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The NBCOT Exam and How to Prepare For It

The National Board of Certification in Occupational Therapy exam is a certification exam for occupational therapists and occupational therapy assistants in the United States. This exam is required for all entry level therapists and assistants in all 50 states, Guam, Puerto Rico, and the District of Columbia. The test is administered by the National Board of Certification in Occupational Therapy Inc. (NBCOT), a not-for-profit credentialing agency that provides certification for the occupational therapy profession. By passing this exam, a practitioner is added to a national data base of qualified therapists and also obtains the right to use the credential Occupational Therapist Registered (OTR) or Certified Occupational Therapy Assistant (COTA).

This credentialing exam was developed to improve the credibility of the profession of occupational therapy. Evidence-based practice methods (practice techniques based on quality research) were used to develop the test questions and passing the exam proves that the therapist is familiar with evidence-based practice techniques.  The exam was originally developed when the profession as a whole realized the necessity for a credentialing system to prevent unqualified individuals from practicing occupational therapy, thus undermining the profession. Since state regulation was not consistent across the country, the American Occupational Therapy Association (AOTA) developed a consistent credentialing standard that would be recognized by both federal and state entities. AOTA began administering the national certification exam in 1977, and formed the American Occupational Therapy Certification Board (AOTCB) in 1986. This board is now known as the National Board for Certification in Occupational Therapy, or NBCOT. Most states now require licensure or some form of certification, but they have adopted many of the standards developed by NBCOT. A passing score on the NBCOT exam is required to obtain state credentials.

NBCOT Requirements

To be eligible to take the exam, an individual must meet the following requirements:

  1. Graduate from an occupational therapy program accredited by the American Council for Occupational Therapy Education (ACOTE). To become an occupational therapist, a person must obtain a master’s degree in occupational therapy, and to become an occupational therapy assistant, a person must obtain an associate degree.
  2. Complete all fieldwork required by the degree program prior to taking the exam.
  3. Submit to NBCOT an official transcript from his or her college or university that shows the degree title and date of graduation. NBCOT previously accepted an Academic Credential Verification Form (ACVF), but starting January 1, 2014, this will no longer be accepted. An official transcript must be provided.
  4.  Accept the NBCOT Code of Conduct and agree to follow it.

A person may apply to take the exam either online or on paper via mail. To apply, a social security number, student identification number from the college or university, and a degree/certificate or graduation clearance are required. A person should have these things available when completing the application. An individual who was educated outside of the United States must have received a letter from NBCOT approving him or her to apply for the exam, plus a student identification number assigned by NBCOT. The test is offered in English and American Spanish, and special testing accommodations may be requested by persons with documented disabilities. Fees must be paid online via credit card. NBCOT states it will not accept offline payments and will charge $35 to return a check. The current application fees are as follows:

  • $500 if applying online
  • $540 if applying via mail
  • $40 for an official score transfer request
  • $45 for a confirmation of examination registration and eligibility notice.

Tools to Prepare

There are many resources available to help an individual prepare for the exam. NBCOT offers its official test preparation resources through its website, www.nbcot.org. These tools include:

  • Free entry-level self assessment tools
  • NBCOT official OTR and COTA study guides
  • Validated domain, task, knowledge and skills statements
  • Examination blueprints
  • Online practice tests

The self assessment tools, validated statements, and examination blueprints are all offered online free of charge. The study guides are available for purchase for $60 each. Both online and paper versions are available. The practice tests range in price from $40 to $215, depending on the test package. Group discounts are available. There are numerous other test preparation materials available through other sources, both free and paid, but the materials listed above are the only test preparation materials that are officially approved by NBCOT.

The certification exam is 4 hours long. Including other administrative requirements, an individual should expect to be at the test center for about 5 hours and 15 minutes. After the exam, a person will receive a letter in the mail from NBCOT that reports test score and whether or not that individual passed or failed. Those who pass the exam will receive NBCOT’s Credentials Essentials Toolkit. Those who fail will receive instructions on how to apply for another exam date. NBCOT credentials are valid for 3 years, at which time an individual must apply for recertification. Therapists do not need to take the exam again to recertify their credentials.