Montana licenses occupational therapists and occupational therapy assistants through the Board of Physical, Rehabilitative, and Developmental Health Care Professionals in the Department of Labor and Industry, a combined board whose rules took effect July 25, 2026. 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.
Montana 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
Set in ARM 24.119.401 (new rule, effective July 25, 2026); confirm on the board's site
Same
Background check
Check with the board
Same
OT Compact
Member, not accepting applications yet. Montana has enacted the OT Compact but has not opened privilege applications, so for now you need a full Montana license. (OT Compact, checked October 18, 2026)
Montana, step by step
Montana Board of Physical, Rehabilitative, and Developmental Health Care Professionals (Department of Labor and Industry)
Apply through the board's online licensing system and disclose every state where you are licensed.
Primary source verification: transcripts and NBCOT scores must be sent directly from your school and NBCOT, not forwarded by you.
NBCOT: pass the OTR or COTA exam.
Fees: the combined board's fees are in ARM 24.119.401, effective July 25, 2026; confirm the OT and OTA amounts on the board's License Information page before you pay.
Keep it: OT and OTA licenses renew by June 15. Montana 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.