CAA-accredited graduate program, national SLP exam, ASHA Clinical Fellowship and CCC-SLP, then a state license.
How to become an SLPA
One of ASHA’s three C-SLPA education pathways, 100 clinical hours, the assistant exam, and state rules that vary.
The shared sequence
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Education
Graduate from an accredited program. Occupational therapy and occupational therapy assistant programs: ACOTE. Physical therapist and physical therapist assistant programs: CAPTE. Speech-language pathology graduate programs: CAA. Use those official directories to find programs. This site does not publish a school directory. See ACOTE, CAPTE, and CAA, how to choose an accredited program, and how long each path takes.
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Exam
OT and OTA graduates exam through NBCOT. PT and PTA graduates exam through FSBPT (the NPTE). Speech-language pathology graduates take the national speech-language pathology exam that ASHA uses for the CCC-SLP. Dedicated pages: NBCOT exam, NPTE, and SLP exams and certification.
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License
Practice is licensed by a state or territory board, even after you pass the national exam. Use the state and territory directory and confirm applications, fees, and renewal on the board site.
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Compact
If you practice in more than one state, check compact rules. The PT Compact is in operation. Speech-language pathologists have the ASLP-IC. For the OT Compact, 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.” Details stay on the compacts page and the official compact sites.
After you are licensed, interview prep covers credentials employers can verify on official sites. Optional physical therapy specialist credentials are summarized on specialties. Pay and outlook quotes BLS handbook figures. Renewal and CE covers NBCOT recertification and state license maintenance. Internationally educated pathways quotes official NBCOT and FSBPT routes.
What they do, exams, licenses, and beyond
What they do
Job duties for each role, quoted from the BLS handbook, with assistant and aide duties separate.
Certification vs licensure
Why NBCOT, FSBPT, and ASHA say a national credential or exam is not a state license.
After the exam
What NBCOT, FSBPT, and ASHA say comes next: applying to the state board.
SLP Clinical Fellowship
ASHA’s 36-week, 1,260-hour mentored experience, segments, and mentor rules.
Verify a credential or find a board
Official NBCOT and ASHA verification tools and FSBPT and ASHA board directories.
PTA to PT bridge
CAPTE’s accredited bridge programs for physical therapist assistants.
PT residencies and fellowships
ABPTRFE-accredited postprofessional programs and the official directory.
Supervision of assistants
APTA and ASHA on how PTAs and SLPAs are supervised; state law sets the rules.
Exam retakes and attempt limits
NBCOT waiting periods, NPTE attempt limits, and ASHA retake rules.
Application services
OTCAS, PTCAS, and CSDCAS: one application to several programs.
Telepractice and telehealth
ASHA and APTA on licensure for remote services.
Fieldwork and clinical education
BLS, APTA, and ASHA on supervised clinical work during the program.
Observation hours
What APTA, BLS, and ASHA say about observation and shadowing for admissions.
Exam day
Scheduling, ID, and test-day rules from NBCOT, FSBPT, ETS, and ASHA.
Testing accommodations
NBCOT, FSBPT, ETS, and ASHA accommodation processes.
Moving with a compact privilege
What the compacts say when you change your home state.
Scores and score reports
NPTE 600 passing standard, ASHA’s 162, and how NBCOT reports results.
Testing before your final transcript
NBCOT’s Degree Verification Form and Early Determination Review.
If certification lapses
NBCOT and ASHA reinstatement rules for expired certification.
Accreditation status
What candidate, preaccredited, and accredited mean to ACOTE, CAPTE, and CAA.
Assistant vs aide
BLS on OT and PT assistants versus aides.
How to become a PT specialist
ABPTS eligibility, the exam, and APTA’s PTA pathways.
Internationally educated SLPs
ASHA’s CCC-SLP route for applicants educated outside the U.S.
How to register for the exams
NBCOT, FSBPT, and ASHA registration steps, from application to ATT and scheduling.
What each exam covers
Official NBCOT, NPTE, and Praxis content outlines.
Rescheduling an exam
NBCOT, FSBPT, and ETS rules for changes, cancellations, and no-shows.
ASHA specialty certification
Board Certified Specialist (BCS) boards ASHA recognizes.
Direct access to PT
APTA on seeing a physical therapist without a referral.
Working in schools
IDEA related services, BLS, APTA, and ASHA on school-based OT, PT, and SLP.
How certification CE works
NBCOT renewal activities and ASHA PDH rules.
Maintaining the ASHA CCC-SLP
ASHA’s 3-year interval and compliance form.
SLP license renewal by state
CE hours and cycles for thirty-seven states from official sources.
OT license renewal by state
OT and OTA CE hours and cycles for twenty-nine states from official sources.
PT license renewal by state
PT and PTA CE hours and cycles for twenty-seven states from official sources.
