NBCOT OTR Exam Requirements

To sit for the NBCOT OTR exam through the U.S. education pathway, you need an entry-level occupational therapy degree from an ACOTE-accredited OT program, you must agree to NBCOT's Code of Conduct, and you must pass NBCOT's character review. If your OT degree is from outside the U.S., NBCOT has to approve your education through its OTED review first. (NBCOT Certification Exam Handbook, p.10; NBCOT eligibility)

Find your situation

Use this to find your next step. NBCOT makes the actual eligibility decision.

Last verified November 4, 2026, against NBCOT's eligibility page, Certification Exam Handbook, Degree Verification Policy, Early Determination Review form, OTED FAQ, and fee schedule, and ACOTE's student FAQ.

The education requirement

For the U.S. education pathway, NBCOT requires OTR candidates to graduate with an entry-level OT degree from an ACOTE-accredited occupational therapy program. ACOTE is the Accreditation Council for Occupational Therapy Education, the body that accredits U.S. OT and OTA programs. (Handbook, p.10)

A master's is enough. Entry-level OT programs come at the master's and doctoral levels, and both lead to the OTR exam. ACOTE says there is no mandate moving OT education to the doctorate. (ACOTE student FAQ)

It has to be an OT program, not an OTA program. An occupational therapy assistant degree leads to the COTA exam. It does not by itself meet the OTR education requirement, and neither does an unrelated bachelor's or master's.

There's no separate postgraduation employment requirement for the standard U.S. route. NBCOT's OTR requirements are the degree, the Code of Conduct agreement, and character review approval. Required fieldwork is part of your education. For OTED, NBCOT assesses academic preparation; employment experience does not substitute for it. (Handbook, p.10; OTED FAQ)

Check your program's accreditation status

Your program's status is what matters, and the labels sound alike:

If a new program isn't accredited before its first class graduates, ACOTE says those students can't take the NBCOT exam unless they transfer to, and graduate from, an accredited program. (ACOTE student FAQ)

Check your OT program in ACOTE's directory

Proving your degree: final transcript or DVF

For first-time U.S. graduates, NBCOT accepts an official final transcript or a Degree Verification Form as academic evidence for testing. Either way, NBCOT needs the official final transcript before it will grant certification. If NBCOT has already approved you through OTED, you do not submit another transcript with the exam application. (Handbook, p.15)

Order matters. NBCOT's application page says to have your school send the transcript after you apply, and that sending documents before you apply will delay your application. Transcripts that arrive before you've even created a MyNBCOT account are destroyed after 30 days. (NBCOT apply page; Handbook, p.15)

Transcript checklist

Your official final transcript must show all of the following (Handbook, p.15):

• Your full name
• Your Social Security number or student ID number
• The name of the school awarding your OT degree
• Every course completed and required for the ACOTE-accredited entry-level degree
• Your major listed as "occupational therapy"
• The title of your entry-level degree
• The date the degree was awarded (conferred). The degree must actually have been awarded. A transcript showing a graduation date later than the date it was issued is rejected.
• The registrar's official seal, stamp, or signature

What NBCOT won't accept: a transcript marked "unofficial," a photocopy, or a letter from your school.

How it must arrive (Handbook, pp.15–16):

• Electronically, through a secure, verifiable transcript service or clearinghouse, sent to transcripts@nbcot.org. NBCOT does not accept transcripts emailed directly from a registrar's office.
• By mail, sent by USPS from your registrar's office to NBCOT, Inc., One Bank Street, Suite 300, Gaithersburg, MD 20878. The envelope must show the registrar's return address or have the registrar's stamp, initials, or "Transcripts Enclosed" on its back flap.

Plan for review time. NBCOT reviews transcripts in the order received, which can take up to 10 business days, longer in busy periods. Check your MyNBCOT account to see when it's been received. (NBCOT apply page)

Degree Verification Form (DVF)

The DVF exists for students who have met every degree requirement but won't get a final transcript right away because of their school's release schedule. For the standard DVF route, all of these must be true (NBCOT Degree Verification Policy, revised 11/17/2025):

• Your program allows it. Each program decides whether the DVF is appropriate for its students. Some don't process DVFs at all.
• You're completely done. All degree and graduation requirements are complete, including OT coursework, Level I and Level II fieldwork, and for OTD students, the doctoral capstone experience and project. The registrar also confirms you've met all financial requirements.
• The timing fits. Your registrar submits it within six months of your anticipated graduation date, and it can only be used in the same calendar year you graduate.
• You don't already have your final transcript. If you do, send that instead.

