Tennessee licenses occupational therapists and occupational therapy assistants through the Tennessee Board of Occupational Therapy in the Department of Health. 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.
Tennessee 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
$100 application + $10 state regulatory fee
$75 + $10
Background check
Criminal background check sent directly by the board's vendor
Same
Limited permit
$25 (ask the board who qualifies)
$25
OT Compact
Member, accepting applications since May 20, 2026. An OT or OTA who lives in and is licensed in another member state that is open can apply for a Tennessee privilege to practice through the OT Compact (not through this board). (OT Compact, checked October 18, 2026)
Tennessee, step by step
Tennessee Board of Occupational Therapy (Department of Health)
Apply online to the Board of Occupational Therapy with the non-refundable application fee, $100 for an OT or $75 for an OTA, plus the $10 state regulatory fee (Rule 1150-02-.06). Applicants also file a Declaration of Citizenship.
NBCOT: pass the OTR or COTA exam and have the result sent to the board.
Background check: the result of a criminal background check must come directly from the vendor named in the board's application materials (Rule 1150-02-.05).
Limited permit: the fee schedule lists a $25 limited permit; ask the board about eligibility and supervision before you work under one.
Keep it: licenses renew every two years ($85 OT, $60 OTA, plus $10). Tennessee has accepted OT Compact privilege applications since May 20, 2026.
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.