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Occupational Therapy Assistant
Total cost: $726 - $819
Governing Authority
Department of Commerce and Consumer Affairs – Professional and Vocational Licensing Division, Occupational Therapy Program
Official website →Some details on this page are not yet confirmed against an official source. See sources below or contact the licensing board to verify.
OTA
Credential
Required
NBCOT Exam
Required
Supervision
Not specifically limited by statute
Supervision Ratio
0 hrs
CE Hours
$726 - $819
Total Initial Fees
ACOTE-Accredited Education
VerifiedDegree Required
Associate's degree from ACOTE-accredited OTA program
ACOTE Accredited
Required
Program Length
2 years (Associate's degree)
Fieldwork Requirement
Level II fieldwork - minimum 16 weeks
Accepted Alternatives
OTAs must graduate from an ACOTE-accredited (Accreditation Council for Occupational Therapy Education) associate’s degree program that includes Level II fieldwork. Some states may accept foreign-educated applicants who meet equivalent standards.
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National Certification Exam
VerifiedRequired
NBCOT COTA Exam
Administered By
National Board for Certification in Occupational Therapy (NBCOT)
190
Questions
4 hrs
Time Limit
Scaled score of 450 or higher
Passing Score
$540
Exam Fee
Format: Computer-based; 190 questions (multiple-choice + multi-select); 4 hours. Scoring: scaled 300-600, pass = 450. Provider: Pearson VUE.
The NBCOT (National Board for Certification in Occupational Therapy) COTA exam is the national certification examination for occupational therapy assistants. Most states require passing this exam for initial licensure.
Overall licensing difficulty: 10/100
Study recommendation: 1–2 weeks of focused review is usually sufficient
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Difficulty rating based on education, exam, and experience requirements. Individual experience may vary.
Study guides for the NBCOT COTA certification exam.
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OTR/L Supervision
VerifiedSupervision by OTR/L Required
Supervisor Credential
Hawaii Certified Occupational Therapist
Supervision Ratio
Not specifically limited by statute
Supervision Type
General supervision; temporary permit holders require direct supervision
Initial Supervision Period
Temporary permit holders must practice under direct supervision of a Hawaii certified OT
Ongoing Requirements
Periodic supervision meetings with supervising OT required
OTAs must practice under the supervision of a licensed and registered occupational therapist (OTR/L). Supervision ratios, types (direct, general, routine), and frequency requirements vary by state.
OTA Practice Scope
Mostly verifiedPermitted Activities
Restricted Activities (OTR/L Only)
Supervision Level for Tasks
Routine tasks under general supervision; complex or new interventions require direct supervision
OTAs implement treatment plans under OTR/L supervision. They may perform treatment implementation, documentation, and patient education, but evaluation, treatment planning, and discharge planning are typically reserved for the supervising OTR/L.
| Fee | Amount |
|---|---|
Application Fee $279 if license issued in odd-numbered year; $186 if issued in even-numbered year | $186 - $279 |
NBCOT Exam Fee Paid directly to NBCOT | $540 |
License Fee | Included in application fee |
Renewal Fee Biennial renewal | $186.00 (OTA – active status) |
NBCOT Renewal Fee Online renewal every 3 years to maintain NBCOT certification | $65 |
Total Initial Fees Includes application/license fee ($186-$279) and NBCOT exam ($540) | $726 - $819 |
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Renewal & CE Requirements
Mostly verified2 years (expires on odd-numbered years)
Renewal Period
0 hrs
CE Hours Required
Yes
NBCOT Renewal
CE Topics
Renewal Fee
$85
Biennial renewal by December 31 of even-numbered years
Regulatory Board
OTA licenses must be renewed on schedule. Most states require continuing education covering occupational therapy practice, ethics, and specialized topics. Some states also require maintaining NBCOT certification.
Out-of-State Reciprocity
VerifiedAccepts Out-of-State Credentials
OT Compact Member
No
Endorsement Available
Yes
Compact Details
OT Compact is ACTIVE and partially operational. Covers both OTs and OTAs. Live states accepting applications as of early 2026: IN (Mar 9, 2026), MN, OH, WV (Jan 12, 2026). Apply through otcompact.gov (not state boards).
Reciprocity Type
Endorsement
Additional Requirements for Transfer
The Occupational Therapy Licensure Compact (OT Compact) allows OTAs to practice across member states with a compact privilege. Non-compact states may accept out-of-state credentials through endorsement or require a full application.
Moving to another state? Use our Transfer Tool to see what you need →
Compare Hawaii with other states →
See how requirements, costs, and timelines differ across all 50 states.
Hawaii's license fees uniquely vary depending on whether the license is issued in an odd-numbered year ($279) or even-numbered year ($186), prorating to the next renewal cycle. The state requires an original NBCOT Verification of Certification document rather than a photocopy. Hawaii has very few in-state OTA training programs, meaning most practitioners are educated on the mainland.
Hawaii license fees vary by year: $279 in odd-numbered years, $186 in even-numbered years.
Original NBCOT Verification of Certification required - no photocopies accepted.
Applicants must be 18+ and a US citizen, national, or authorized to work.
Temporary permits available for graduates awaiting exam; practice only under direct supervision.
Hawaii is NOT a member of the OT Licensure Compact.
Hawaii has limited ACOTE-accredited OTA programs, so many practitioners train on the mainland.
OTA requirements in nearby states
| State | Total Cost | Timeline | |
|---|---|---|---|
| Hawaii (you) | $726 - $819 | 112–126 wks | |
| California | $639 | 112–126 wks | → |
| Alaska | $820 | 112–126 wks | → |
See how Hawaii compares: OTA License Fees by State — Cheapest to Most Expensive →
Hawaii is not currently a member of the Occupational Therapy Licensure Compact. OTA licensees must apply through standard reciprocity or endorsement. See which states are in the OT Compact →
Related Guides
Explore requirements for other professional licenses in Hawaii.
OTA Schools in Hawaii
Compare approved training programs, costs, and requirements.
Moving to Hawaii? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your OTA license to Hawaii →
Hawaii requires the NBCOT COTA exam for occupational therapy assistants. OTAs must practice under Hawaii Certified Occupational Therapist supervision. All licensing is managed through the Department of Commerce and Consumer Affairs – Professional and Vocational Licensing Division, Occupational Therapy Program.
Requirements vary by state. Always verify current requirements with your state licensing authority.