healthcare · United States edition
It’s easy to be an Occupational Therapist.
Becoming an occupational therapist in the US means earning a bachelor's degree, then completing an ACOTE-accredited master's or doctoral program with supervised fieldwork, and passing the NBCOT certification exam. All 50 states require licensure. BLS reports a $100,330 median salary in 2025, with 14% projected job growth through 2034 — among the fastest-growing healthcare occupations.
Last verified Version 1By Editorial Team
Key facts
United States- Time to qualify
6–8 years
About six years for the master's route: a four-year bachelor's degree with prerequisite science and psychology coursework, then a two-to-three-year ACOTE-accredited Master of Occupational Therapy (MOT) including a minimum 24 weeks of full-time Level II fieldwork. The entry-level clinical doctorate (OTD) route runs seven to eight years total. Both end the same way: pass the NBCOT exam, then get licensed in your state.
- Cost to qualify
$77,716 – $150,000
A three-year entry-level program costs $77,716 total at the University of Missouri (public, flat-rate tuition with no out-of-state markup, 2025-26) and $119,175 at Touro University's 9-semester OTD program (private) — two ACOTE-accredited programs fetched directly for this run. Other private and non-resident programs report totals above $150,000. On top of tuition: the NBCOT certification exam costs $540 online ($595 paper), annual renewal is $65-$75, and state licensing fees typically add another $100-$400 depending on the state.
All figures apply to United States. Salaries, licensing, and timelines differ by country — where other editions exist, switch between them at the top of the page.
Is it easy for you?
Tell us where you are now and get a personalized gap analysis for becoming an Occupational Therapist — what you’ve already met, what’s left, and your likely remaining time. Computed from the sourced requirements on this page; nothing is stored unless you explicitly ask us to introduce you to a programme afterwards.
How to become an Occupational Therapist — step by step
- 1
Complete a bachelor's degree with the right prerequisites 4 years
Any major works, but line up biology, anatomy and physiology, psychology and statistics coursework early — most OT programs require them specifically, and missing one can cost you an admissions cycle. Observation or volunteer hours with a practicing OT strengthen your application.
- 2
Apply to an ACOTE-accredited MOT or OTD program Application year
Admissions are competitive; many programs weigh observation hours and a personal statement alongside GPA. Confirm ACOTE accreditation directly — a non-accredited program cannot lead to NBCOT certification.
- 3
Complete didactic coursework 1.5 to 3 years
Anatomy, kinesiology, neuroscience, and therapeutic and assistive-technology techniques across pediatric, physical-rehabilitation and mental-health practice areas.
- 4
Complete Level II fieldwork placements 24+ weeks
Full-time supervised clinical placements across at least two practice settings. Sites are often not local to your program, so budget for the possibility of relocating for weeks or months at a time.
- 5
Graduate and sit the NBCOT exam Within 3 years of graduating
A computer-based exam costing $540 online ($595 paper). Passing grants the OTR (Occupational Therapist, Registered) credential.
- 6
Apply for your state license 4 to 12 weeks
Submit your NBCOT score, a background check and the state fee. Requirements and turnaround time vary by state, and there is no national reciprocity.
- 7
Start practicing and choose a setting Ongoing
Hospitals, outpatient clinics, schools, skilled nursing and home health all hire OTs, but pay, caseload size and productivity-quota pressure differ sharply between them.
Requirements to be an Occupational Therapist
- Bachelor's degree with prerequisite courseworkeducationRequired
Most ACOTE-accredited graduate programs require a completed bachelor's degree (any major) plus specific undergraduate coursework in biology, anatomy and physiology, psychology and statistics before you can apply.
- ACOTE-accredited master's or doctoral OT programeducationRequired
Entry to practice requires graduating from a program accredited by the Accreditation Commission for Occupational Therapy Education (ACOTE) — either a Master of Occupational Therapy (MOT) or an entry-level Doctor of Occupational Therapy (OTD). A 2017 mandate to make the doctorate the sole entry point by 2027 was suspended after pushback from AOTA members, so both degree levels remain valid entry routes as of 2026.
- Level II fieldworkexperienceRequired
ACOTE standards require a minimum of 24 weeks of full-time supervised clinical fieldwork, plus a capstone project for OTD students. You cannot sit the certification exam without completing it.
- NBCOT certification exam (OTR)certificationRequired
The National Board for Certification in Occupational Therapy exam costs $540 online ($595 paper) and must be taken within three years of finishing your coursework and fieldwork. Passing grants the credential Occupational Therapist, Registered (OTR).
- State occupational therapy licenselicenseRequired
All 50 states, DC and US territories require a separate state license to practice, on top of NBCOT certification. Licenses do not automatically transfer between states, so moving means a new application, fee and sometimes a jurisprudence exam.
- Background check and fingerprintingcertificationRequired
Required by most states and clinical placement sites before you can work with patients, including vulnerable populations such as children and older adults.
- Practical, adaptive problem-solvingskillRequired
Redesigning a task, piece of equipment or environment around what someone can still do — rather than what they've lost — is the core clinical skill, not a soft extra.
