The five steps to become an occupational therapist
All states require occupational therapists to be licensed, and every license starts with a degree from an ACOTE-accredited program and the NBCOT certification exam.[ooh_ot][acote][nbcot_fees]
- Earn a bachelor's degree. Admission to graduate occupational therapy programs requires a bachelor's degree; check each program's prerequisite courses before you apply.[ooh_ot_how]
- Choose an entry-level master's or doctorate. ACOTE accredits both. The master's (MOT or MSOT) adds up to five to six full-time-equivalent years of college in total and the doctorate (OTD) at least six.[acote]
- Finish the program, including supervised fieldwork. BLS says master's programs usually take two to three years and require a specified number of hours of supervised fieldwork.[ooh_ot_how]
- Pass the NBCOT exam. The online application costs $540 and a retake $430; passing earns the OTR credential.[nbcot_fees]
- Get a state license. Apply to your state's OT board. The OT Licensure Compact now accepts privilege applications in 11 states, so a license in one of them can let you practice in the others.[ooh_ot][otcompact]
How long it takes to become an occupational therapist
About six to seven years after high school: four years for the bachelor's and two to three for the graduate program.[ooh_ot_how] At the University of Utah the MOT runs seven terms (about 2.3 years) and the entry-level OTD about three years.[s_utah_ot]
| Stage | Typical length | What you finish with |
|---|---|---|
| Bachelor’s degree + prerequisites | About 4 years | Graduate program eligibility |
| MOT/MSOT (ACOTE) | 2 to 3 years (BLS) | NBCOT eligibility |
| or entry-level OTD | About 3 years (e.g. Utah) | NBCOT eligibility |
| NBCOT exam + state license | A few months | OTR and license to practice |
MOT vs OTD: which degree to choose
Both degrees lead to the same NBCOT exam, license and job, so the doctorate mainly adds time and cost. At the University of Utah resident tuition and fees total $70,984 for the MOT and $78,951 for the OTD (2026–27).[s_utah_ot] Since July 2026 federal graduate loans are capped at $20,500 a year and $100,000 in total for OT students, because occupational therapy is not on the Department of Education's professional-degree list.[fr_therapy] Costs, length and a payback calculator are on occupational therapy school.
How to become an occupational therapy assistant
An occupational therapy assistant needs an ACOTE-accredited associate or bachelor's program, the NBCOT exam for the COTA credential and, in most states, a license.[acote][nbcot_fees][ooh_ota] It is the faster route: Cape Fear Community College in North Carolina estimates $8,240 in-state for its OTA program, and OTAs earn a median $72,300 ($34.76 an hour).[s_cfcc_ota][onet_ota] OTAs enter through an ACOTE-accredited associate or bachelor’s program and need a state license in most states.
| Occupational therapist | OT assistant (COTA) | |
|---|---|---|
| Degree | Master’s or entry-level doctorate | Associate or bachelor’s |
| NBCOT exam fee (online) | $540 | $540 |
| Median salary (May 2025) | $100,330 | $72,300 |
| 10th percentile | $71,690 | $51,490 |
| Jobs (BLS) | 162,450 | 51,290 |
What occupational therapists earn
New OTs usually start near the lower percentiles, $71,690 at the 10th and $82,510 at the 25th, against a median of $100,330.[onet_ot] BLS projects OT jobs to grow 15% from 2025 to 2035. California pays OTs the most ($124,510; metro pay and the state license on occupational therapist salary California); every state and metro is on occupational therapist salary.[ooh_ot][onet_ot]
Weighing OT against physical therapy? PTs need a doctorate and earn $102,760 at the median; the steps are on how to become a physical therapist, and every therapy career is ranked on therapist salary.[onet_pt]
Frequently asked questions
How long does it take to become an occupational therapist?
About six to seven years: a four-year bachelor’s degree, then a two- to three-year master’s (or about three years for an OTD), the NBCOT exam and a state license.
Do you need a doctorate to be an occupational therapist?
No. ACOTE accredits both entry-level master’s and doctoral programs, and both lead to the same NBCOT exam and license.
How much does the NBCOT exam cost?
$540 for the online initial application and $430 for an online retake (NBCOT).
How do you become an occupational therapy assistant?
Complete an ACOTE-accredited OTA associate or bachelor’s program, pass the NBCOT exam to become a COTA, then apply for your state license. OTAs earn a median $72,300.
Sources
- Occupational Outlook Handbook: Occupational Therapists
- Occupational Outlook Handbook: Occupational Therapists, How to Become One (bachelor’s for admission; master’s 2 to 3 years)
- From the Director, February 2022: entry-level OT doctoral, OT master’s and OTA degree definitions
- Fees (online initial exam application $540; retake $430)
- Before you apply: states accepting OT Compact privilege applications
- MOT and OTD tuition estimates 2026-27 (MOT $70,984 resident; OTD $78,951 resident)
- Federal Student Loan Program Final Regulations: professional degree list and preamble on PT, OT, SLP and audiology (91 FR 23768)
- Occupational Outlook Handbook: Occupational Therapy Assistants and Aides
- Occupational Therapy Assistant estimated cost of attendance ($8,240 in-state)
- Local Wages: 29-1122.00 Occupational Therapists (state and metro percentiles)
- Local Wages: 31-2011.00 Occupational Therapy Assistants (state and metro percentiles)
- Local Wages: 29-1123.00 Physical Therapists (state and metro percentiles)