How it works: you apply for the exam, then request the DVF in MyNBCOT. It goes electronically to your program director, who completes their section and forwards it to the registrar. The registrar completes, signs, and seals it and sends it to NBCOT by USPS or email to transcripts@nbcot.org.

The catch: your exam result is not released until NBCOT receives and approves your official final transcript with your degree date and degree title. (NBCOT apply page)

Military provision: students in accredited military OT doctoral programs may request a DVF after completing all academic coursework, Level I fieldwork, and all Level II fieldwork. All other DVF rules still apply. (DVF policy, Military Provision)

Educated outside the U.S.: the OTED route

If you didn't earn your entry-level OT master's or doctorate from a U.S.-accredited college or university, you must apply for Occupational Therapist Eligibility Determination (OTED). OTED checks whether your education and fieldwork are comparable to current U.S. entry-level standards. (NBCOT eligibility)

Education that can be reviewed through OTED:

• An entry-level master's degree in occupational therapy, or
• A bachelor's in OT plus a post-professional master's or doctorate in OT, or
• A bachelor's in OT plus a master's in a related field. Email international@nbcot.org to confirm your related field qualifies. (OTED FAQ)

A post-graduate diploma in OT doesn't qualify, and a bachelor's in OT from another country doesn't make you eligible for the COTA exam either. (OTED FAQ)

Fieldwork: at least 960 hours, completed through your entry-level degree-granting institution at a minimum bachelor's level. Extra coursework may be needed to meet the standards. (NBCOT eligibility)

What NBCOT asks for: official final transcripts; course syllabi from when you took the courses; a Program Director Form; government recognition documentation and a Verification of Academic Credential Form if applicable; verification of every OT license, registration, or certification you've ever held, active or expired; and a Professional Practice History Form. Most of these must come straight from the school or agency. (NBCOT eligibility; OTED FAQ)

Know before you pay:

• The OTED fee is $850, and it isn't refunded once you've started the application. (NBCOT fees; OTED FAQ)
• Work experience does not substitute for the academic preparation assessed in OTED. A U.S. post-professional OT degree doesn't guarantee approval either. NBCOT reviews your combined education individually.
• Approval isn't an Authorization to Test. You get an OTED ID and then complete a separate OTR exam application in MyNBCOT.
• Approval lasts seven years. You must take and pass the exam in that window, or you'll need to go through OTED again.

Review NBCOT's OTED requirements · Read the OTED FAQ

The conduct requirements

Code of Conduct

You agree to the NBCOT Code of Conduct when you sign the exam application's attestation. In practice, that means (Handbook, pp.7–9):

• Answer the application and character questions truthfully. Dishonest answers are a violation in their own right.
• Follow exam security rules. Sharing exam content or NBCOT study-tool content, including through AI tools, social media, or forums, is prohibited.
• Once certified, report any criminal, legal, or disciplinary matter to NBCOT within 60 days.

Character review

All first-time applicants answer eight character questions on the application. They come in four pairs, each asking about the past and about anything currently pending (NBCOT character review; Handbook, p.13):

1. Felony guilty pleas or convictions, or a current felony charge
2. A professional license, registration, or certification that was surrendered, denied, revoked, suspended, or put on probation, or one under review now
3. A court, administrative, or disciplinary finding of negligence, malpractice, recklessness, or willful or intentional misconduct that harmed someone, or a current charge of it
4. A suspension or expulsion from a college or university, or an active investigation that could lead to one

Use the actual application questions to decide what you must disclose; this list is a summary.

NBCOT also runs a background check on all first-time applicants. It needs a real street address in your profile, not a P.O. box. (Handbook, p.12)

If you answer yes, upload a detailed written explanation: what happened, your involvement, and how it was discovered. If you've been on parole or probation at any point in the last seven years, include proof you complied with or completed the court's terms, such as a probation officer's letter. NBCOT reviews each case individually and tells you in writing whether you can sit for the exam. (Handbook, pp.13–14)

Answered yes by mistake? Change it while your application is still in "New" status. After that, email professional.conduct@nbcot.org.