- Caseload documentation and productivityskillRequired
Most employers, especially skilled-nursing and outpatient settings, track billable-unit productivity targets closely; a large share of the working week is assessment notes, care plans and insurance documentation rather than hands-on treatment.
A day in the life of an Occupational Therapist
A typical day mixes hands-on treatment with a lot of writing. In a hospital you might help a stroke patient relearn how to get dressed; in a school, help a child with sensory-processing difficulties manage a classroom; in an outpatient clinic, run a caseload of a dozen or more patients back-to-back through 30-to-60-minute sessions. Skilled-nursing and home-health work means driving between locations and working around family and caregiver schedules. Across every setting, a meaningful share of each day is documentation — evaluations, progress notes and insurance justifications — rather than direct treatment time.
Is it worth it to be an Occupational Therapist?
Worth it if you want strong, faster-than-average job growth (14% through 2034, about 10,200 openings a year), a median salary above $100,000, and the flexibility to work in hospitals, schools, outpatient clinics, skilled nursing or home health depending on the pace and setting you want. It is not for you if you want a quick or cheap credential — a three-year accredited program commonly costs $75,000 to $150,000 or more and typically means loans — or if you dislike paperwork: productivity quotas and documentation are a real, daily part of the job in many settings, not an occasional chore. Level II fieldwork placements can also require relocating away from home for weeks or months at a time, which catches some students by surprise.
Common mistakes to avoid
- Assuming a bachelor's degree alone qualifies you to practice — it doesn't; every practicing OT needs a master's or clinical doctorate from an ACOTE-accredited program.
- Enrolling in a program that isn't ACOTE-accredited — graduates of unaccredited programs cannot sit the NBCOT exam or get licensed, no matter how good the coursework looked.
- Not confirming prerequisite coursework (biology, anatomy and physiology, psychology, statistics) before applying — missing even one required class can push your application back a full admissions cycle.
- Underestimating the total cost — $75,000 to $150,000-plus in tuition is common, and unlike undergraduate study, grant funding for OT graduate school is limited, so most students borrow the difference.
- Not planning for fieldwork logistics — Level II placements often require relocating for weeks or months, and program-arranged sites aren't always near where you live.
- Assuming every OT job looks the same — pay, caseload size and productivity-quota pressure vary sharply between hospital, school, skilled-nursing and outpatient-chain employers, and some settings are far more paperwork-heavy than others.
Frequently asked questions
How long does it take to become an occupational therapist in the US?
About six years for the master's route (a four-year bachelor's degree plus a two-to-three-year accredited master's program), or seven to eight years for the entry-level clinical doctorate (OTD). Both require passing the NBCOT exam and getting a state license before you can practice.
Do I need a doctorate (OTD), or is a master's enough?
A master's degree is still a fully valid entry point. ACOTE mandated in 2017 that programs move to doctorate-only entry by 2027, but that mandate was suspended after significant pushback from AOTA members, and as of 2026 both the master's (MOT) and doctoral (OTD) routes lead to the same NBCOT exam and license.
How much do occupational therapists earn?
The BLS OEWS median for May 2025 is $100,330 a year, with the middle half of the profession earning between $76,980 and $114,400. Pay varies by setting and state — the bottom 10 percent earn under $64,770 and the top 10 percent over $133,700.
What's the difference between an OT and an OTA?
An Occupational Therapy Assistant (OTA) holds an associate degree, passes a separate NBCOT exam (COTA), and works under an OT's supervision with a narrower scope of practice and lower pay. It's a faster, cheaper route into the field but not a substitute for full OT licensure.
Does my license transfer if I move states?
No. NBCOT certification is national, but the state license is not — moving means a fresh application, fee and sometimes a jurisprudence exam in the new state, even though your underlying certification doesn't change.
What's the difference between occupational therapy and physical therapy?
Occupational therapy focuses on enabling everyday activities — dressing, cooking, working, driving — often by adapting the task, tool or environment. Physical therapy focuses on restoring movement and physical function itself through exercise and manual therapy. The two professions frequently treat the same patient side by side.
Sources
Every figure on this page traces to one of these primary sources.
- 1Eligibility requirements for the NBCOT certification exam — National Board for Certification in Occupational Therapy · accessed August 26, 2026
- 2NBCOT exam and certification fees — National Board for Certification in Occupational Therapy · accessed August 26, 2026
- 3Occupational Employment and Wage Statistics, May 2025: Occupational Therapists (29-1122) — U.S. Bureau of Labor Statistics · accessed August 26, 2026
- 4Occupational Outlook Handbook: Occupational Therapists — U.S. Bureau of Labor Statistics · accessed August 26, 2026
- 5Occupational Therapists (29-1122.00) Summary Report — O*NET OnLine / U.S. Department of Labor · accessed August 26, 2026
- 6OTD program cost and financial aid — University of Missouri School of Health Professions · accessed August 26, 2026
- 7OTD tuition and fees — Touro University · accessed August 26, 2026