The federal health care worker certificate for internationally educated OTs, PTs, and SLPs
A federal regulation, 8 CFR 212.15, requires a health care worker certificate from an approved credentialing organization before a person can be admitted to the United States, or change, extend, or adjust status, to work as an occupational therapist, physical therapist, or speech-language pathologist, among other occupations. The certificate checks education, license, English, and exam results, and must be used within five years. It is not a license or a visa. This page quotes the regulation and USCIS and copies no fees. Audiology careers are not covered on this site.
Quoted from official pages checked November 12, 2026. Confirm current requirements, fees, and dates on those sites. This page is not legal advice and does not guarantee eligibility, certification, or licensure.
Sources read on November 12, 2026: 8 CFR 212.15, Certificates for foreign health care workers on eCFR (displayed as up to date as of 11/09/2026) and USCIS’s Health Care Worker Certification page (last reviewed/updated 06/29/2026). National exam and education routes are on internationally educated pathways and internationally educated SLPs.
Who needs it
The regulation’s covered occupations paragraph “applies to any alien seeking admission to the United States to perform labor in one of the following health care occupations, regardless of where he or she received his or her education or training:”. Its list includes “Occupational Therapists.”, “Physical Therapists.”, and “Speech Language Pathologists and Audiologists.” It also lists nurses, medical technologists and technicians, and physician assistants. The covered-occupations list does not name assistant occupations such as OTA, PTA, or SLPA; ask USCIS or a credentialing organization whether a certificate applies to you.
USCIS says workers in an affected occupation must present a valid certification each time they seek admission, change status, extend status, or adjust status, and states: “The certification requirement is no longer applicable once the worker is a lawful permanent resident.”
Who issues it
The regulation states: “The Commission on Graduates of Foreign Nursing Schools (CGFNS) is authorized to issue certificates under section 212(a)(5)(C) of the Act for nurses, physical therapists, occupational therapists, speech-language pathologists and audiologists, medical technologists (also known as clinical laboratory scientists), medical technicians (also known as clinical laboratory technicians), and physician assistants.”
For OT and PT it states: “The National Board for Certification in Occupational Therapy (NBCOT) is authorized to issue certificates in the field of occupational therapy pending final adjudication of its credentialing status under this part.” And: “The Foreign Credentialing Commission on Physical Therapy (FCCPT) is authorized to issue certificates in the field of physical therapy pending final adjudication of its credentialing status under this part.”
USCIS’s page words it without the pending language: “The National Board for Certification in Occupational Therapy (NBCOT) is authorized to issue certifications for occupational therapists.” And: “The Foreign Credentialing Commission on Physical Therapy (FCCPT) is authorized to issue certifications for physical therapists.” FSBPT’s page, quoted on internationally educated pathways, names TruMerit, formerly CGFNS. These wordings are shown side by side.
What the certificate verifies
The regulation requires verification “That the alien's education, training, license, and experience are comparable with that required for an American health care worker of the same type;” and “Either that the alien has passed a test predicting success on the occupation's licensing or certification examination, provided such a test is recognized by a majority of states licensing the occupation for which the certification is issued, or that the alien has passed the occupation's licensing or certification examination.”
USCIS adds: “USCIS does not accept a health care worker certification as the sole evidence that the foreign worker has met the minimum requirement for the given position and is, therefore, eligible for the requested visa classification.”
English requirements
The regulation states that “every alien must meet certain English language requirements in order to obtain a certificate.” Exempt are “Aliens who have graduated from a college, university, or professional training school located in Australia, Canada (except Quebec), Ireland, New Zealand, the United Kingdom, or the United States.”
For OT and PT: “An alien seeking to perform labor in the United States as an occupational or physical therapist must obtain the following scores on the English tests administered by ETS: Test Of English as a Foreign Language (TOEFL): Paper-Based 560, Computer-Based 220; Test of Written English (TWE): 4.5; Test of Spoken English (TSE): 50.” And: “The certifying organizations shall not accept the results of the TOEIC, or the IELTS for the occupation of occupational therapy or physical therapy.”
The score paragraphs do not name speech-language pathologists; they set scores for occupational and physical therapists, for nurses and other occupations requiring a baccalaureate degree, and for occupations requiring less than one. Ask the certifying organization which scores and which current tests it accepts for your occupation.
How long it lasts
The regulation states: “The individual's certification or certified statement must be used for any admission into the United States, change of status within the United States, or adjustment of status within 5 years of the date that it is issued.” USCIS adds: “For this reason, the certification is only valid for five years.”
What this page does not do
It does not copy fees, does not cover audiology careers, and does not say whether anyone qualifies for a certificate or a visa. Immigration questions belong with USCIS or an immigration attorney. It is not legal, medical, billing, or immigration advice. Confirm current rules with the agency or organization that publishes them, your employer, and your state board.