Find your state licensure answers

Occupational therapy is a regulated health care profession in all 50 states, plus Washington, DC, Puerto Rico, and Guam. This means that these jurisdictions have passed a law requiring that occupational therapists and occupational therapy assistants hold a license before being allowed to provide occupational therapy services. In order to obtain a license, you must meet certain requirements that are intended to show that you have obtained a certain level of knowledge, experience, and competency so that you will provide high-quality services in a safe manner.

Explore the steps to obtaining a state license.

The National Board for Certification in Occupational Therapy (NBCOT) administers the national certification exam for occupational therapists and occupational therapy assistants. Learn more about certification requirements by visiting NBCOT's website. State licensure laws establish requirements that must be met before someone can obtain a license and practice their profession. Initial certification with NBCOT is one of the core licensure requirements in the occupational therapy profession.

No. AOTA is the nationwide professional association in the United States for occupational therapy, but we have no authority to issue a license or certification. However, we do offer continuing education, certifications in certain practice areas, networking and leadership opportunities, and support of the profession at the state and federal level, all intended to preserve and promote access to occupational therapy services. We support the state regulation of occupational therapy through state licensure laws.

In most cases, no. You can apply for a license at anytime. However, you will not be issued a license unless you meet all of the requirements established in law or regulation by the state or jurisdiction in which you are applying. Some states have requirements for those that do not become licensed after completing their education and passing the exam.

No. Most state licenses must be renewed every two years. Renewal requirements vary from state to state. It is your responsibility to know what you must do to renew your license. If you fail to renew your license, you cannot work as an occupational therapy practitioner and can get in a lot of trouble if you continue working without a license.

Renewal requirements vary from state to state. Generally, you must fill out a renewal application form, pay a fee, and complete a certain amount of continuing education or continuing competency activities.

Continuing education or continuing competency refers to a set of activities that you must undertake or complete to renew your license. The intent of these activities is to stay current on changes in the occupational therapy profession, enhance your own professional practice, and demonstrate your clinical knowledge and competency. Activities may include volunteering occupational therapy services, conducting occupational therapy research, mentoring another practitioner or supervising fieldwork or doctoral students, or editing occupational therapy journal articles. Each state has its own list of acceptable continuing education or continuing competency activities.

Initial application fees vary from state to state.

All 50 states and the District of Columbia have the same core licensure requirements. Applicants need to graduate from an accredited occupational therapy program, complete a course of supervised fieldwork and pass the NBCOT entry-level certification exam. Internationally trained candidates need to graduate from an occupational therapy education program (including supervised fieldwork) that is deemed comparable to an ACOTE-Accredited program and pass the NBCOT exam.

The National Board for Certification in Occupational Therapy (NBCOT) administers the OTR© certification exam. Internationally trained candidates that did not graduate from an ACOTE Accredited program must apply for the Occupational Therapist Eligibility Determination (OTED^®) process administered by NBCOT. That process determines if the candidate’s education and fieldwork experience is comparable to education programs in the United States. Not everyone is eligible for the OTED process. To see if you are eligible, visit NBCOT’s website.

Once your degree and experience is deemed comparable, you would be eligible to sit for the certification exam. Passing the NBCOT examination would then allow you to apply for state licensure. See this page for additional information how to obtain a license.

As stated above, all 50 states and the District of Columbia have the same core licensure requirements. Applicants need to graduate from an accredited occupational therapy program, complete a course of supervised fieldwork, and pass the NBCOT entry-level certification exam. To obtain a license as an occupational therapy assistant in the United States, you must graduate from an ACOTE-accredited occupational therapy program with an associate’s degree or a bachelor’s degree. Then you may apply to NBCOT to be deemed eligible to sit for the certification exam.

State requirements vary, but generally you must be licensed in the state where your patient or client is located. This may involve obtaining a full license in the client’s or patient’s state of residence; some states require a certification, rather than a full license. AOTA maintains a chart of state laws and regulations related to telehealth. For additional information, contact the state licensing agency in the state where your client or patient is located.

It is also important to note that insurance providers and health care facilities may have their own specific requirements in addition to state licensing agency requirements. You should consult with these entities before providing services virtually to ensure full compliance and that you are acting in the best interest of your patients. If you have additional questions, please contact us at State@aota.org.

You must be licensed in the state where your client or patient lives. If your client or patient leaves their home state, even temporarily, and travels to another state, you must obtain a license in that state to provide services virtually to your client or patient. Some states have temporary licenses or permits available.

Contact AOTA State Affairs staff at State@aota.org.