An OT license is a new license, not an upgrade. After an ACOTE-accredited OT program, you pass the NBCOT OTR exam and apply to the board for a separate OT license. NBCOT lets your COTA stay active alongside the OTR, renewing together, and OTA practice hours generally do not count toward OT-only credentials.
An OT license is a new license, not an upgrade of your OTA license. When an OTA finishes an OT program, the path runs: graduate from an ACOTE-accredited OT program, pass the NBCOT OTR exam, then apply to the state board for an OT license. Your years of practice as an OTA do not shortcut those steps, and your OTA license stays a separate license until you or the board does something with it.
Which exam do you take?
The NBCOT OTR exam. NBCOT's eligibility page says OTR candidates "must graduate with an entry-level occupational therapy degree from an ACOTE-accredited occupational therapy (OT) program." Your COTA credential does not substitute for any part of it. The initial exam application is $540 online, per NBCOT's fee schedule.
What happens to your COTA certification?
It can stay active. NBCOT's dual certification policy says a certificant "may have active certification for both the OTR and COTA credentials at the same time," and that when a COTA earns the OTR, the COTA "will remain Active in Good Standing" with its expiration date moved to match the OTR's. From then on the two renew together: meet the renewal requirements and both update; miss them and "both credentials will expire." The policy also says "all Disciplinary actions will be reported on both credentials." Most states do not require active NBCOT certification for licensure, so whether to keep renewing is usually your call. See NBCOT renewal and state license renewal.
Is the OT license application different for a former OTA?
In structure, no; in detail, sometimes. Boards issue OT and OTA licenses as separate license types with separate fees. Tennessee's fee rule, for example, lists a $100 application fee for OTs and $75 for OTAs (Tenn. Comp. R. & Regs. 1150-02-.06), and New York's licensure fees are $294 for OTs and $147 for OTAs, with different minimum ages (21 and 18). You file an OT application with your OT transcript and an NBCOT OTR score transfer.
Two things are different for you. First, the board will see your OTA license history, so list it and expect a verification, including any discipline. Second, the right application type is not always obvious. Texas, for example, routes applicants who have passed NBCOT and are "currently licensed as an occupational therapist or occupational therapy assistant in another state" to endorsement rather than the exam route (40 Tex. Admin. Code § 364.1(c)), while other boards treat a new OT as a first-time applicant. Ask the board which application to file before you pay a non-refundable fee. See your first OT license as a new graduate.
Can you work as an OT while waiting on the exam?
Only where the state offers a permit for new graduates, and only on its terms. California issues limited permits to recent graduates waiting to take the national exam, if they applied to NBCOT within four months of finishing their education and fieldwork; the permit lasts three months, ends on a failing score, and requires supervision. Until you hold an OT license or permit, you practice as an OTA, under your OTA license and its supervision rules. See temporary and limited OT licenses.
Which OTA hours count toward OT-only credentials?
Often none. HTCC's eligibility rules for the Certified Hand Therapist credential say clinical hours "obtained as an occupational therapy assistant" cannot be submitted, so the 4,000 hours start from your OT license. State rules that limit certain work to OTs, such as Tennessee's dry needling rule, which says it "may not be delegated to an occupational therapy assistant," also start counting from the OT license. See licensing questions for hand therapists.
Should you keep your OTA license?
Ask the board how it handles someone who holds both, and how it wants the OTA license closed out, before you let it go. If you let it lapse rather than retiring or surrendering it in the way the board prefers, it shows up as an expired license on future applications. If you hold OTA privileges under the OT Compact, remember that each privilege depends on your home-state license; once you are an OT, you will need OT privileges for OT work.
How do we help bridge graduates?
We file your first OT license as a Full State License Application ($749), coordinate the NBCOT score transfer and verifications of your OTA history, and help you close out or keep the OTA license cleanly. State and NBCOT fees are separate. Each state's requirements are in the license index.
Common questions
- Does my OTA license convert to an OT license?
- No. Boards issue OT and OTA licenses separately. You apply for a separate OT license after passing the NBCOT OTR exam.
- Can I keep my COTA after I pass the OTR?
- Yes. NBCOT's dual certification policy keeps both active, aligns the COTA's expiration with the OTR, and renews them together. Discipline is reported on both.
- Do I apply for my first OT license by endorsement or as a new applicant?
- It depends on the state. Texas routes applicants who passed NBCOT and hold an OT or OTA license elsewhere to endorsement; other boards treat a new OT as a first-time applicant. Ask before paying.
- Do my OTA hours count toward the CHT?
- No. HTCC says hours obtained as an OTA cannot be submitted toward the 4,000 hours of hand therapy practice it requires.
Need Help with Your Application?
We handle the OT licensing process end-to-end — eligibility screening, documents, board follow-ups, and tracking.