Frequently Asked Questions

Application requests are normally processed within a week of receipt by the Board office. Licenses are usually issued on Fridays within one(1) to two (2) weeks after the application and all required documentation is received and processed by the Board office. Click the License Verification tab of the website after 5:00 p.m. on Fridays to verify licenses issued that day.

Annual License Renewal Fee. $50

Application Packet. $10

Duplicate License Certificate. $15

Duplicate Renewal Card. $5

Initial License Fee. $100

Late Renewal Fee. $50

License Verification Fee. $20

Mailing List. $100

Practice Act Booklet. $15

You may go to the License Verification tab of this website (free of charge) or submit a written verification request to the Board office along with a $20 fee. The fee must be in the form of a certified check or money order if your NC license is not current at the time of the request.

NO LICENSE VERIFICATIONS ARE DONE BY PHONE OR FAX

No, foreign trained therapist who have not taken and passed the NBCOT exam are not eligible for licensure in North Carolina.

The forms should be completed by two different occupational therapists or occupational therapy assistants who are currently licensed as an OT or OTA or have, at one time, been certified by the National Board for Certification in Occupational Therapy (NBCOT).

The applicant does not need to request a license verification if the state did not have licensure, at that time.

Licenses expire on June 30th every year. If your license is issued between January 1st and March 31st, it will expire on June 30th of the same year it is issued. If it is issued between April 1st and December 31st, it will expire on June 30th of the following year.

The application instructions sent by email when you request the application online contains all of the information you will need to take the Jurisprudence Exam.

The licensure process is not different but Rule .0201(b) states that an applicant re-entering the field after more than 24 months shall complete 90 days of general supervision and shall provide to the Board a written plan for the supervision within 10 days of accepting employment and monthly documentation confirming that the supervision is being provided.

You need to re-apply just as if you’d never held a NC license before. Please see the Application Process tab on this website.

Yes, you will need to provide a copy of your military orders and identification and the Board will waive the initial application fee of $100. Please contact Board staff at administrator@ncbot.org to assist you with this process.

Renewal and Continuing Competence

Please refer to the Renewals tab of the website for detailed instructions.

Online Renewal are mandatory.

No. You do not need to maintain your certification with the National Board for Certification in Occupational Therapy (NBCOT) in order to be licensed in NC. However, the National Board for Certification in Occupational Therapy (NBCOT) owns the trademarks OTR and COTA. If you wish to use those letters, you must maintain certification with National Board for Certification in Occupational Therapy (NBCOT) or you will be violating trademark laws.

Continuing education is a structured educational experience beyond entry-level academic degree work that is intended to provide advanced or enhanced knowledge in a particular area. Continuing education is only one of several types of continuing competence activities. Section .0805 of the Rules of the North Carolina Occupational Therapy Board lists the activities that qualify as continuing competence activities.

One contact hour of continuing competence equals 60 minutes in a learning activity, excluding meals and breaks.

OTs and OTAs are both required to complete fifteen (15) continuing competence activity points annually.

All continuing competence courses and activities must relate to the licensee's current or anticipated roles and responsibilities in occupational therapy and must enhance the therapist’s continuing competence. Qualified activities are set out in Rules .0803(a) and .0805 and contain many opportunities for completing continuing competence requirements.

Licensees have to submit proof of completion of continuing competence activities and shall keep such proof for at least two (2) years and may be subject to random audits by the Board.

No. Rule .0802(d) states that continuing competence activities may not include new employee orientation or annual training required by the employer.

Rule .0802(b) states for each renewal period, each licensee shall document completion of at least one contact hour (one point) of an ethics course related to the practice of occupational therapy. The one point may be included in the total of the required point total for the renewal period.

The ethics course must meet the requirements for continuing competence activity found in Rules Section .0800 (Rules .0801 - .0808). Additionally, whoever presents the course must meet the requirements of Rule .0803(b). It may not be an in-service offered by a co-employee who attended an ethics course.

Enter your ethics activity in the CCA category Ethics regardless of what category of CCA it belongs. This allows the computer to recognize it as your ethics requirement.

