West Virginia licenses occupational therapists and occupational therapy assistants through the West Virginia Board of Occupational Therapy. West Virginia was one of the first states to open OT Compact privileges, on January 12, 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.
West 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
Paid in the board's online application; check with the board
Same
Background check
Not required for a West Virginia license; needed only to become OT Compact eligible
Same
Limited permit
Recent graduates awaiting NBCOT, then a Limited Permit to Full Licensure application
Same
OT Compact
Member, accepting applications since January 12, 2026. An OT or OTA who lives in and is licensed in another member state that is open can apply for a West Virginia privilege to practice through the OT Compact (not through this board). (OT Compact, checked October 18, 2026)
West Virginia, step by step
West Virginia Board of Occupational Therapy
Pick your path: the board has separate new-applicant pages for West Virginia residents and non-residents.
Passed NBCOT already? Use the full license application.
Waiting on NBCOT? Recent graduates of an approved school can file the Limited Permit Application to work in West Virginia while awaiting the exam, then the Limited Permit to Full Licensure application after passing.
Background check: the board states that the FBI criminal background check is not required to get a West Virginia license.
OT Compact: a West Virginia license does not automatically make you compact-eligible. Finish licensure, then use the board's OT Compact Eligibility link (in your Certemy account) before buying privileges in other member states.
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.