How to Become an Occupational Therapy Assistant

Key points

• The route is an ACOTE-accredited OTA program, fieldwork, the NBCOT exam for the COTA credential, and a state license where required.
• BLS states that OTAs typically need an associate’s degree; some bachelor’s-level OTA programs exist.
• An OTA program is not an OT program, and a certificate or aide course is not NBCOT certification.
• A degree alone does not grant a license. Check your state board.

What an OTA does

NBCOT describes the COTA professional as the one who implements and documents the therapeutic interventions, working with an OTR who evaluates the client and plans treatment. See OT vs OTA vs aide.

Step 1: Choose an accredited OTA program

NBCOT states that COTA candidates need an entry-level degree from an ACOTE-accredited occupational therapy assistant program. BLS states that OTAs typically need an associate’s degree from an accredited program, though some bachelor’s programs exist, and that associate’s programs take about two years full-time.

ACOTE’s school directory lists OTA associate and OTA baccalaureate programs separately. ACOTE’s public guidance states that there is no mandate regarding the degree level for OTA education, and that institutions may offer an associate’s degree, a bachelor’s degree or both. Browse OTA programs and filter by award, because the label matters: an OTA associate degree and an OTA bachelor’s degree are different programs.

Prerequisites vary by school. Many community colleges ask for specific science or general-education courses, and some use their own application instead of OTCAS, which is mainly used for OT programs. Check each school’s admissions page.

Step 2: Complete coursework and fieldwork

BLS states that OTA coursework includes anatomy, psychology and kinesiology, and that OTAs must complete several months of fieldwork to gain hands-on work experience. Fieldwork takes place in person. Some OTA programs deliver part of the coursework online or in a hybrid format, but that does not replace labs or fieldwork. See online coursework and in-person fieldwork and online programs.

Step 3: Sit the NBCOT exam

BLS states that OTAs must pass an exam to use the title Certified Occupational Therapy Assistant (COTA). The exam is run by NBCOT, and you must have graduated from an accredited program to be eligible. Admission to a program does not guarantee that you will be eligible for certification, because eligibility depends on graduating and meeting NBCOT’s requirements at the time. Read NBCOT certification and state licensure.

Step 4: Apply for a state license

BLS states that OTAs usually need a state-issued license, which requires an accredited program, fieldwork and passing an exam, and that some states also require a background check. Licensure is state-specific; the state board is the authority. Passing the NBCOT exam is not the same as being licensed, and NBCOT says so directly: certification is not licensure.

Aides and short courses

BLS states that occupational therapy aides typically need a high school diploma or equivalent and on-the-job training, and that aides are typically not regulated by state law. Aide training does not qualify someone for the OTA exam. A certificate in an unaccredited program is not a route to COTA. See certificates vs professional certification and our certificates page.

Going on to become an OT

An OTA who later wants to become an occupational therapist usually has to apply to an OT program. Whether OTA credits transfer is decided by each school. Some institutions offer bridge programs; confirm the details and the accreditation status with the program. See how to become an OT.

Checklist before you enrol

• Is the specific OTA program on ACOTE’s accredited list at the level you are applying for? See understanding ACOTE accreditation.
• What are the prerequisites, and is there a waitlist?
• How does the program arrange fieldwork, and do you have to travel?
• What is the total cost? See tuition and funding.
• What does your state board require, including any background check?

Limits of this guide

We do not state pass rates, wages or job numbers here. For official employment figures, read the BLS pages directly, and note the year printed on the page.

Sources

Checked 2026-11-03.

• BLS, Occupational Therapy Assistants and Aides: https://www.bls.gov/ooh/healthcare/occupational-therapy-assistants-and-aides.htm
• NBCOT, eligibility: https://www.nbcot.org/get-certified/eligibility
• NBCOT, what is an OTR or COTA professional: https://www.nbcot.org/occupational-therapy/what-is-an-otr-or-cota
• ACOTE, students and the public: https://acoteonline.org/students-public/