In this guide, we break down whether Certified Occupational Therapy Assistant (COTA) certifications are worth the investment—looking at costs, salaries, job outlook, and career potential.
Is COTA certification worth it? The short answer is that it can be, depending on your goals.
A good paycheck, steady hours, a respected healthcare role—and the chance to actually help people live better lives every single day. That’s what makes becoming an occupational therapy assistant (OTA) so appealing right now.
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But, of course, like any big decision, it’s not all sunshine and success stories. You’ve got to look at the whole picture.
Yes, the job is rewarding—but getting there takes time, money, and effort. Tuition, exam fees, and licensing costs can add up. And while the pay is definitely decent, it’s not exactly millionaire territory. The work itself can also be challenging—physically and emotionally—especially when you’re helping people through tough moments.
So, is it all worth it? Let’s break it all down— including what the day-to-day work actually looks like, how to get certified, and the Certified Occupational Therapy Assistant salary.
What Is a Certified Occupational Therapy Assistant (COTA)?
So, what does a Certified Occupational Therapy Assistant actually do all day? A lot more than you might think—and every task is focused on helping someone get back to living a fuller, more independent life.
Here’s a glimpse into what a typical day might involve:
- Helping patients with therapeutic exercises. Whether it’s rebuilding strength after surgery or improving fine motor skills, you’ll guide patients through exercises designed to support their recovery.
- Teaching people how to use assistive tools. This could be anything from special eating utensils to wheelchairs or dressing aids. You’ll help patients learn how to use these tools confidently and safely in their daily lives.
- Documenting progress and reporting back to the OT. COTAs work closely with Occupational Therapists and play a key role in tracking patient progress and adjusting treatment plans as needed.
- Working one-on-one or in group settings. Sometimes, you’ll focus on individual care; other times, you’ll run small therapy groups, depending on the setting and the goals.
- Providing emotional support. Let’s be honest: recovery can be tough. Part of your role is simply being there—cheering patients on during their progress and offering compassion during setbacks.
One of the great things about becoming a COTA is the variety of places you can work. You’re not tied to a hospital or locked into one type of facility. Here are some common settings:
- Hospitals
- Rehabilitation centers
- Schools
- Nursing homes and long-term care facilities
- Home health agencies
- Mental health facilities
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How Do You Get COTA Certified?
Becoming a Certified Occupational Therapy Assistant (COTA) is more accessible than many other healthcare careers, but it does require specific education, training, and certification steps. Here’s the lowdown:
Education and Training
- Get an associate’s degree.
- First, you’ll need to finish an Occupational Therapy Assistant (OTA) program that’s accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Only grads from ACOTE-approved programs can take the certification exam.
- These programs mix classroom time with hands-on fieldwork. You will work directly with patients while learning the theory behind occupational therapy.
- How long does it take?
- Most full-time programs take about two years to finish. Some schools might offer part-time or online options if you need more flexibility, but two years is the usual timeline.
Getting Certified
- Pass the NBCOT Exam.
- After you graduate, you’ll have to pass the National Board for Certification in Occupational Therapy (NBCOT) exam. Once you pass, you officially become a Certified Occupational Therapy Assistant (COTA).
State Licensing
- Get licensed or registered in your state before you can start working.
- Each state has its own rules, so check with your local licensing board to find out exactly what you need to do.
- At this point, is a COTA certification worth it? Absolutely yes. Becoming an OTA is a rewarding career, and it’s relatively quick and straightforward to pursue compared to many other healthcare paths.
How Much Does a COTA Certification Cost?
Before you decide to jump in, you should know the Occupational Therapy Assistant certification cost. It’s important to keep in mind that the exact cost will depend on several things:
- Where you go to school: community colleges are usually cheaper than private schools.
- COTA program length: longer programs can cost more.
- Living expenses: moving or commuting adds up.
- Books, supplies: these small costs add up, too.
- Exam and licensing fees: remember the NBCOT exam and state license costs.
Tuition Costs
Most OTA programs range between $10,000 and $30,000 total.
- Community or technical colleges usually fall closer to $10,000–$15,000.
- Private or out-of-state schools can cost $25,000 to $30,000 or more.
Exam Fees
Here are the current NBCOT certification exam fees:
- Initial Exam Application:
- Online: $540
- Paper: $595
- Retake Exam Application:
- Online: $430
- Paper: $485
There are also certification maintenance fees:
- Online Renewal Application: $65
- Paper Renewal Application: $75
- Reinstatement Within 3 Years of Expiration: $125
- Reinstatement After 3 Years: $175
- Verification of Certification: Free
Books and Supplies
Plan to spend around $300 to $600 on textbooks, clinical gear, uniforms or scrubs, and any required software or materials.
Licensing Fees
State licensing fees typically range from $50 to $200, depending on where you live.
Additional Costs
Other expenses like background checks, immunizations, travel for clinical placements, and application fees can add up to a few hundred dollars more, depending on your program and location.
Financial Aid Options for COTA Programs
Meeting the Occupational Therapy Assistant education requirements can be expensive for some, especially those balancing work, family, or other financial responsibilities. Luckily, there are several ways to make it more affordable:
Scholarships, Grants, and FAFSA
If you’re attending an accredited program, you likely qualify for federal financial aid. Fill out the FAFSA (Free Application for Federal Student Aid) and you might get:
- Pell Grants (free money!)
