To practice occupational therapy you need three things: a degree from an ACOTE-accredited program, a passing score on the NBCOT certification exam, and a license from the state where you will work.
1. Graduate from an ACOTE-accredited program
The Accreditation Council for Occupational Therapy Education (ACOTE) accredits entry-level OT programs (master’s and OTD) and OTA programs (associate and bachelor’s). Only graduates of accredited programs can sit for the NBCOT exam, which is why every program on this site comes from ACOTE’s directory. Programs include supervised Level II fieldwork: at least 24 weeks full-time for OT students and at least 16 weeks for OTA students.
Find an accredited OT program · Find an accredited OTA program
2. Pass the NBCOT exam
The National Board for Certification in Occupational Therapy (NBCOT) runs the national certification exam. OT graduates who pass earn the OTR credential; OTA graduates earn COTA. NBCOT also publishes each school’s new-graduate pass rates on its school performance page; we compare them for every program in NBCOT pass rates by school.
Need to check someone’s license? OT license lookup for every state →
3. Apply for a state license
Each state’s occupational therapy board (or the agency that regulates OT) issues licenses. Requirements usually include proof of graduation, your NBCOT result, a fee, and sometimes a background check or a state jurisprudence (law) exam. Some states offer a temporary or limited permit while you wait for exam results. Apply to the board in the state where you plan to work, and check its current rules on the board’s official site.
4. Keep your license and certification current
States require license renewal, usually with continuing-education hours. NBCOT certification renewal is separate from state licensure; whether you need to keep NBCOT certification active depends on your state and employer.
OT Licensure Compact
The Compact Commission lists 36 member states. A member state’s licensees can apply for privileges only once both their home state and the destination state are issuing. States issuing privileges as of October 5, 2026: Arkansas, Indiana, Maryland, Minnesota, Mississippi, Ohio, Tennessee, Virginia, West Virginia, Wisconsin. See the OT Compact map, fees and how to apply.
Licensing board and compact status by state
| State | Licensing agency | OT Compact |
|---|---|---|
| Alabama | Alabama State Board of Occupational Therapy | Member, not yet issuing |
| Alaska | Alaska Board of Physical Therapy and Occupational Therapy (Division of Corporations, Business and Professional Licensing) | Member, not yet issuing |
| Arizona | Arizona Board of Occupational Therapy Examiners | Member, not yet issuing |
| Arkansas | Arkansas State Medical Board | Issuing since October 5, 2026 |
| California | California Board of Occupational Therapy | Not a member |
| Colorado | Colorado Office of Occupational Therapy (Department of Regulatory Agencies, Division of Professions and Occupations) | Member, not yet issuing |
| Connecticut | Connecticut Department of Public Health, OT Licensure | Not a member |
| Delaware | Delaware State Board of Occupational Therapy (Division of Professional Regulation) | Member, not yet issuing |
| District of Columbia | D.C. Department of Health, Health Professional Licensing Administration (Allied and Behavioral Health Boards) | Not a member |
| Florida | Florida Board of Occupational Therapy Practice (Florida Department of Health) | Not a member |
| Georgia | Georgia State Board of Occupational Therapy (Office of Secretary of State) | Member, not yet issuing |
| Hawaii | Hawaii Occupational Therapy Program (Professional and Vocational Licensing) | Not a member |
| Idaho | Idaho Division of Occupational and Professional Licenses, Health Professions Bureau | Not a member |
| Illinois | Illinois Department of Financial and Professional Regulation | Not a member |
| Indiana | Indiana Occupational Therapy Committee (Professional Licensing Agency) | Issuing since March 9, 2026 |
| Iowa | Iowa Board of Physical and Occupational Therapy | Member, not yet issuing |
| Kansas | Kansas State Board of Healing Arts (OT Advisory Council) | Member, not yet issuing |
| Kentucky | Kentucky Board of Licensure for Occupational Therapy | Member, not yet issuing |
| Louisiana | Louisiana State Board of Medical Examiners | Member, not yet issuing |
| Maine | Maine Board of Occupational Therapy Practice (Office of Professional & Occupational Regulation) | Member, not yet issuing |
| Maryland | Maryland Board of Occupational Therapy Practice | Issuing since April 15, 2026 |
| Massachusetts | Massachusetts Board of Allied Health Professionals (Division of Occupational Licensure) | Not a member |
| Michigan | Michigan Bureau of Professional Licensing (Department of Licensing and Regulatory Affairs) | Member, not yet issuing |
| Minnesota | Minnesota Board of Occupational Therapy Practice | Issuing since January 12, 2026 |
| Mississippi | Mississippi State Department of Health, Bureau of Professional Licensure | Issuing since October 5, 2026 |
| Missouri | Missouri Board of Occupational Therapy | Member, not yet issuing |
| Montana | Montana Board of Physical, Rehabilitative, and Developmental Health Care Professionals | Member, not yet issuing |
| Nebraska | Nebraska DHHS Licensure Unit, Office of Rehabilitation & Community Services | Member, not yet issuing |
| Nevada | Nevada State Board of Occupational Therapy | Not a member |
| New Hampshire | New Hampshire Office of Professional Licensure and Certification (Occupational Therapy Governing Board) | Member, not yet issuing |
| New Jersey | New Jersey Occupational Therapy Advisory Council (Division of Consumer Affairs) | Not a member |
| New Mexico | New Mexico Board of Examiners for Occupational Therapy (Regulation and Licensing Department) | Not a member |
| New York | New York State Education Department, Office of the Professions (State Board for Occupational Therapy) | Not a member |
| North Carolina | North Carolina Board of Occupational Therapy | Member, not yet issuing |
| North Dakota | North Dakota State Board of Occupational Therapy Practice | Member, not yet issuing |
| Ohio | Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board | Issuing since January 12, 2026 |
| Oklahoma | Oklahoma State Board of Medical Licensure & Supervision | Member, not yet issuing |
| Oregon | Oregon Occupational Therapy Licensing Board | Not a member |
| Pennsylvania | Pennsylvania State Board of Occupational Therapy Education and Licensure | Not a member |
| Puerto Rico | Puerto Rico Office of Regulation and Certification of Health Professionals | Not a member |
| Rhode Island | Rhode Island Board of Occupational Therapy (Department of Health) | Member, not yet issuing |
| South Carolina | South Carolina Occupational Therapy Board (Department of Labor, Licensing and Regulation) | Member, not yet issuing |
| South Dakota | South Dakota Board of Medical & Osteopathic Examiners | Member, not yet issuing |
| Tennessee | Tennessee Board of Occupational Therapy (Department of Health) | Issuing since May 20, 2026 |
| Texas | Texas Board of Occupational Therapy Examiners (Executive Council of Physical Therapy and Occupational Therapy Examiners) | Not a member |
| Utah | Utah Division of Professional Licensing | Member, not yet issuing |
| Vermont | Vermont Office of Professional Regulation (Occupational Therapy Advisory Board) | Member, not yet issuing |
| Virginia | Virginia Board of Medicine (Department of Health Professions) | Issuing since March 20, 2026 |
| Washington | Washington Occupational Therapy Practice Board (Department of Health) | Member, not yet issuing |
| West Virginia | West Virginia Board of Occupational Therapy | Issuing since January 12, 2026 |
| Wisconsin | Wisconsin Department of Safety and Professional Services (Occupational Therapists Affiliated Credentialing Board) | Issuing since May 29, 2026 |
| Wyoming | Wyoming Board of Occupational Therapy | Member, not yet issuing |
Agencies from NBCOT’s regulatory body contact list (rev. July 2026); compact status from otcompact.gov (updated October 5, 2026).