In Virginia, occupational therapists and occupational therapy assistants are licensed by the Board of Medicine, advised by its Advisory Board of Occupational Therapy. The regulations are 18VAC85-80. 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.
Virginia 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
$130 initial license fee
$70
Before your score
Practice as "O.T.L.-Applicant" for up to 6 months after graduation
Practice as "O.T.A.-Applicant", same limits
Background check
Not listed in the OT regulations; check with the board
Same
OT Compact
Member, accepting applications since March 20, 2026. An OT or OTA who lives in and is licensed in another member state that is open can apply for a Virginia privilege to practice through the OT Compact (not through this board). (OT Compact, checked October 18, 2026)
Virginia, step by step
Virginia Board of Medicine (Advisory Board of Occupational Therapy), Department of Health Professions
Apply with the completed application and fee: $130 for an OT, $70 for an OTA (18VAC85-80-26). Include verification of your OT education and, if you hold a license anywhere else, verification that no disciplinary action is taken or pending there.
NBCOT: document passing the national exam (OTR for OTs, COTA for OTAs).
Working as a graduate: a graduate of an accredited program may practice as "Occupational Therapist, License Applicant" (O.T.L.-Applicant), or for assistants "O.T.A.-Applicant", until a failing NBCOT score or six months from graduation, whichever comes first, and must use the title on every signature (18VAC85-80-45).
Keep it: licenses renew in your birth month in even-numbered years ($135 OT, $70 OTA).
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.