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Occupational Therapy Assistant
Total cost: $625
Governing Authority
Board of Occupational Therapy (under Tennessee Department of Health)
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
1 OTR:3 OTAs
Supervision Ratio
24 hrs
CE Hours
$625
Total Initial Fees
ACOTE-Accredited Education
VerifiedDegree Required
Entry-level occupational therapy degree from an ACOTE-accredited OTA program (Associate's degree or higher)
ACOTE Accredited
Required
Program Length
2 years (Associate's degree)
Fieldwork Requirement
Level II fieldwork — minimum 16 weeks; at least 2 months supervised clinical OT work
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 (on a scale of 300–600)
Passing Score
$540
Exam Fee
Format: Computer-based; 190 items comprising three- and four-option single-response multiple-choice items and six-option multi-select items; 4 hours. Scaled score 300–600, passing = 450. Administered by Pearson VUE at Pearson Professional Centers and PTC Selects.
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: 13/100
Study recommendation: 1–2 weeks of focused review is usually sufficient
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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:3 OTAs
Supervision Type
General supervision
Initial Supervision Period
Direct supervision during initial practice period
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 | $85 |
NBCOT Exam Fee Paid directly to NBCOT | $540 |
License Fee Included in application fee | $85 |
Renewal Fee Biennial renewal; $60 for OTAs, $85 for OTs | $60 |
NBCOT Renewal Fee Online renewal every 3 years to maintain NBCOT certification | $65 |
Total Initial Fees Includes application/license fee ($85) and NBCOT exam ($540) | $625 |
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Renewal & CE Requirements
VerifiedBiennial (2-year) renewal cycle
Renewal Period
24 hrs
CE Hours Required
No
NBCOT Renewal
CE Topics
Renewal Fee
$60
Biennial renewal; $60 for OTAs, $85 for OTs
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 Licensure Compact and 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 Tennessee with other states →
See how requirements, costs, and timelines differ across all 50 states.
Tennessee uniquely requires a letter of recommendation from a non-family member attesting to good character as part of the OTA application. A Mandatory Practitioner Profile form is also required. Tennessee was the 19th state to enact the OT Licensure Compact (April 25, 2022). The board operates under the Tennessee Department of Health.
Tennessee requires a letter of recommendation from a non-family member attesting to good character.
A Mandatory Practitioner Profile form must be completed as part of the application.
Tennessee enacted the OT Licensure Compact on April 25, 2022.
24 CE hours required per biennial renewal with at least 2 hours in ethics.
NBCOT certification required for initial licensure but ongoing NBCOT renewal is not required.
OTA requirements in nearby states
See how Tennessee compares: OTA License Fees by State — Cheapest to Most Expensive →
✓ OT Compact Compact State — Tennessee 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 Tennessee.
OTA Schools in Tennessee
Compare approved training programs, costs, and requirements.
Moving to Tennessee? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your OTA license to Tennessee →
Transfer your OTA license from Tennessee to: Alabama → | Arkansas → | Georgia → | Kentucky → | Mississippi → | Missouri → | North Carolina → | Virginia →
Tennessee 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 Board of Occupational Therapy (under Tennessee Department of Health).
Requirements vary by state. Always verify current requirements with your state licensing authority.