Exam Certification 

PART I: NBCOT National Certification Requirements

(National Credentialing – ACOTE B.4.5)

1. What does NBCOT stand for, and what credential do entry-level OTs earn upon passing the exam?

NBCOT stands for the National Board for Certification in Occupational Therapy. Upon completion of the exam, the associated credential is Registered Occupational Therapist (OTR) (NBCOT, 2025 p. 6).

2. List three eligibility requirements to sit for the NBCOT exam.

The three eligibility requirements needed to sit for the NBCOT exam are:

• Obtain an occupational therapy degree that meets current entry-level; 

• Agree to abide by the NBCOT Practice Standards & Code of Conduct; and

• Receive character review approval (NBCOT, 2025, p. 9).

3. How many questions are on the NBCOT OTR exam, and how much time is allotted?

There are 180 items on the NBCOT OTR exam to be completed within 4 hours (NBCOT, 2025, pp. 22, 28).

4. Is the NBCOT exam computer-based or paper-based?

The NBCOT exam is a computer-based administration via Pearson VUE (NBCOT, 2025, p. 7).

5. What is the passing score, and how is the exam scored?

A total score of at least 450 out of a scale from 300 to 600 is required to pass the OTR certification exam. The exam is criterion reference, meaning that only candidates who obtain a score equal or greater than the minimum score will pass the exam (NBCOT, n.d.-c).

6. How many times can a candidate retake the NBCOT exam, and what waiting period applies?

Candidates could retake the exam as many times as needed, however the waiting periods will be adjusted based on the number of retakes. For second or third attempts, candidates must wait 30 days from the date of last exam administration. For fourth through sixth attempts, candidates will wait 60 days from the date of last exam administration. For seven or more attempts, candidates must wait 6 months from the date of last exam administration (NBCOT, 2025, p. 32).

7. What documentation is required if a candidate requests testing accommodations?

To request testing accommodations, candidates must provide supporting documentation from qualified healthcare professionals licensed and/or certified to assess, diagnose, and treat the applicant’s relevant disability. Required info would include the healthcare professional’s contact info, licensure/certification info, the applicant’s disability diagnosis with the associated DSM code and date, the disability impact, and testing accommodation recommendations completed by the healthcare professional (NBCOT, n.d.-a).

PART II: State Licensure Requirements

(State-Level Legal Requirements – ACOTE B.4.5)

8. Identify the state licensing board responsible for occupational therapy licensure in your chosen state.

The Connecticut Department of Public Health’s Practitioner Licensing and Investigations Section is responsible for occupational licensure in Connecticut (Department of Public Health, n.d-a.). 

9. List three requirements for initial OT licensure in that state.

• Hold a baccalaureate degree in occupational therapy from a program accredited by the American Occupational Therapy Association;

• Satisfactorily completed at least 24 weeks of supervised fieldwork experience at a recognized educational institution or training program approved by the educational institution where the academic requirements were met; 

• Submission of documentation for the official occupational therapy education transcript, official report of NBCOT examination scores, and complete application (Department of Public Health, n.d.-a).

10. Does the state require:

• NBCOT certification? Yes.

• A jurisprudence exam? No.

• Background check or fingerprinting? Yes.

11. What is the initial licensure fee?

The initial licensure fee is $200.00 which covers the cost of eligibility determination and related administrative functions (Department of Public Health, n.d.-b).

12. How often must the OT license be renewed, and what is the renewal cycle?

 OT licensure is renewed biennially every two years ($205.00) ending on the last day of July (Department of Public Health, n.d.-b)..

Include the official state website.: Occupational Therapist Licensure

PART III: Federal & Legal Considerations

(Consistency with Federal & State Law – ACOTE B.4.5)

13. Is the NBCOT certification the same as state licensure? Explain the difference in 2–3 sentences.

NBCOT certification is different from state licensure in that the ability to practice occupational therapy is regulated by state licensure agencies whereas the certification is earned by passing the exam administered by the NBCOT (AOTA, n.d.). The NBCOT certification is a representation of practitioners' commitment to the profession, holding them to the highest standards of conduct, providing professional credibility, and providing a national standard for OT practice (NBCOT, n.d.-d).

14. What could happen legally and professionally if an individual practices OT without a valid license?

Individuals who do not maintain their license will not be able to legally practice occupational therapy (AOTA, n.d.). 

PART IV: Professional Responsibility & Maintenance

(Ongoing Credentialing Knowledge – ACOTE B.4.5)

16. How often must NBCOT certification be renewed, and what is required to maintain it?

NBCOT certification status should be renewed every 3 years between January and March annually regardless of the month indicated on the certificate's initial certification document. To renew, one must fulfill the requirement of 36 units, agree to the NBCOT certificant Attestation, complete the renewal application, and pay the associated fees (NBCOT, 2026, p. 10).

17. What is professional continuing education (CE), and why is it required for licensure?

Professional continuing education (CE) is continuous learning and training that professionals complete after initial certification to maintain and expand their skills and competence in the field that can range from workshops, seminars, and hands-on training. It is required for licensure to ensure the practitioner is up to date with the most current health trends and demonstrates continued competence for clients’ safety. CEs are necessary to maintain licensure as part of the renewal requirements (NBCOT, 2026, p. 6).

18. Identify two consequences of failing to maintain NBCOT certification or state licensure.

1. Loss of employment through suspension, termination, or being unhireable for employers that require a current NBCOT certification and active licensure.

2. Ineligibility to practice legally or result in disciplinary action, fines, or legal penalties.