You are now able to store your continuing competence activity online by clicking on the Continuing Competence tab and following the detailed instructions.

Rule .0804 states that CCA must be related to the licensee's current or anticipated roles and responsibilities in OT and must enhance the licensee's continuing competence. Courses that are sponsored or approved by the North Carolina Occupational Therapy Association (NCOTA), American Occupational Therapy Association (AOTA), or National Board for Certification in Occupational Therapy (NBCOT) are considered to be approved by the NC Board, however it is not required that a licensee complete courses approved by these organizations. Read Section .0800 of the Rules of the North Carolina Board of Occupational Therapy for more information about what activities qualify for maintaining continuing competence.

License Verification

Please refer to the License Verification link.

Please refer to the License Verification link.

Links to Other Related Boards

Forms

Name change requests are required to be submitted to the Board office by mail or email, along with a photocopy of proof of your name change, i.e.: marriage license, divorce papers, or court documents relating to legal change of birth name. Please use the Name Change Only Notification Form located under the Information Update tab on the website.

Please refer to Continuing Competence tab on the website

Please refer to Continuing Competence tab on the website

Supervision Questions

Yes, an OTA must always have an OT supervisor.

The amount of supervision will depend on the experience and service competency demonstrated by the OTA. Supervision needs to be an interactive process between the OT and the OTA. Refer to the Practice Act and Rules of the Board and the Supervision section on the website.

Yes. Refer to Rule .0901 of the Rules of the Board.

All supervising OTs who have determined that you are competent to provide treatment in your particular work setting and who determines that you are receiving the appropriate supervision.

Refer to Section .0900 of the Rules relating to supervision and roles of the OTA. Rule .0903 states that OTAs at all levels shall require general supervision by an OT. Pursuant to Rule .0103(21), supervisory visits may be in-person or through videoconferencing but must occur at least once a month. The specific frequency, methods, and content of supervision may vary by practice setting and are dependent on the complexity of client needs, number and diversity of clients, demonstrated service competency of the OT and OTA, type of practice setting, requirements of the practice setting, and federal and state regulatory requirements."

Rule .0905(1)(a)(ix) of The Rules of the North Carolina Board of Occupational Therapy states that the OT must initiate the evaluation. In occupational therapy practice, the term initiate is understood to mean making the first, in person, face-to-face contact with the client.

In the initial contact with the client, the OT: (1) determines the need for service, (2) defines the problems within the domain of occupational therapy that need to be addressed, (3) determines the client’s goals and priorities, (4) establishes intervention priorities, (5) determines specific further assessment needs, and (6) determines specific assessment tasks that can be delegated to the OTA.

After the initial contact with the client by the OT, the OTA may implement specifically delegated assessments for which service competency has been established, demonstrated and documented.

The OT is then responsible for completing the evaluation, interpreting the information provided by the OTA who completed the assessments, establishing intervention priorities, and developing the intervention plan.

“General supervision” requires at least monthly direct contact, with supervision available as needed by other methods pursuant to Rule .0103(21)(a).

General Information

Yes. Pursuant to Section .0401 of the Rules, it is the licensee’s responsibility to notify the Board of each change of name, residence, trade name, business address or mailing address within ten days of such change. You may now do this online by going to the Information Update tab of the website and following the detailed instructions. Do not mail written updates to the Board office after you update your online profile.

See the Practice Act (N.C.G.S.90-2570.78 (3)) which lists the abbreviations you may use once you are licensed. Remember that the National Board for Certification in Occupational Therapy (NBCOT) owns the trademarks OTR and COTA. If you wish to use those letters, you must maintain certification with National Board for Certification in Occupational Therapy (NBCOT) or you will be violating trademark laws. The NC Board does not require that you maintain your certification and does not use the C for OTAs or the R for OTs in its records. You may continue to use such designations if you maintain your national certification.

The Board does not require that you maintain your certification with the National Board for Certification in Occupational Therapy and does not use the C for OTAs or the R for OTs in its records. You may use such designations if you maintain your national certification.

