Certified Hand Therapist (CHT): what the Hand Therapy Certification Commission requires

The Certified Hand Therapist (CHT) credential is awarded by the Hand Therapy Certification Commission (HTCC), a not-for-profit agency that certifies occupational therapists and physical therapists in upper limb rehabilitation. HTCC requires a current OT or PT credential to practice, at least three years as a licensed or certified OT or PT, and at least 4,000 hours of direct practice experience in hand therapy, then an exam. CHTs recertify every five years. HTCC calls the program voluntary; it is a certification, not a state license.

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.

Sources read on November 10, 2026: HTCC’s home page, overview, CHT credential, eligibility requirements, examination overview, and certification FAQ pages. HTCC publishes its fees, deadlines, and passing rates on its own site; they are not copied here.

Who HTCC certifies

HTCC’s overview states: “The Hand Therapy Certification Commission, Inc., (HTCC) incorporated in 1989, is a not-for-profit agency that provides a voluntary credentialing program to certify occupational therapists and physical therapists in the advanced clinical specialty of rehabilitation of the upper limb.” It also states: “The Hand Therapy Certification Commission (HTCC) was founded through the American Society of Hand Therapists (ASHT).”

HTCC’s home page defines the field: “Hand therapy is the art and science of rehabilitation of the upper limb, which includes the hand, wrist, elbow and shoulder girdle. It is a merging of occupational therapy and physical therapy theory and practice that combines comprehensive knowledge of the structure of the upper limb with function and activity.”

The credential page states: “CHTs are certified or licensed occupational therapists or physical therapists who, through advanced education, clinical experience, and independent study, have become proficient in the treatment of pathological upper limb conditions resulting from trauma, disease, or congenital or acquired deformity.” It also states: “Hand therapy certification is voluntary and difficult to attain.”

The CHT is HTCC’s own credential. It is not one of the ABPTS specialty areas on how to become a PT specialist or one of the AOTA Board Certifications on AOTA Advanced Certification, and the HTCC pages read for this site do not describe it as either.

Eligibility

HTCC’s eligibility page states: “You must be an occupational therapist or physical therapist with a current professional credential. Depending on your profession and where you practice, a professional credential may include a license, certificate, or registration. In all cases, it is the credential that you need to legally practice in that location. This credential must be active, and you must be in good standing with the agency that issued it.”

It states: “You must have been certified or licensed for a minimum of three years, based on date of issue of the certificate or license.” And: “Work under a temporary license cannot be included.” It also states: “You must have accrued a minimum of 4,000 hours of Direct Practice Experience in hand therapy as described below.” And: “Clinical hours obtained as an occupational therapy assistant, physical therapist assistant or with a temporary license cannot be submitted.”

HTCC defines the hours: “Direct Practice Experience is the direct provision of patient care through assessment and implementation of an individualized treatment plan including but not limited to orthotics/splinting, modalities and/or exercise/activities to prevent dysfunction, maximize functional recovery or influence the effect of pathology in the upper limb. It does not include time spent in administration, research, teaching or consultation.”

Assistants

HTCC’s FAQ states: “HTCC has been asked why there is not a certification examination for COTAs and PTAs and this is something we have considered and explored.” It suggests contacting AOTA or APTA about advanced practice certifications for assistants. APTA’s program for PTAs is on PTA Advanced Proficiency Pathways.

The exam and recertification

HTCC’s examination overview states: “The Hand Therapy Certification Examination (HTCE) is a four-hour computer-based test consisting of 200 multiple-choice items.” It states: “The exam is administered in the spring and the fall, each over a three-week window.” HTCC’s overview states: “Each CHT must recertify every five years by attesting to continued competency obtained through practice and participating in ongoing professional development.”

What this page does not do

It copies no fees, deadlines, passing rates, or salary figures, and it does not say whether any state, employer, or payer recognizes the credential. Confirm current rules with HTCC. A CHT does not replace a state OT or PT license.