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Exam Overview
The COTA exam is a computer-based exam delivered at Pearson VUE test centers in the United States and internationally. You may take it after you graduate from an accredited occupational therapy assistant program, your degree is conferred and NBCOT approves your application.
| Feature | Details |
|---|---|
| Full name | NBCOT Certified Occupational Therapy Assistant (COTA) examination |
| Credential earned | COTA |
| Certifying body | National Board for Certification in Occupational Therapy (NBCOT) |
| Delivery | Computer-based, in person at Pearson VUE test centers |
| Number of items | 190, including a preselected number of unscored field-test items |
| Time | 4 hours; the appointment takes about 4 hours 45 minutes, and the optional tutorial is not timed |
| Item types | Single-response multiple choice and standalone six-option multi-select |
| Answer choices | Three or four options with one correct or best answer; multi-select items have six options, three of them correct |
| Multi-select scoring | Credit for each correct option selected; no deduction for incorrect selections |
| Navigation | Flag items for review, highlight text, strike out options and change answers until you submit |
| Breaks | Allowed, but the exam clock keeps running |
| Passing score | Total scaled score of 450 on a scale of 300 to 600; no domain-level passing standard |
| Exam fee | $540 online initial application; $430 online retake application (paper applications cost more) |
| Renewal | Every three years with at least 36 units (PDUs, competency assessment units or both) |
Who Can Take the Exam
To be eligible, you must meet all of the following requirements:
- Graduate from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE), with your degree conferred and your fieldwork completed.
- Submit an official final transcript, or a Degree Verification Form if your school uses one, showing the occupational therapy assistant major and the conferral date.
- Agree to the NBCOT Code of Conduct and complete the character review questions on the application.
Candidates educated outside the United States should confirm their eligibility with NBCOT before applying. If you have a past legal or professional matter that may affect eligibility, NBCOT offers an optional Early Determination Review before you apply.
Applying and Scheduling
Create a MyNBCOT account and apply online. Your application stays open for 90 days. When NBCOT approves it, you receive an Authorization to Test (ATT) letter, usually within three business days, and the ATT is active for 90 days. Use it to schedule your appointment with Pearson VUE at least one day in advance. You can reschedule or cancel up to 48 hours before your appointment; a no-show or late cancellation requires a paid ATT reissue. Bring two original, signed forms of identification, one of them a primary ID such as a current government-issued photo ID, with first and last names that match your ATT letter. Arrive 30 minutes before your appointment. Testing accommodations are available for candidates with a documented disability and are requested during the application.
What the Test Covers
The content outline comes from the NBCOT practice analysis, a national study of what entry-level occupational therapy assistants actually do. NBCOT repeats the practice analysis about every five years so the exam keeps pace with practice.
| Domain | Percent of Exam |
|---|---|
| Domain 1: Collaborate and Gather Information | 27% |
| Domain 2: Select and Implement Interventions | 55% |
| Domain 3: Uphold Professional Standards and Responsibilities | 18% |
Domain 1: Collaborate and Gather Information
How development, aging, health conditions, culture and life experience affect occupational performance; gathering information for the occupational profile; activity analysis; client-centered collaboration with clients, families and the team; and monitoring the intervention with the occupational therapist, including precautions, vital signs and lab values. Covered in Sections 1 to 3.
Domain 2: Select and Implement Interventions
Preparatory methods and physical agent modalities, wound care, occupation-based interventions across ADLs, IADLs, health management, rest and sleep, education, work, play, leisure and social participation, feeding and swallowing, functional transfers, cognitive, perceptual, sensory and mental health interventions, motor and physiological interventions, orthotics and prosthetics, assistive technology, wheelchairs and seating, and environmental modification. Covered in Sections 4 to 9.
Domain 3: Uphold Professional Standards and Responsibilities
Evidence-based practice, quality improvement, population programs, infection control, emergency response and risk management, laws, regulations and reimbursement, documentation, ethics and professional development. Covered in Sections 10 and 11.
What Kinds of Questions to Expect
How the Test Is Scored
The COTA exam is criterion-referenced: you are measured against a fixed standard of entry-level competence, not against other candidates. Results are reported on a scale of 300 to 600, and a total scaled score of at least 450 passes. There is no separate passing score for each domain; only the total counts. The unscored field-test items are mixed in at random and look like every other item, so answer every question as if it counts. Because there is no penalty for wrong answers, never leave an item blank.
Scores are released on the dates in the NBCOT exam scoring calendar and posted in your MyNBCOT account. If you want your score on a particular release date, test at least three days before it. Candidates who do not pass receive a feedback report showing performance by domain, which tells you where to focus before the next attempt.
Retakes
If you do not pass, you submit a new application and pay the retake fee. You must wait 30 days after your last attempt for attempts two through four, 60 days for attempts five through seven, and 90 days for attempt eight and later. You may reapply up to 30 days before your next eligible test date.
After You Pass
Order a score transfer to the occupational therapy licensing board in the state where you plan to work (one transfer is free if you request it with your application). Your state license is a separate step from NBCOT certification, so apply to your state board and follow its rules for supervision, scope and continuing competence.
Keeping Your Credential
NBCOT certification is renewed every three years. You earn at least 36 units in each cycle, as professional development units (PDUs), competency assessment units or both, and you renew during the renewal season from January through March of your renewal year. Only certificants with current certification may use the COTA credential. State license renewal has its own rules, so track both.
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