If you are practicing occupational therapy in the United States, that means at one point you paid for the National Board for Certification in Occupational Therapy (NBCOT) certifying exam (current cost: $540), took the 180-question test, and you passed! 🎉
While taking this initial exam is required in all 50 states, renewing with NBCOT after the initial 3 year certification is up to you.
In this post, we’ll help you weigh the considerations for whether renewing with NBCOT is right for you.
An Interview with NBCOT’s Interim President and CEO
To kick us off, I thought it would be helpful to hear directly from NBCOT’s Interim President and CEO, Angela Macauley, PMP. I’ve gotten to collaborate with Angela multiple times over the years, and I’m so thankful she took the time to share:
- Her 2 minute pitch on why to renew with NBCOT
- Her favorite NBCOT perk for members
- What Angela sees on the horizon for NBCOT
What is required to renew with NBCOT?
Ok, now on to the need to know details. To maintain your NBCOT certification, you’ll need to renew every three years. The deadline for renewal is on March 31st, and the year in which you renew depends on when you originally registered. I recommend logging in to MyNBCOT to check your own renewal date.)
(Note: For the very first renewal, it is 4 years, then three years every year after that. That provides fairness to those that earn their certification towards the end of the year, by providing everyone three full years.)
The steps to renew involve:
- Completing at least 36 professional development units (PDUs) within your renewal cycle. These can include continuing education courses, professional presentations, publications, volunteer work, and more. See the full chart fo NBCOT renewal activities here. You can then check our guide to OT Continuing Education Requirements State by State, to see how these activities may overlap with your licensure requirements.
- Submitting your renewal application and fee If you renew by March 31st of your renewal year, the fee $65. If you renew anytime after that by December 31st of your renewal year, it is an additional $25 late fee. If you miss your renewal year, then you must complete the reinstatement process and there are two fees based on the length of time.
- Agreeing to uphold NBCOT’s Practice Standards and Code of Conduct.
Renewals are processed through the NBCOT portal, and once completed, you can continue using your “R” designation or “C” designation.
Benefits of Renewing with NBCOT
Keeping Your “R” or your “C”
For many OTs, a major benefit of renewing with NBCOT is keeping the “R” in your OTR credential. This signifies that you are an OT who is registered with NBCOT. The credential OTR/L means you are an OT who is both registered with NBCOT and licensed by your state.
For OTAs, renewing with NBCOT means you can designate yourself as a COTA, or certified occupational therapy assistant.
These designations can signal to colleagues, clients, and potential employers that you maintain national certification.
Meeting your continuing education requirements for your license
Many states’ license renewal requirements overlap with NBCOT’s professional development requirements. If you’re already taking CEUs to maintain your state license, those same activities can often count toward your NBCOT renewal—making it less of an extra burden.
In fact, NBCOT states that “eleven states accept current NBCOT certification as an option for fulfilling state licensure continuing education renewal requirements”:
- Alaska
- Colorado
- Hawaii (NBCOT certification is a requirement for licensure)
- Maine
- Maryland
- Mississippi
- Nevada
- New Hampshire
- Oregon (requires courses additional education on cultural competence and pain management)
- South Carolina (NBCOT certification is a requirement for licensure)
- South Dakota
- Vermont
Contributing to the profession
NBCOT plays a key role in setting national standards for OT practice. By renewing, you’re supporting the organization’s ongoing work in research, advocacy, and credentialing. One particularly notable effort to me has been NBCOT’s role in the OT Licensure Compact. For some OTs, this sense of contributing to the profession is a meaningful reason to maintain certification.
Important considerations
NBCOT renewal is required in South Carolina and Hawaii
While most states leave renewal as a personal choice, South Carolina and Hawaii require OTs and OTAs to maintain active NBCOT certification for licensure. If you practice in South Carolina or Hawaii—renewing is non-negotiable.
OT professionals in Massachusetts should not include the “R” or “C” in their credential
For OTs and OTAs who are licensed in Massachusetts, your state doesn’t permit the use of the “R” in the OTR/L credential or the “C” in an “COTA” credential even if you are NBCOT-certified. Here is the guidance they give, in your state practice act:
3.06: Designations (1) Occupational therapists shall use the initials OT after their name. (2) Students enrolled in an accredited program in occupational therapy shall use the initials OT/s after their name. (3) Occupational therapy assistants shall use the initials OTA after their name. (4) Students enrolled in an accredited program in occupational therapy assistants shall use the initials OTA/s after their name.
The bottom line:
Renewing with NBCOT can be a straightforward decision for some OTPs—especially if you value your “R” or “C,” need it for your state or employer, or want to align your CEUs with both state and national standards. For others, it may be an optional credential they choose to let lapse.
Ultimately, it’s about your professional goals, your state’s requirements, and how you want to present yourself in the OT world.
2 replies on “Should I Renew with NBCOT?”
Thanks for the information
It’s a shame that NBCOT requires fees and recertification. They also now require you to retake your exam if you don’t recertify after 9 years. Physical therapists aren’t required to recertify or pay fees. Fortunately, most states don’t recognize the NBCOT to maintain an active license.