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Occupational Therapy Assistant
Total cost: $749
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
1 OTR:2 OTAs
Supervision Ratio
24 hrs
CE Hours
$749
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: 14/100
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
Mostly verifiedSupervision by OTR/L Required
Supervisor Credential
OTR/L (Occupational Therapist Registered/Licensed)
Supervision Ratio
1 OTR:2 OTAs
Supervision Type
General supervision
Initial Supervision Period
First 90 days — direct supervision required
Ongoing Requirements
Periodic face-to-face meetings with supervising OTR/L required; frequency varies by setting
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 may be performed 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 Licensure by exam; $265 for licensure by reciprocity | $209 |
NBCOT Exam Fee Paid directly to NBCOT | $540 |
License Fee | Included in application fee |
Renewal Fee | $200 |
NBCOT Renewal Fee Online renewal every 3 years to maintain NBCOT certification | $65 |
Total Initial Fees Includes application/license fee ($209 by exam) and NBCOT exam ($540) | $749 |
Use our licensing cost calculator to estimate your total investment including education and exam fees.
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Renewal & CE Requirements
VerifiedTwo years preceding the license's expiration date (biennial)
Renewal Period
24 hrs
CE Hours Required
No
NBCOT Renewal
CE Topics
Renewal Fee
$200
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
Yes
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
OT Compact / Endorsement ($265)
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 Maryland with other states →
See how requirements, costs, and timelines differ across all 50 states.
Maryland has a relatively fast license approval time of 1-3 business days for complete applications. Licensure by reciprocity ($265) costs more than licensure by exam ($209). Maryland was the third state to join the OT Compact, and license expiration follows an even/odd year schedule based on year of issuance.
Maryland licenses are valid for up to 2 years; expiration aligns with even/odd year based on issuance.
24 CE hours required per biennial renewal, with at least 16 hours in OT principles and procedures.
Licensure by reciprocity costs $265 compared to $209 for licensure by exam.
Maryland was the third state to join the OT Licensure Compact.
Application approval typically takes 1-3 business days once complete.
1-3 days approval time
OTA requirements in nearby states
| State | Total Cost | Timeline | |
|---|---|---|---|
| Maryland (you) | $749 | 112–126 wks | |
| District of Columbia | $675 | 112–126 wks | → |
| Delaware | $636 | 112–126 wks | → |
| Pennsylvania | $570 | 112–126 wks | → |
| Virginia | $610 | 112–126 wks | → |
See how Maryland compares: OTA License Fees by State — Cheapest to Most Expensive →
✓ OT Compact Compact State — Maryland is a member of the Occupational Therapy Licensure Compact. Licensed otas from other member states may be eligible for expedited practice privileges.
Related Guides
Explore requirements for other professional licenses in Maryland.
OTA Schools in Maryland
Compare approved training programs, costs, and requirements.
Moving to Maryland? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your OTA license to Maryland →
Transfer your OTA license from Maryland to: Delaware → | Pennsylvania → | Virginia → | West Virginia → | District of Columbia →
Maryland requires the NBCOT COTA exam for occupational therapy assistants. OTAs must practice under OTR/L (Occupational Therapist Registered/Licensed) supervision. All licensing is managed through the Maryland Board of Occupational Therapy Practice.
Requirements vary by state. Always verify current requirements with your state licensing authority.