National Board for Certification in Occupational Therapy (NBCOT) Certified Occupational Therapy Assistant (COTA) Examination

The NBCOT Certified Occupational Therapy Assistant (COTA) Examination is the national certification exam for graduates preparing to practice as occupational therapy assistants in the United States. It assesses whether candidates can apply entry-level knowledge and clinical reasoning to support safe, effective occupational therapy services under appropriate supervision. Candidates generally need to graduate from an eligible occupational therapy assistant program and meet NBCOT application requirements. NBCOT certification is distinct from state licensure, so candidates should also check the licensing requirements in the state where they plan to work.

COTA exam content covers the occupational therapy process, including screening, evaluation, intervention planning, and implementation, as well as the occupational profile and activity analysis. Candidates should also review documentation, outcomes, care coordination, clinical reasoning, and evidence-based practice. The exam emphasizes applying knowledge to client and practice situations, not simply recalling definitions. For the 2027–2028 cycle, use the current NBCOT exam outline and candidate handbook to confirm the structure and content in effect, then build a study plan around weaker areas and regular review.