NH Occupational Therapy License: NBCOT Exam, OPLC Application, Renewal

To practice in the state, you need a New Hampshire occupational therapy license issued by the Office of Professional Licensure and Certification (OPLC). The core requirements: finish an ACOTE-accredited OT or OTA program, complete your supervised fieldwork, pass the NBCOT certification exam, clear state and FBI background checks, and submit an application with a $121 fee.¹ The same fee applies whether you’re licensing as an occupational therapist or an occupational therapy assistant.

Who Qualifies

RSA 326-C:5 sets the baseline. You must be at least 17, show good moral character, and have graduated from an occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). The degree depends on the credential: ACOTE accredits master’s and doctoral programs for OTs and associate or baccalaureate programs for OTAs.²

You also need supervised fieldwork approved by your school. The statutory minimum is six months for OTs and two months for OTAs.² Most accredited programs build in more than that because ACOTE’s own standards require 24 weeks of full-time Level II fieldwork for OT students and 16 weeks for OTA students.³

Good moral character is reviewed through your application disclosures and references. The board asks about prior disciplinary actions, license denials, and criminal history. A past conviction isn’t an automatic bar; the question is whether it relates to safe practice.

The NBCOT Exam

You have to pass the entry-level exam from the National Board for Certification in Occupational Therapy. There are two versions: the OTR exam for occupational therapists and the COTA exam for assistants. Both run year-round at Prometric centers, and you must finish all education and fieldwork before registering.²

The online initial application costs $540. A retake, if you need one, is $430.⁴ The test has 170 multiple-choice questions plus a clinical simulation section, all inside a four-hour window. Passing takes a scaled score of 450 or higher on a 300-to-600 scale.⁵ NBCOT imposes a waiting period after a failed attempt before you can retest; the length is in their exam handbook.

One timing trap catches people who delay. If you passed the NBCOT exam more than one year before applying for your New Hampshire license, the board will require you to meet continuing competency requirements before processing your application.²

Applying Through the OPLC

Applications go through the OPLC’s online portal. The fee is $121.¹ Beyond the application itself, the OPLC needs these items sent to it directly from the source:

Official transcripts from your OT or OTA program, confirming completion.
A fieldwork verification letter from your supervising occupational therapist or school documenting duration and settings.
Proof that you passed the NBCOT exam.
License verification from any other state where you’ve held an occupational therapy license, including any disciplinary history.⁶

Third-party documents are the usual bottleneck. Transcripts and verification letters can take weeks, so request them before you file.

Background Check

You need both a New Hampshire criminal history check and an FBI fingerprint-based background check. The OPLC’s instructions place occupational therapy under Option B for applicants who can be fingerprinted in-state and Option C for those who can’t. For in-state fingerprinting, you schedule through the New Hampshire Department of Safety’s Criminal Records Portal. The fee is $48.25, paid online by credit or debit card, and you’ll bring a valid government-issued photo ID. Processing usually takes two to four weeks, and your application won’t move until the results arrive.⁷

If You’re Already Licensed in Another State

Holding an active, unrestricted occupational therapy license somewhere else lets you apply by endorsement instead of starting from scratch. You won’t retake the NBCOT exam. The fee is still $121.¹ Your current licensing board must send verification directly to the OPLC, including any disciplinary record.⁶ If the OPLC decides your other state’s requirements don’t substantially match New Hampshire’s, it can require supplemental coursework or supervised practice before issuing the license.

Occupational Therapy Licensure Compact

The Occupational Therapy Licensure Compact lets OTs and OTAs licensed in one member state practice in other member states through a compact privilege, with no separate license required. As of early 2026, 32 states have joined, though only a handful have completed the technical integration needed to actually issue privileges through CompactConnect.⁸ New Hampshire has enacted compact legislation, but whether its integration with CompactConnect is live may still be in progress. Confirm current status with the OPLC or at otcompact.gov before relying on a privilege. Compact privilege or not, you follow New Hampshire’s practice standards when treating patients in the state.

Military Spouses and Service Members

RSA 332-G:7 requires the OPLC to count education, training, and service completed during military duty toward occupational therapy licensing qualifications. Licensed OTs or OTAs called to active duty with the reserves or National Guard can place their license on inactive status for the deployment and then have one year after release to reactivate by paying the renewal fee and completing any outstanding CE. A military spouse who left employment to accompany a service member transferring to New Hampshire and holds a substantially equivalent license elsewhere gets expedited issuance.⁹

Renewing Your License

New Hampshire occupational therapy licenses renew every two years. The renewal fee is $121 for both OTs and OTAs.¹ Miss the deadline and your license becomes inactive, which forces you into reinstatement before you can practice again.

Each renewal cycle requires 24 hours of continuing education. The board requires coverage in two subject areas: clinical application of occupational therapy skills, and general occupational therapy theory and practice.¹⁰ The OPLC audits for compliance, and falling short can trigger disciplinary action.

Reinstating a Lapsed License

If your lapse is recent, reinstatement means paying outstanding fees and showing you’ve met continuing education requirements. No shadowing, no re-examination.

If the license has been lapsed more than six years and you haven’t been practicing, the bar is much higher. You’ll need to complete 100 hours of job-shadowing with a licensed occupational therapist during the six months before you apply, retake and pass the NBCOT exam, and submit a reinstatement application with the required fee and documents. The supervising OT provides a signed letter on business letterhead confirming the shadowing hours.¹¹

If You’ll Be Supervising OTAs

New Hampshire doesn’t cap OTA supervision by headcount. The rule is hours-based: an occupational therapist may not supervise OTAs whose combined hours exceed the equivalent of two full-time occupational therapy assistants at any one time.¹² Three part-time OTAs adding up to two full-time equivalents is permitted; three simultaneous full-time OTAs is not.

1
NH Office of Professional Licensure and Certification. Occupational Therapists License Fees
2
New Hampshire General Court. New Hampshire Revised Statutes Section 326-C:5 – Eligibility for Licensure
3
Accreditation Council for Occupational Therapy Education. 2018 ACOTE Standards
4
National Board for Certification in Occupational Therapy. Fees
5
National Board for Certification in Occupational Therapy. Foundations of the Certification Examinations
6
New Hampshire Office of Professional Licensure & Certification. Occupational Therapist Initial Application Checklist
7
Office of Professional Licensure & Certification. How to Obtain a Criminal Background Check
8
American Occupational Therapy Association. Occupational Therapy Licensure Compact Begins Issuing Compact Privileges
9
New Hampshire General Court. New Hampshire Revised Statutes Section 332-G:7 – Military Service, Occupational Experience or Training, Spouses
10
NH Office of Professional Licensure and Certification. Occupational Therapists Continuing Education
11
Legal Information Institute. New Hampshire Administrative Code Occ 403.07 – Reinstatement of Licensure for Occupational Therapists Who Have Not Been Active in the Profession and Seek Reinstatement of Licenses Lapsed More Than Six Years Ago
12
Legal Information Institute. New Hampshire Administrative Code Occ 407.08 – Limitation on Number of Occupational Therapy Assistants Under Supervision