Certified Occupational Therapy Assistant (COTA) Certification Exam

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Exam Content

The Certified Occupational Therapy Assistant (COTA) exam, administered by the National Board for Certification in Occupational Therapy (NBCOT), is designed to assess the knowledge, skills, and abilities required for entry-level practice as an occupational therapy assistant. The exam content focuses on four primary domains:

1. Obtaining information to evaluate the client’s occupational needs

      This domain assesses your ability to gather relevant information about the client’s occupational history, context, and performance in order to develop an appropriate intervention plan. This includes understanding client factors, activity demands, contexts, and environments, as well as the role of the OTA in the evaluation process.

      2. Implementing intervention plans

      This domain evaluates your ability to select and implement appropriate interventions based on the client’s needs, goals, and the intervention plan developed by the occupational therapist. This includes understanding various intervention approaches, activity analysis, grading and adapting activities, and working with clients across the lifespan and in various practice settings.

      3. Maintaining the safety and well-being of the client

      This domain focuses on your ability to ensure the safety, well-being, and dignity of clients throughout the evaluation and intervention process. This includes understanding and applying principles of infection control, body mechanics, ergonomics, and safe use of equipment and assistive technology, as well as recognizing and addressing potential hazards or barriers to participation.

      4. Upholding professional standards and responsibilities

      This domain assesses your understanding of the ethical, legal, and professional standards that govern occupational therapy practice. This includes knowledge of the NBCOT Code of Conduct, the American Occupational Therapy Association (AOTA) Code of Ethics, and state and federal laws and regulations, as well as the role of the OTA in the supervision process, interprofessional collaboration, and advocacy for the profession and clients.

          Learn More About the Occupational Therapy Assistant Curriculum
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          Exam Format

          The COTA exam consists of multiple-choice questions, and may also include clinical simulation questions, which present you with scenarios and ask you to select the most appropriate course of action. The exam is designed to assess your knowledge in various domains of occupational therapy practice, including evaluation, intervention planning, implementation, and professional responsibilities.

          Number of questions

          The exam consists of approximately 200 questions, including 20 pretest questions that do not count towards your final score. Pretest questions are included to gather statistical information and are indistinguishable from scored questions.

          Exam Duration

          You will have a total of 4 hours to complete the COTA exam.

          Eligibility Criteria

          The eligibility criteria to take the Certified Occupational Therapy Assistant (COTA) exam administered by the National Board for Certification in Occupational Therapy (NBCOT) are as follows:

          1. Education: You must have graduated from an accredited Occupational Therapy Assistant (OTA) program. The program must be accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or an equivalent accrediting body.
          2. Fieldwork: As part of your OTA program, you need to complete the required supervised fieldwork experience. Fieldwork requirements are typically determined by the educational program and accrediting body (e.g., ACOTE). This hands-on experience is crucial in allowing you to apply the knowledge and skills you’ve learned in the classroom to real-world settings.
          3. Character Review: You will need to complete a character review process as part of your application to take the COTA exam. This review assesses your professional behavior and may involve disclosing any history of criminal convictions, disciplinary actions, or other issues that could impact your ability to practice as an OTA. NBCOT reviews each case individually and may require additional documentation or information to make a determination regarding your eligibility.
          4. Entry-Level Self-Assessment: Prior to applying for the COTA exam, you must complete the NBCOT’s Occupational Therapy Assistant (OTA) Entry-Level Self-Assessment. This self-assessment helps you identify areas where you may need additional study or review and provides guidance on exam preparation.

          Please note that eligibility criteria may be subject to change. It is essential to consult the NBCOT website and review the most recent NBCOT Exam Candidate Handbook for the latest information on eligibility requirements.

          Exam Fee

            The COTA exam fees may vary depending on your eligibility category (e.g., new graduate, re-examination, re-entry). As of September 2021, the exam fees range from $515 to $555 for U.S. candidates. Please check the NBCOT website for the most up-to-date fee information.

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              Exam preparation

              To prepare for the COTA exam, consider the following strategies:

              a. Review the NBCOT Exam Candidate Handbook, which provides detailed information about the exam, including content outlines, sample questions, and study resources.

              b. Complete the NBCOT’s Occupational Therapy Assistant (OTA) Entry-Level Self-Assessment to identify areas where you may need additional study or review.

              c. Use study materials, such as textbooks, review books, and online resources, to review key concepts and practice questions.

              d. Participate in study groups or online forums to discuss topics and share study tips with fellow candidates.

              e. Create a study schedule to help you manage your time effectively and stay on track with your exam preparation.

              Passing Score

              The passing score for the COTA exam is determined through a criterion-referenced approach, which means it is based on the level of knowledge required to practice as an entry-level OTA, rather than a fixed percentage of correct answers. The passing score may vary slightly for each exam form, but it typically falls within a range of scaled scores.

              Exam Day

              Arrive early

              Plan to arrive at the testing center at least 30 minutes before your scheduled exam time. This allows you to check in, review the testing center rules, and settle in before the exam begins.