- Federal student loans (which you’ll repay later, ideally after landing a good job)
- Work-study opportunities
Aside from federal and school-based financial aid for COTA programs, you should also check for scholarships from professional organizations like:
- The American Occupational Therapy Foundation (AOTF)
- Your college’s financial aid office
- Local healthcare employers (some offer tuition reimbursement)
Tips for Finding Affordable Programs
- Look into community colleges with OTA programs—they’re often just as good as pricier schools.
- See if there are hybrid or online programs that reduce transportation or housing costs.
- Apply early—some programs fill up fast, and last-minute applications can cost more.
What Can You Earn as a COTA?
According to the U.S. Bureau of Labor Statistics, the average annual salary for a COTA is around $68,340 (as of 2024). But your earnings can vary based on where you work:
- Home Healthcare Services: $76,800/year
- Nursing Care Facilities: $75,860/year
- Therapists’ Offices (Physical, Occupational, Speech, Audiology): $65,590/year
- Hospitals (State, Local, Private): $65,280/year
- Educational Services (State, Local, Private): $59,240/year
Besides a decent salary, most full-time COTA jobs offer:
- Health insurance
- Paid time off
- Retirement plans
- Continuing education assistance
Job Outlook: Are COTAs in Demand?
Yes!
The COTA job outlook is growing. According to BLS projections, job growth is expected to increase by 21 percent from 2023 to 2033—much faster than the average for all occupations.
Why? An aging population and increasing focus on rehabilitation and long-term care are driving up the need for OT services. That means more jobs for COTAs across the country.
Is a COTA Certification Worth It?
Now for the big question.
Pros
- Quick entry into healthcare: You can be working in just 2 years.
- Good salary: $60K+ is pretty solid, especially without a 4-year degree.
- Emotionally rewarding: You’ll actually make a difference in people’s lives.
- Job security: Healthcare is a stable industry, and COTAs are in high demand
Cons
- Upfront costs: Even a community college program will cost a few thousand dollars.
- Limited upward mobility: You may need to become a full OT or get a bachelor’s degree to advance.
- Physically and emotionally demanding: You’ll be on your feet, and you’ll deal with people in tough situations.
So, is COTA certification worth it? For many people, yes—especially if you want a meaningful, stable career without years of schooling.
Affordable Online and Hybrid Programs to Consider
Not everyone can drop everything and go to school full-time. If you need flexibility, look into the following affordable occupational therapy assistant programs:
- American Career College – This 20-month OTA program combines classroom, lab, and hands-on training to prepare you to support patients with physical, mental, or developmental challenges.
- Black Hawk College – Focuses on building your skills in rehab, therapeutic techniques, and holistic care. Hands-on clinical training gets you ready to help individuals, groups, and communities reach their goals.
- Brookline College – This 72-credit OTA program includes hands-on experience in settings like hospitals, schools, and clinics. With built-in fieldwork, you’ll work with real clients in areas like pediatrics and rehab—earning your degree in as little as 96 weeks.
COTA Certification vs. Full OTA Degree: What’s the Difference?
If you’re looking into a career in occupational therapy, you might come across the comparison between a COTA certification vs OTA degree. So what’s the difference?
The truth is—they’re actually part of the same path. To become a Certified Occupational Therapy Assistant (COTA), you first need to complete an OTA degree. This is typically a 2-year associate degree from an ACOTE-accredited program.
Once you graduate, you take the NBCOT exam, and if you pass, you earn your COTA certification. So, the certification isn’t a separate option—it’s the final step after earning your degree.
In short:
- OTA degree = your education and training
- COTA certification = your official credential to work
Final Thoughts: Making the Right Choice for Your Future
Choosing whether to pursue a COTA certification isn’t just about the numbers or the degree title. It’s about your life, your goals, your values, and your day-to-day happiness.
Here are a few key questions to ask yourself before enrolling:
- Do I enjoy helping people in a hands-on way? COTAs spend a lot of time with patients—often more than the OTs themselves. If you love building relationships, being supportive, and seeing real progress in people’s lives, this might be your calling.
- Am I okay with a job that can be physically and emotionally demanding? Helping others can be deeply rewarding but also challenging. Patients may struggle or decline. You’ll need to stay patient, compassionate, and positive—even on the hard days.
- What’s my long-term plan? If you see yourself staying in a support role long-term, that’s totally valid. But if you’re dreaming of running your show or specializing, think about whether further education is in your future.
- Can I afford the upfront investment—or find financial aid? Don’t just look at the sticker price. There are scholarships, grants, and affordable programs out there. You might be surprised what’s possible once you dig a little deeper.
Still not 100% sure? That’s okay. Here are a few steps you can take to get more clarity:
- Talk to a COTA in your area. Most professionals are happy to share their experiences.
- Visit local schools or community colleges. Ask about their OTA programs and financial aid.
- Shadow an occupational therapist. See what the work really feels like before you commit.
- Join an online forum. Reddit, Facebook groups, and other communities for OTAs can offer unfiltered insights.
Some helpful links to start your research:
- https://www.nbcot.org – For certification info
- https://www.acoteonline.org – Accredited programs list
- https://www.bls.gov – Job outlook and salary info
- https://www.aota.org – American Occupational Therapy Association