About the NBCOT COTA Exam

The National Board for Certification in Occupational Therapy, Inc. (NBCOT) administers the COTA exam. COTA means Certified Occupational Therapy Assistant. Pearson VUE delivers the COTA exam.

Passing the COTA exam is part of earning NBCOT certification. You must also apply to your state licensing board and meet its requirements before you practice.

You need an entry-level degree from an ACOTE-accredited occupational therapy assistant program. Current U.S. entry routes are an associate or bachelor's degree. NBCOT limits COTA eligibility to graduates of accredited U.S. OTA programs.

First-time applicants answer eight character questions and undergo a background check. If you answer yes to a character question, you must supply the required documents.

The COTA exam covers gathering information and collaboration; selecting and implementing interventions; and professional standards and responsibilities.

Single-response multiple-choice items have three or four options. You choose the single best answer. Independent multi-select items have six options, and you choose three.

The COTA exam assesses occupational therapy assistants and uses independent multi-select items. The OTR exam assesses occupational therapists and includes client scenarios with related questions. If you are an OT student, see our About the OTR Exam page.

On January 2, 2024, the COTA exam began following a content outline based on NBCOT's 2022 practice analysis, and it moved to Pearson VUE test centers. The COTA item types did not change.

You have four hours to complete the COTA exam. Plan for an appointment of about four hours and 45 minutes. That includes check-in and an optional tutorial, which does not use your exam time.

There are no scheduled breaks. You can take a break whenever you need one, but the exam clock keeps running while you are away. You must stay in the building and repeat the entry checks when you return, so keep breaks short and build them into your pacing. Approved testing accommodations can change these rules.

No. NBCOT describes the COTA exam as one timed exam of 190 items, with single-response and multi-select items mixed together.

Yes. You can flag questions for review, go back to them, and change your answers until time runs out or you submit the exam.

If time runs out, the answers you selected are submitted for scoring. A flagged question you left blank gets no credit, so make sure to answer every question before you go back to review.

The COTA exam has 190 items. Some of them are unscored field-test items that NBCOT is trying out for future exams. They are mixed in at random, you cannot tell which ones they are, and they do not count toward your score.

NBCOT does not publish how many field-test items there are, so treat every question as if it counts.

The COTA exam uses a scaled score of 300 to 600, and you need 450 to pass.

After NBCOT approves your eligibility and issues your Authorization to Test (ATT), you can schedule the COTA exam. Pearson VUE appointments are available year-round, subject to availability and the published year-end pause.

If you have completed all degree requirements, your program may approve the Degree Verification Form (DVF) route before your final transcript is available. Standard requirements include Level I and Level II fieldwork. NBCOT holds DVF results until it receives the final transcript.

Use the COTA content outline to organize your study plan. Give more study time to domains with larger percentages, then adjust for the topics you miss in practice.

Practice single-response items and independent multi-select items. Review why each selected option fits the question. Use timed practice to plan your pace and breaks within the four-hour limit. Typical Prep's question bank and mock exam platform is a great resource to help you practice and prepare.

NBCOT lists the NBCOT Exam StudyPack and COTA Practice Tests 1, 2, and 3 among its preparation tools. Use resources that include the current COTA exam item types.