Rule .0103(15)(c)(xiii) of the Rules Occupational Therapy Board provides occupational therapy services (interventions and procedures) include the use of physical agent modalities (PAMs) and the use of specific therapeutic procedures to enhance performance skills. Therefore, PAMs are allowed in OT practice. However, it is the opinion of the NC Board that an OT may use PAMs in the course of their occupational therapy practice, so long as they are trained and competent to do so AND their competency has been demonstrated and documented, provided they are billing for OT services. It is also the opinion of the Board that an OTA may use PAMs in the course of their occupational therapy practice, so long as they AND their supervising OT are trained and competent to do so AND their competency has been demonstrated and documented, provided they are billing for OT services. The burden is on the occupational therapy practitioners to prove that they are competent to provide the treatment.

Yes, under the supervision of an Occupational Therapist.

The OT is responsible for the overall completion of the discharge summary. The OT should write the discharge summary or should provide or review the information the OTA uses to write the discharge summary for the OT. The OT should sign the discharge summary. The OTA may report data for the discharge summary and may formulate discharge and/or follow-up plans under the supervision of the OT.

An order is not a requirement of the NCBOT but may be required by some facilities, billing services, or third party payers.

Whether or not an OTA can do "screens" depends on the information sought to be gathered in the "screen". An OTA can state or write observations but cannot make an evaluation or determine a need for occupational therapy services. This must be determined and requested by an OT.

Go to the How to File a Complaint tab at the Board’s website and follow the instructions.

An OT may provide wound care, including sharp wound debridement, so long as it is in the course of OT treatment and the OT is trained and competent to provide wound care, including sharp wound debridement, and such competency has been demonstrated and documented.

An OTA may provide wound care, excluding sharp wound debridement, so long as it is in the course of OTA treatment and the OTA and the supervising OT are trained and competent to provide wound care, excluding sharp wound debridement, and such competency has been demonstrated and documented by both the supervising OT and the treating OTA

In all instances, the burden of proof is on the therapist (OT or OTA) to prove competency to provide wound care.

There is no “Inactive” status. Your license is either current or expired. If you choose to renew your license within 24 months of the expiration date, you will still be required to complete the continuing competency requirements and pay the renewal fees for the period of time your license was not current, along with any applicable late fee.

Persons whose license has expired for more than 24 months, and who desire to reinstate their license, must make a new application for licensure and meet all requirements then existing.

In 2006 the Board agreed to participate annually with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill in collecting data for their annual publication on NC Health Professions. Each year the Center publishes a book with data from approximately 20 health care professions. This data is used by the legislature, policy makers, educators, the press and others in identifying emerging health workforce issues, monitoring trends in health professional supply and distribution and providing policy makers with objective, timely data for informed health workforce policy debates. You may get more information on this program at http://www.shepscenter.unc.edu.

There is a $15 fee for a duplicate license and a $5 fee for a duplicate renewal card. A duplicate license or card can be requested under the Information Update tab on the Board’s website. You can also print your card for free under the Renewals tab.

The Board at its September 18, 2023, meeting, reviewed its position on dry needling. In doing so it considered recent positions taken by AOTA and other states.

The Board determined, pursuant to N.C.G.S. 90-270.67(4) and 21 NCAC 38 .0103(15)(c)(xiii), dry needling is a physical agent modality within the scope of practice of occupational therapy in North Carolina, provided that the occupational therapy practitioner demonstrates and documents competency in the modality and is practicing within the occupational therapy scope of practice. If the dry needling modality will be administered by an occupational therapy assistant both the supervising occupational therapist and occupational therapy assistant must demonstrate and document competency in the techniques and modality.

At its July 22, 2019 Board meeting, the Board agreed that pursuant to Rule .0103(15)(c)(xiii), Class III and Class IV lasers designed and approved for therapeutic procedures may be used to enhance occupational performance skills so long as the OT practitioner has been trained to do so, is competent to do so, and the training and competence of the OT practitioner has been demonstrated and documented.

At its July 22, 2019 Board meeting, the Board agreed that integrated and therapeutic listening is within the scope of practice of occupational therapy and can only be used in conjunction with other occupational therapy interventions so long as the OT practitioner has been trained to do so, is competent to do so, and the training and competence of the OT practitioner has been demonstrated and documented.