Early Determination Review: get an answer before you apply

If you're a prospective or current OT student and a past event would make you answer yes to question 1a, 2a, 3a, or 4a, you can ask NBCOT for an Early Determination Review (EDR) before you apply, or even before you start school. It costs $225 and can't be canceled or refunded. (EDR request form, ID 24 rev052726; NBCOT EDR page)

To request one, email professional.conduct@nbcot.org for a secure upload link. You'll submit the signed request and background-check authorization forms, a detailed written explanation, official records of the allegations and findings, and court compliance documents if you were on parole or probation in the last seven years. Upload personal records through that secure link; do not email sensitive documents.

A favorable EDR doesn't let you skip the question later. You still answer yes on the exam application and go through a new background check. When reapplying about the same issue, with no further incidents, email professional.conduct@nbcot.org to confirm that. (Handbook, p.14)

Before you apply: the rules that can cost you

These are the application rules that can push your test date back or cost you money (Handbook, pp.10–11, 18–20, 36; NBCOT fees):

Fees tied to eligibility:

Testing accommodations: NBCOT provides accommodations under the ADA for eligible candidates with a documented disability. Request them in your exam application and upload at least one supporting document. Submit all documentation NBCOT requires for review. Requests can lengthen processing, so build in time. (NBCOT accommodations; Handbook, pp.12, 14–15)

Open NBCOT's exam application instructions

If something goes wrong

NBCOT says you're ineligible. You can appeal in writing to NBCOT's Board of Directors within 21 days of the notice. Send it by traceable mail (certified, UPS, or FedEx) and explain why your application should be accepted. For ineligibility based on a Code of Conduct violation, follow NBCOT's separate enforcement procedures. (Handbook, p.10)

The rules change before you test. If NBCOT changes eligibility requirements and you aren't certified yet, you have three years from the graduation date on your final transcript to test under the old rules. This only applies when rules change; it isn't a general deadline. (Handbook, p.10)

Passing the exam doesn't license you

NBCOT certification and a state license are separate. All 50 states, plus Washington, D.C., Puerto Rico, and Guam, require NBCOT initial certification for occupational therapy regulation such as licensing. But applying for the exam, or sending your score to a board, doesn't start a license application, and practicing without a required license or permit is illegal. (Handbook, pp.6, 17)

Two details that trip people up (Handbook, pp.16–18):

• NBCOT doesn't automatically send your score to a state board; order a Score Transfer if your board requires it. Hawaii doesn't accept them.
• An Eligibility Confirmation Notice tells a board or employer you're approved to test. These states don't accept it: Alabama, Arizona, Colorado, Hawaii, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, New Hampshire, North Carolina, South Carolina, Washington, and Wisconsin.

Check with your state board before ordering either one.

Find your occupational therapy licensing board

Official sources

All checked November 4, 2026.

Eligibility and accreditation

• NBCOT: Eligibility (U.S. and OTED)
• NBCOT Certification Exam Handbook, ID 40 rev092526 v26: eligibility and appeals (p.10), application (pp.11–13), character review (pp.13–14), academic documents and DVF (pp.15–16), reporting services (pp.16–18), ATT and scheduling (pp.18–20), accepted ID (pp.26–27)
• ACOTE: Student FAQ on program accreditation status · ACOTE school directory

Transcripts and DVF

• NBCOT: Apply for your exam
• NBCOT: Degree Verification Policy (revised 11/17/2025)

International applicants

• NBCOT: OTED FAQ

Conduct

• NBCOT: Character review
• NBCOT: Early Determination Review · EDR request form
• NBCOT: Procedures for Enforcement

Fees, accommodations, and licensing

• NBCOT: Fees
• NBCOT: Testing accommodations
• NBCOT: Exam-day identification requirements
• NBCOT: State licensing board contacts

By the Castleport Test Prep Editorial Team. We compiled this page from the official NBCOT and ACOTE sources listed above.

Castleport Test Prep is an independent exam prep publisher and is not affiliated with, endorsed by, or approved by the National Board for Certification in Occupational Therapy, Inc. (NBCOT) or ACOTE. Exam and credential names identify their subjects; trademarks belong to their respective owners. NBCOT makes all exam eligibility decisions, and your state board makes all licensing decisions.