Occupational Therapy Exam Guide

By Andrea Cohen, Tests.com Contributing Writer

The National Board for Certification in Occupational Therapy (NBCOT) is the only recognized organization that provides certification for all occupational therapists and occupational therapy assistants within the United States. There are two certification credentials available – the Occupational Therapist Registered (OTR) or the Certified Occupational Therapy Assistant (COTA). Certification exams are required for both credentials, as well as other educational and fieldwork requirements that must be met. The OTR and COTA exams are designed to assess the knowledge and skills required for entry level practice in the field of occupational therapy. Passing the exams does not constitute state licensing, but is one aspect of receiving a state license to practice within the field of occupational therapy.

OTR and COTA Requirements

Candidates for OTR certification must graduate from an NBCOT-accredited occupational therapy education program at the post-baccalaureate degree level. COTA candidates must graduate from an accredited occupational therapy education program at the associate or technical degree level. Candidates must also complete a clinical fieldwork requirement and then take and pass either the OTR or COTA certification exams.

Initial NBCOT certification after passing the OTR or COTA exams is valid for three years. Candidates must renew their certification and in order to be renewed must acquire 36 professional development units (PDU) between their initial certification and renewal date, complete a renewal application and pay a fee.

Each state has its own licensing requirements and passing the OTR or COTA exams is just one aspect of that requirement. It is up to candidates to obtain a state license prior to working as an occupational therapist or occupational therapy assistant. Passing the OTR or COTA exams does not in and of itself constitute state licensure.

OTR and COTA Exams

Both exams are computerized. The OTR exam includes a simulation test as well as a multiple choice test with 170 items. The COTA exam includes only multiple choice questions and there are 200 items on the test. There is a four hour time limit for each exam.

OTR and COTA certification exams are administered by Prometric, a third-party testing center. They have locations all throughout the United States and worldwide. Tests can be scheduled at the location and at a time that is most convenient to the testing candidate.

Candidates register directly with NBCOT to take the exam and can do so either online, by mail or by fax. Candidates should not apply to take the exam until they have graduated or have been cleared for graduation. Candidates must have schools submit official transcripts or an NBCOT Academic Credential Verification Form (ACVF) to determine eligibility to test. If candidates received their education from a school outside of the United States or from a non-NBCOT recognized program, additional documentation must be submitted and approved prior to taking the exams.

Once registration is approved by NBCOT, candidates will receive an Authorization to Test (ATT) letter by email or mail. The candidate can then contact Prometric, a third-party testing center, directly to schedule a location and time to take the exam. ATT letters are valid for 90 days and can be reactivated, if necessary, for a fee if the candidate does not take the exam within that time frame. ATT letters can be reactivated as many times as necessary during the one year that exam applications are valid (one year from date of submission).

Exam fees for both OTR and COTA are $500 each. Any score reports that must be sent are an additional $40 each.

Candidates must bring three valid and current forms of identification. They all must match the name of the ATT letter exactly and have visible signatures. At least one must be a government issued ID (like a drivers license).

OTR and COTA Exam Scores

Scoring is done by converting total raw scores (how many questions were correct) into a scaled score with the scale ranging from 300 to 600 points. This is done to insure uniformity and fairness among different testing forms. The minimum passing score is 450 points, and this is an absolute standard and not dependent on what other candidates score on the exam. Scores take approximately four weeks to receive. Official scores can be sent to state regulatory boards with a request to transfer form. There is a fee for each score report sent.

Interested in becoming an Occupational Therapist Registered (OTR) or Certified Occupational Therapy Assistant (COTA)? Check out our Occupational Therapy Test Directory for information about OTR and COTA Exams and test preparation services.