Alabama licenses occupational therapists and occupational therapy assistants through the Alabama State Board of Occupational Therapy. You must hold a license (or qualify for an exemption) before you practice. Everything below comes from the board's own pages and rules, checked October 18, 2026. Fees and rules change, so confirm on the linked pages before you pay.
Check with your board. OT Ticket is a study aid, not clinical or legal guidance. Not affiliated with, endorsed by or connected to the National Board for Certification in Occupational Therapy (NBCOT), AOTA, ACOTE, the OT Compact Commission or any state board; NBCOT, OTR and COTA are their marks, used here only to name the exam.
Alabama at a glance
Occupational therapist (OT)
OT assistant (OTA)
Exam
NBCOT OTR exam (180 questions, 4 hours), $540 to NBCOT
NBCOT COTA exam (190 questions, 4 hours), $540 to NBCOT
Board fees
$140 initial license (first license runs about one year)
$115
Limited permit
Separate limited permit application; supervision rules in 625-X-8-.02
Same
Background check
Criminal history questions on the application; no fingerprint step listed
Same
OT Compact
Member, not accepting applications yet. Alabama has enacted the OT Compact but has not opened privilege applications, so for now you need a full Alabama license. (OT Compact, checked October 18, 2026)
Alabama, step by step
Alabama State Board of Occupational Therapy
Apply on the board's license application (online or on paper) with the initial license fee: $140 for an OT, $115 for an OTA, payable to the Alabama State Board of Occupational Therapy Fund. An OTA lists a supervising OT licensed in Alabama.
NBCOT: pass the written exam the board approves (NBCOT's OTR or COTA).
Limited permit (optional): the board has a separate Limited Permit Application; holders work under the supervision rules in Ala. Admin. Code 625-X-8-.02.
Keep it: the first license expires in about a year; renewals are for two years ($140 OT, $115 OTA). Alabama has enacted the OT Compact but is not accepting privilege applications yet.
Every state licenses occupational therapists and OT assistants on NBCOT certification: an ACOTE-accredited degree with its Level II fieldwork, then NBCOT's exam (the OTR exam for OTs, 180 questions in 4 hours; the COTA exam for OT assistants, 190 questions in 4 hours; 450 on a 300-600 scale passes; $540 to apply online). NBCOT certification is not a license: you apply to your state board separately, and NBCOT sends the board your score (the Score Transfer is free if you add it when you apply for the exam, $35 later). The full walk-through: How to get your OT license.