CE requirements by state
OT, PT, and SLP state CE summaries in one table.
Documentation software
HHS and HealthIT.gov on EHRs, business associates, and cloud services.
Travel vs local jobs
IRS tax home and assignment-length rules, plus licensure links.
Assistive technology basics
ACL and IDEA definitions and state AT programs.
Federal therapy jobs
OPM qualification standards for OT, PT, SLP, and assistants.
Interprofessional practice
IPEC competencies and how OT, PT, and SLP work as a team.
Temporary permits
Sixteen states’ rules on practicing before passing the exam.
Clinical education minimums
ACOTE and CAPTE full-time fieldwork and clinical education.
Find jobs and licenses
CareerOneStop and USAJOBS search tools by state.
State hubs
One page per state for OT, PT, and SLP renewal, boards, and compacts.
SLP state board directory
Verified SLP licensing boards and ASLP-IC status.
Professional ethics codes
Who AOTA’s, APTA’s, ASHA’s, and NBCOT’s codes cover; state practice acts are separate.
Becoming a clinical instructor
ACOTE, CAPTE, and ASHA rules for supervising students, and APTA’s CCIP.
Working in home health
BLS, Medicare.gov, APTA, and ASHA on home health therapy.
Working in hospitals
BLS, APTA, and ASHA on hospital-based OT, PT, and SLP.
Working in nursing homes
BLS, Medicare.gov, APTA, and ASHA on skilled nursing facilities.
Working in outpatient and private practice
BLS, APTA, ASHA, and Medicare.gov on outpatient therapy.
Working in early intervention
IDEA Part C and ASHA on OT, PT, and SLP for infants and toddlers.
The AOTA Fellowship Program
AOTA-recognized post-professional fellowships for licensed OTs.
AOTA Advanced Certification
AOTA Board Certification in gerontology, pediatrics, and physical rehabilitation.
PTA Advanced Proficiency Pathways
APTA’s eight PTA pathways, mentors, and requirements.
IEPs and IFSPs
IDEA Part B and Part C plans, and where OT, PT, and SLP fit.
Compare the three compacts
OT Compact, PT Compact, and ASLP-IC in their own words.
Working in inpatient rehabilitation
Medicare.gov, federal IRF criteria, and ASHA on IRFs.
Working in hospice
Medicare hospice rules, APTA, and ASHA on PT, OT, and SLP in hospice.
Entry-level degrees
Which degree levels ACOTE, CAPTE, APTA, the CAA, and ASHA describe for each role.
HIPAA for OT, PT, and SLP
HHS on covered entities, the Privacy Rule, and the Security Rule.
The National Provider Identifier
CMS on the NPI, NPPES, and Entity Type 1 vs Type 2.
Section 504 plans
Section 504, FAPE, and 504 plans vs IEPs, from the Department of Education.
Medicare therapy plans of care
CMS rules for outpatient PT, OT, and SLP plans, certification, and recertification.
Skilled maintenance therapy
CMS on the Jimmo Settlement and maintenance programs.
Therapy students and Medicare
CMS Part B and SNF Part A rules on students, quoted separately.
FERPA for school-based therapy
Education records, treatment records, consent, and where HIPAA does not apply.
Good faith estimates
CMS and 45 CFR 149.610 on estimates for uninsured and self-pay patients.
Public Service Loan Forgiveness
StudentAid.gov on qualifying employers, direct employment, and full-time work.
Using your credentials
NBCOT, APTA, and ASHA on OTR, COTA, PT, DPT, PTA, CCC-SLP, and C-SLPA.
Working in private practice
Medicare’s therapist-in-private-practice rules, APTA, and ASHA.
Mental and behavioral health
BLS, APTA, and ASHA on each profession’s role, quoted separately.
Medicare progress reports
Chapter 15 rules for progress reports, treatment notes, and discharge notes.
The ADA in therapy settings
ADA.gov on access to medical care and effective communication.
The Medicare ABN
CMS and Medicare.gov on the Advance Beneficiary Notice and its three options.
Therapy at the VA
VA’s own pages on OT, PT, and speech-language pathology care.
Certified Hand Therapist
HTCC eligibility, exam, and recertification for OTs and PTs.
Federal loan repayment programs
Which HRSA and IHS programs list OT, PT, or SLP.
Medicare appeals
The five levels and fast appeals, with deadlines as Medicare states them.
Section 1557
HHS OCR and 45 CFR Part 92 on language access and disability nondiscrimination.
Medicare enrollment
CMS’s four steps, PECOS, and the CMS-855I for OTs, PTs, and SLPs.
Medicare group therapy and co-treatment
Chapter 15 and the RAI Manual’s Part A and Part B definitions.
