OTR Exam Registration and Cost

U.S. applicants need an entry-level degree from an ACOTE-accredited occupational therapy program. Internationally educated occupational therapists must complete the Occupational Therapist Eligibility Determination (OTED) process before applying.

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

Your final transcript must show your awarded degree title and conferral date. It must also include your name, SSN or student ID, institution, courses, major, and registrar authentication.

Ask your school to mail a paper transcript or send an electronic transcript through a secure, verifiable service. If you qualify for early testing, ask your program about the Degree Verification Form (DVF). NBCOT holds DVF results until it receives your final transcript.

1. Read the Certification Exam Handbook.

2. Create a MyNBCOT account.

3. Complete the OTR exam application.

4. Pay the application fee.

5. Ask your school to send your final transcript or the permitted DVF.

6. Check your application status in MyNBCOT.

Apply before your school sends documents. Transcript review can take up to 10 business days, with longer waits during busy periods.

NBCOT issues your ATT within three business days after approval. Your application and ATT each have a 90-day validity period. Check both dates when you plan your OTR exam appointment.

After you receive your ATT, use MyNBCOT to reach Pearson VUE scheduling. Follow the instructions in your ATT.

If your application remains active, an ATT reissue gives you another 90 days. Cancel existing appointments before requesting reissue. If your application expires, you must apply again and pay the fee.

All fees below are in U.S. dollars.

Use Pearson VUE through MyNBCOT to change or cancel at least 48 hours before your appointment. After a late change or no-show, you need an ATT reissue after the appointment date. The reissue fee is $115.

If you withdraw, request a partial refund by email. Approved refunds have a $40 processing fee; reapply at least three months after your refund request.

Before applying, read NBCOT's Testing Accommodations Handbook and check its preapproved comfort-aid list. Submit your accommodation request and supporting documents within your OTR exam application.

A qualified healthcare professional must document your diagnosis, functional limitations, and their effect on testing. The documents must explain each recommended accommodation. Documentation normally must be within seven years.

Initial review is within 10 business days of submission or your latest request update, whichever is later. Busy periods can take longer. After approval, accept the Approval Notice and follow its scheduling instructions.

You can request extended time or approved breaks with specific durations.