IowaOccupational Therapist License Requirements

Prerequisite Courses

Occupational therapists must earn a Master's degree or entry-level Occupational Therapy Doctorate (OTD) from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Programs include extensive fieldwork experience in clinical settings.

Retake Policy

NBCOT exam may be retaken after 45 days; max 5 attempts in 5 years

The NBCOT OTR exam is a computer-based assessment that includes multiple choice and clinical simulation questions. A scaled score of 450 or higher is typically required to pass. Many states also require a separate jurisprudence exam on state-specific laws and regulations governing OT practice.

Clinical Settings

Level II fieldwork is a required component of occupational therapy education, providing supervised clinical experience in various practice settings. Students must complete a minimum of 24 weeks of Level II fieldwork under the supervision of a licensed occupational therapist.

Advanced Practice

Dry needling status varies; verify with state board.

Restricted Activities

• •Medical diagnosis
• •Prescribing medications
• •Surgical procedures

Occupational therapy scope of practice varies by state and may include physical rehabilitation, mental health services, pediatrics, hand therapy, driving rehabilitation, and ergonomic assessments. Advanced practice privileges such as dry needling vary significantly by state.

NBCOT Recertification

36 PDUs per 3-year cycle; separate from state renewal

Required CE Topics

Regulatory Board

Occupational therapy licenses must be renewed on schedule. Most states require continuing education hours covering topics such as ethics, evidence-based practice, and professional development. NBCOT recertification is separate from state licensure renewal.

Compact Details

Iowa has enacted the OT Licensure Compact. The compact is partially operational as of early 2026.

Reciprocity Requirements

• •Active OT license in good standing
• •ACOTE-accredited program
• •NBCOT exam passage
• •Background check

The OT Licensure Compact allows licensed occupational therapists to practice in other compact member states without obtaining additional licenses. Non-compact states require license by endorsement, which typically involves verifying NBCOT certification, completing a background check, and meeting state-specific requirements.