Medicaid EPSDT
CMS on physical, speech/language, and occupational therapies for children under 21.
TRICARE therapy coverage
TRICARE’s OT, PT, and speech therapy coverage pages, quoted separately.
Medicare telehealth
CMS’s Telehealth FAQ on therapists and Medicare telehealth, with its dates.
Military spouses and license portability
The SCRA’s 50 U.S.C. 4025a and what the OT, PT, and SLP compacts say.
Mandated reporting
Federal sources on child and adult abuse reporting; state law decides.
Medicare Advantage appeals
Organization determinations, plan reconsiderations, and the IRE, as Medicare.gov and CMS describe them.
Opting out of Medicare
CMS’s opt-out rules and the list that excludes OTs, PTs, and SLPs.
ADA, Section 504, and IDEA
OCR and ADA.gov on how the three laws differ.
Bloodborne pathogens
OSHA’s 29 CFR 1910.1030 on exposure control plans, vaccination, and training.
Safe patient handling
OSHA and NIOSH on lifting, transfers, and safe patient handling programs.
RESNA ATP credential
RESNA’s Assistive Technology Professional eligibility, exam, and recertification.
Medicare home health therapy rules
Chapter 7 on qualifying, OT’s continuing need, and 30-day reassessments.
Medicare SNF therapy rules
Chapter 8’s four factors, skilled therapy, the daily-basis rule, and the PDPM group and concurrent limit.
Medicare IRF coverage rules
The 60 percent threshold, preadmission screening, the overall plan of care, and the IRF-PAI.
The Medicare KX modifier
What the KX modifier confirms and when CMS says to use it; no threshold amounts copied.
RESNA SMS credential
RESNA’s Seating and Mobility Specialist eligibility, exam, and disclosure guidelines.
Augmentative and alternative communication (AAC)
ASHA on AAC and the SLP’s role, and IDEA’s assistive technology rules.
CLT-LANA lymphedema credential
LANA’s eligible professions, CDT training, exam, and recertification.
HIPAA breach notification
HHS on what counts as a breach and who must be notified, and when.
IDEA Child Find
How Part B and Part C require states to find, refer, and evaluate children.
ADED CDRS driver rehabilitation credential
ADED’s seven exam pathways, experience hours, and three-year renewal.
Fall prevention with CDC’s STEADI
Screen, assess, intervene, and where STEADI names PT and OT referrals.
Swallowing disorders (dysphagia)
ASHA on the SLP’s role, assessment, the team, and schools.
Workplace violence in healthcare
OSHA’s advisory guidelines, who they cover, and the five building blocks.
Medicare wheelchair and power mobility coverage
Face-to-face rules, the PT or OT specialty evaluation, and the supplier’s ATP.
Federal workers’ compensation (FECA)
OWCP enrollment, the 120-day PT window, and therapy requests.
Concussion
CDC on recovery, return to school, and vestibular rehabilitation.
Stroke rehabilitation
NINDS on when rehab starts, who does it, and where.
Autism
CDC on speech, occupational, and physical therapy and early intervention.
Federal health care worker certificate
8 CFR 212.15: who needs it, who issues it, English rules, five-year validity.
Parkinson’s disease
NINDS on PT, OT, and speech therapy, voice exercises, and exercise.
Multiple sclerosis
NINDS on PT and OT for spasticity, walking, and fatigue.
ALS
NINDS on PT, OT, and speech therapy and communication devices.
Spinal cord injury rehabilitation
NINDS on the rehab team and what PT and OT cover.
Aphasia
NIDCD on SLP referral, speech-language therapy, and family involvement.
Stuttering
NIDCD on how SLPs diagnose and treat stuttering.
Traumatic brain injury rehabilitation
NINDS on the severe TBI rehab team and cognitive rehabilitation.
Osteoarthritis and rheumatoid arthritis
NIAMS on exercise, splints, and the PT and OT roles.
Hip replacement recovery
NIAMS on physical therapy before and after surgery.
Low back pain
NIAMS on physical therapy and NCCIH on nondrug care first.
Voice disorders
NIDCD on hoarseness, vocal fold paralysis, and voice therapy.
Pressure ulcer prevention
AHRQ’s hospital bundle and the PT and OT role.
Osteoporosis
NIAMS on exercise, safe movement, and the PT and OT roles.
Carpal tunnel syndrome
NIAMS on splints, surgery, and the OT and PT role.
Balance disorders and BPPV
NIDCD on evaluation, the Epley maneuver, and vestibular rehabilitation.
Lymphedema after cancer
NCI on the certified lymphedema therapist and decongestive therapy.
Apraxia of speech
NIDCD on how SLPs diagnose and treat AOS.
Medicaid school-based services
CMS’s 2023 guide on PT, OT, and speech services in schools.
