How to Become a Certified Occupational Therapy Assistant (COTA): Steps, Exam & Licensing

A certified occupational therapy assistant (COTA®) earned a median of $68,340 in May 2024, a strong return for a career you can enter with a two-year associate degree. Learning how to become a COTA comes down to three milestones: finishing an accredited associate program, passing the national certification exam, and earning a state license. This path takes most students about two years and leads into one of the faster-growing roles in healthcare.

What a Certified Occupational Therapy Assistant Does

A certified occupational therapy assistant delivers hands-on therapy under the direction of a licensed occupational therapist. COTAs help patients rebuild the everyday skills that illness or injury has disrupted, from dressing and cooking to fine motor coordination. A closer look at what an OTA does shows how much of the job is direct patient work. Typical responsibilities include:

• Guiding patients through therapeutic activities and exercises
• Teaching the use of adaptive equipment for daily tasks
• Recording progress and reporting it to the supervising therapist
• Preparing treatment areas and materials for each session

COTAs work in outpatient clinics, hospitals, schools, and skilled nursing facilities. The full range of OTA duties varies by setting, but the core mission stays the same: helping people regain independence.

Steps to Become a COTA

Knowing how to become an occupational therapy assistant is easier when the path is broken into clear stages. The sequence looks like this:

1. Earn a high school diploma or equivalent and complete any program prerequisites.
2. Graduate from an ACOTE®-accredited associate degree program in occupational therapy assisting.
3. Complete the supervised fieldwork your program requires.
4. Pass the National Board for Certification in Occupational Therapy (NBCOT) exam to earn the COTA credential.
5. Apply for a license in your state and begin practicing.

Earn an ACOTE-Accredited Associate Degree

The foundation is a two-year associate degree from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE®). Coursework pairs classroom science with lab practice and supervised clinical fieldwork. CBD College outlines what to expect inside OTA courses so you can see how the curriculum builds toward practice.

Pass the NBCOT Certification Exam

After graduation, candidates sit for the NBCOT certification exam. Passing it confers the “certified” in certified occupational therapy assistant and is required before licensure. CBD College explains the NBCOT exam and how to prepare for it. The exam tests clinical knowledge across assessment, intervention, and professional practice.

Get Your State License

Most states require COTAs to hold a license to practice, and that license is built on NBCOT certification. Requirements vary by state, but they generally include proof of certification, an application, and a fee. Once licensed, COTAs renew periodically and complete continuing education to stay current.

How Long Does It Take to Become a COTA?

Most students reach licensure in about two years. That covers the full-time associate degree, including fieldwork. Exam preparation and the licensure application add a few weeks on top. If you still need prerequisite coursework before entering a program, budget extra time for that. Part-time enrollment extends the timeline but can suit students who work while studying.

COTA Salary and Job Outlook

The payoff is strong for a two-year credential. Occupational therapy assistants earned a median of $68,340 in May 2024, with the lowest 10 percent under $49,070 and the top 10 percent above $86,930. Employment of occupational therapy assistants and aides is projected to grow 18 percent from 2024 to 2034, much faster than the average for all occupations, driven by an aging population that needs rehabilitation and daily-living support.

Pay varies with a few factors:

• Setting — home health and skilled nursing often pay more than schools
• State — California and New York report some of the highest wages
• Experience — pay rises with tenure and specialty skills

COTA vs. Occupational Therapist

The two roles are often confused. A COTA holds an associate degree and delivers therapy under supervision. An occupational therapist (OT) holds a master’s or doctoral degree, evaluates patients, and sets the treatment plan the COTA helps carry out. OTs earned a higher median wage of $98,340 in May 2024, reflecting the longer education. CBD College breaks down the difference between an OT and OTA if you are weighing the two paths.

Start Your COTA Career

If you are ready to begin, the first step is enrolling in an accredited program. Explore the CBD College OTA program to review admission requirements, course structure, and fieldwork, then request information or apply to start the two-year path toward certification and licensure.