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How to become an occupational therapy assistant

The official U.S. path is an ACOTE-accredited occupational therapy assistant program, the NBCOT COTA exam, and a license from the jurisdiction where you will practice. OTA and COTA are used together here because COTA is the NBCOT certification credential for occupational therapy assistants.

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: “COTA candidates must graduate with an entry-level occupational therapy degree from an ACOTE®-accredited occupational therapy assistant (OTA) program.” If you were educated in the United States, that page says you must have graduated from an ACOTE-accredited program.

    ACOTE’s U.S. school directory lists OTA programs at the associate and baccalaureate levels. On its students and public page, ACOTE states there is no mandate to move OTA programs to the baccalaureate-degree level: institutions can transition to the baccalaureate level, remain at the associate’s degree level, or offer both.

    That ACOTE page also states: “One must graduate from an ACOTE-accredited program to be eligible to take the NBCOT certification examination.” Check a program’s accreditation status in ACOTE’s directory, including whether it is fully accredited or still developing. This site does not publish a school list.

  2. Exam

    Apply for the NBCOT COTA certification exam. Start at Get Certified, read the exam handbook, and confirm eligibility. NBCOT states on Get Certified: “Certification is not the same as licensure.” Our NBCOT exam page walks through the official steps for OTR and COTA candidates.

  3. License

    NBCOT states that OTR and COTA professionals are also state-licensed professionals. Use the state and territory directory and confirm the assistant license or equivalent on the board site. Titles and supervision rules are set by the jurisdiction, not by this page.

  4. Compact

    The official OT Compact homepage describes the compact as facilitating interstate practice of occupational therapy and states that occupational therapists and occupational therapy assistants who are licensed in good standing in a compact member state will be eligible to practice in other member states via a privilege to practice, subject to the compact’s official rules.

    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.

How COTA work is described

NBCOT’s What is an OTR or COTA professional? page states that the OTR and COTA professionals work collaboratively, and that the COTA professional implements and documents the therapeutic interventions and provides feedback to the OTR professional on the client’s progress during treatment. Only people who maintain Active in Good Standing status with NBCOT can use the COTA credential.

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