              Bring identification

              You will need to present a valid, government-issued photo ID with your signature, such as a driver’s license or passport, to verify your identity. Make sure that the name on your ID matches the name on your Authorization to Test (ATT) letter.

              Follow testing center rules

              Familiarize yourself with the testing center rules and regulations, which typically include prohibitions on personal items, such as cell phones, bags, or study materials, in the testing room. You may also be required to sign a confidentiality agreement before beginning the exam.

              Navigating the exam

              The COTA exam is a computer-based test with a time limit of 4 hours. You can use the on-screen tools to navigate through the exam, flag questions for review, and track your remaining time. Take breaks if needed, but be aware that the exam timer will not pause during breaks.

                Exam Results

                Preliminary results: After completing the COTA exam, you may receive a preliminary pass or fail status on the computer screen at the testing center. This initial result is not your official score, but it provides an indication of your performance on the exam.

                Official results: Your official exam results will be available through your NBCOT online account, typically within 1-2 weeks after your test date. You will receive an email notification when your results are ready to be viewed.

                Passing the exam: If you pass the COTA exam, you will receive a notification of your passing status, your scaled score, and information on how to maintain your certification. You will also be granted the Certified Occupational Therapy Assistant (COTA) credential.

                Failing the exam: If you do not pass the COTA exam, you will receive a notification of your failing status, your scaled score, and a breakdown of your performance in each content area. This information can help you identify areas for improvement and guide your study efforts if you decide to retake the exam.

                  Certification Maintenance

                  After passing the COTA exam and becoming certified, you will need to maintain your certification by completing the required continuing education activities and renewing your certification every three years, as specified by the NBCOT.

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                  Retakes for the Certified Occupational Therapy Assistant Certification Exam

                  If you do not pass the Certified Occupational Therapy Assistant (COTA) exam administered by the National Board for Certification in Occupational Therapy (NBCOT) on your first attempt, you may retake the exam. Here is what you need to know about the retake process:

                  1. Waiting period: There is a waiting period between exam attempts. According to NBCOT’s policy, you must wait a minimum of 45 days from your most recent exam date before retaking the COTA exam.
                  2. Application process: To retake the exam, you will need to submit a new exam application through your NBCOT online account. This includes paying the required exam fees, which may vary depending on your eligibility category (e.g., re-examination, re-entry). Ensure that you meet all the eligibility requirements before applying to retake the exam.
                  3. Preparation: Use the feedback provided in your exam results to identify areas where you need to improve. Focus on the content areas where your performance was weaker and consider using additional study materials, joining study groups, or seeking guidance from faculty or mentors to enhance your understanding of those topics. Develop a study plan and schedule to ensure adequate preparation for your retake attempt.
                  4. Retake limit: As of September 2021, NBCOT does not impose a limit on the number of times a candidate can retake the COTA exam. However, it is important to verify the current policy on the NBCOT website or in the Exam Candidate Handbook, as the retake policy may be subject to change.
                  5. Maintaining eligibility: Make sure you continue to meet the eligibility criteria for the COTA exam during the retake process. This may include maintaining your professional credentials, completing any necessary continuing education, or adhering to the NBCOT Code of Conduct.

                  Renewal of COTA

                  Maintaining your Certified Occupational Therapy Assistant (COTA) certification requires renewing it periodically. The National Board for Certification in Occupational Therapy (NBCOT) sets the renewal process and requirements. Here are the key aspects of the COTA certification renewal process:

                  1. Renewal cycle: The COTA certification must be renewed every three years to maintain your active status.
                  2. Continuing Competence: To renew your certification, you must meet the NBCOT’s Continuing Competence requirements. This involves completing a certain number of professional development units (PDUs) during each renewal cycle. As of September 2021, COTAs are required to complete at least 36 PDUs every three years.
                  3. Professional Development Activities: PDUs can be earned by participating in a variety of professional development activities, such as:
                    • Attending workshops, conferences, or seminars
                    • Completing online courses or webinars
                    • Publishing articles or presenting at professional events
                    • Participating in research projects or serving on professional committees
                    • Engaging in mentorship or supervision roles
                  4. PDU Documentation: Keep records of your professional development activities, including certificates of completion, transcripts, or other documentation that verifies your participation and the number of PDUs earned. You may be required to submit this information to NBCOT during the renewal process or in case of an audit.
                  5. Renewal fees: There are fees associated with renewing your COTA certification. As of September 2021, the renewal fee is $125 for NBCOT certificate holders who are also members of the American Occupational Therapy Association (AOTA) and $175 for non-members. These fees may be subject to change, so consult the NBCOT website for the most current fee information.
                  6. Renewal application: To renew your certification, you must submit a renewal application through your NBCOT online account. This includes verifying your compliance with the NBCOT Code of Conduct, attesting to your completion of the required PDUs, and paying the renewal fees.
                  7. Renewal deadline: Your COTA certification expires on the last day of the month in which the three-year renewal cycle ends. It is essential to submit your renewal application and complete the required PDUs before this deadline to maintain your active certification status.
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