Down syndrome
NICHD on the PT, speech-language, and OT roles from infancy on.
Muscular dystrophy
NINDS on physical, occupational, and speech therapy in MD.
Spina bifida
NINDS and CDC on mobility, early PT, and the care team.
Limb loss and amputation rehabilitation
The VA amputation team, MedlinePlus, and Medicare prosthetics.
Pulmonary and cardiac rehabilitation
NHLBI, Medicare coverage, and session limits in the regulations.
Guillain-Barré syndrome
NINDS on rehab settings, PT, and occupational and vocational therapy.
Huntington’s disease
NINDS on speech and swallowing changes and specialist referral.
Dystonia
NINDS on PT with splints, biofeedback, speech therapy, and OT.
Essential tremor
NINDS on therapists, assistive utensils, and easier dressing.
Peripheral neuropathy
NINDS on braces, orthopedic shoes, splints, and pain care.
Cleft lip and palate
NIDCR and CDC on the cleft team and speech therapy.
Sports injuries
NIAMS on rehabilitation and the physical therapist’s role.
Rotator cuff injuries
MedlinePlus on physical therapy and other shoulder treatments.
Plantar fasciitis
MedlinePlus on stretching, night splints, and orthotics.
Developmental language disorder
NIDCD on DLD evaluation and treatment by SLPs.
Speech sound disorders
ASHA on articulation and phonology and SLP roles.
Dysarthria
ASHA on adult dysarthria treatment, AAC, and care partners.
Selective mutism
ASHA on the SLP’s role on the selective mutism team.
Laryngectomy
MedlinePlus on voice prostheses and speech rehabilitation.
Medicare and speech generating devices
CMS NCD 50.1 on SGDs as durable medical equipment.
All speech-language pathology topics
Every SLP-related page on the site in one list.
Social communication disorder
ASHA on SCD and SLP roles.
Resonance disorders
ASHA on resonance disorders beyond cleft palate.
Dementia
ASHA on SLP cognitive-communication and swallowing roles.
Right hemisphere disorder
ASHA on communication after right-side brain injury.
Cerebral palsy
NINDS on physical, speech, and occupational therapy.
Written language disorders
ASHA on reading, writing, dyslexia, and SLP roles.
Spoken language disorders
ASHA on listening and speaking disorders in children.
Late language emergence
ASHA on late talkers ages 2 to 4.
Deaf and hard of hearing children
ASHA on SLP language and communication roles.
Charcot-Marie-Tooth disease
NINDS on PT, OT, braces, and splints.
Orofacial myofunctional disorders
ASHA on what SLPs evaluate and treat.
Pediatric traumatic brain injury
ASHA on SLP roles from hospital to school.
Scoliosis
NIAMS on bracing and physical therapy.
Fibromyalgia
NIAMS on exercise and physical therapists.
Juvenile idiopathic arthritis
NIAMS on PT, OT, and splints.
Knee replacement
MedlinePlus on PT before surgery and rehab after.
Developmental coordination disorder
MedlinePlus on motor problems and treatment.
Ehlers-Danlos syndrome
MedlinePlus on loose joints and physical therapy.
Gender affirming voice and communication
ASHA on the SLP’s role.
Head and neck cancer
ASHA on SLP communication and swallowing roles.
POTS
NINDS on standing, activity, and rehabilitation.
Frozen shoulder
MedlinePlus on daily physical therapy.
Colles wrist fracture
MedlinePlus aftercare on physical therapy.
Tracheostomy and ventilator dependence
ASHA on SLP communication and swallowing roles.
Inducible laryngeal obstruction
ASHA on the SLP’s role.
Refractory chronic cough
ASHA on the SLP’s role.
Executive function deficits
ASHA on the SLP’s role.
Intellectual disability
ASHA on SLP communication roles.
Accent modification
ASHA on SLP services for adults.
Tennis elbow
MedlinePlus on physical therapy and work setup.
Compare roles and settings
OT vs PT
Degree, accreditor, exam, licensure, and BLS figures side by side.
OT vs OTA
Therapist and assistant, as BLS and NBCOT describe them.
PT vs PTA
Therapist and assistant, as BLS, APTA, and CAPTE describe them.
Work settings
Where each role works, and median pay by setting, from BLS.
How long it takes
Official program lengths and exam timing for each role.
OT vs SLP
ACOTE vs CAA, NBCOT vs the national SLP exam, and BLS figures.
PT vs SLP
CAPTE vs CAA, NPTE vs the national SLP exam, and BLS figures.
SLP vs SLPA
ASHA’s CCC-SLP and C-SLPA requirements side by side.
Keep the license, and any national certification, current. National OT/OTA certification figures are on the directory and in Methodology & sources. Associations such as AOTA and APTA publish practice resources; they do not issue state licenses.