2026 How to Become an Occupational Therapist in Massachusetts

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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Massachusetts offers a robust demand for occupational therapists, with employment projected to grow by 14% from 2022 to 2032, surpassing the national average. This growth reflects the state’s aging population and expanding healthcare services, making the field promising for job stability and career advancement.

However, prospective students should consider the rigorous education and licensing requirements that shape entry into this profession. Balancing the high cost of education against potential earnings and job satisfaction requires careful evaluation.

This article outlines the precise steps to become an occupational therapist in Massachusetts. Prepared by experts in career planning, it aims to provide clear, reliable guidance tailored to the state’s regulatory environment. Readers will find essential information that supports informed decisions about pursuing this fulfilling healthcare career.

Key Things to Know About Becoming an Occupational Therapist in Massachusetts

What are the education requirements to become an occupational therapist in Massachusetts?

Formal education lays the foundation for occupational therapists to effectively address the complex physical, emotional, and developmental challenges faced by patients. It cultivates the scientific knowledge, clinical reasoning, and interpersonal skills needed to implement evidence-based interventions safely within diverse healthcare settings.

Below are the key education requirements needed to pursue a career as an occupational therapist in Massachusetts.

• Bachelor’s Degree Prerequisite: Before entering graduate studies, candidates must earn a bachelor’s degree, often in health science, psychology, or biology. Although no specific major is required, completing coursework in anatomy, physiology, psychology, and statistics prepares students for the academic rigor of occupational therapy programs and meets typical admissions expectations.
• Graduate Degree in Occupational Therapy: Aspiring therapists must obtain a master’s (MSOT) or doctoral degree (OTD) from an accredited occupational therapy program. Massachusetts features several accredited occupational therapy programs in Massachusetts that meet the standards set by the Accreditation Council for Occupational Therapy Education (ACOTE). These graduate programs generally require two to three years and provide specialized training to develop advanced clinical skills.
• Supervised Fieldwork Completion: Integral to any accredited program is supervised fieldwork, which includes Level I and Level II experiences. Level II involves at least 24 weeks of full-time clinical practice under licensed professionals, offering hands-on patient care training and critical real-world exposure.
• Graduation from an ACOTE-Accredited Program: Only students graduating from ACOTE-accredited programs are eligible to sit for the National Board for Certification in Occupational Therapy (NBCOT) exam, a mandatory step before Massachusetts licensure. This accreditation ensures that programs meet consistent educational quality and prepare candidates for professional practice.
• Preparation for Licensure and Certification: After completing educational and fieldwork requirements, candidates must pass the NBCOT exam and apply for state licensure. The strong performance of Massachusetts graduates on this exam reflects the effectiveness of local accredited occupational therapy programs. For those considering alternative healthcare training timelines, exploring how fast can you finish medical billing and coding school can offer perspective on different career pathways within health services.

How do you get a state license to practice occupational therapy in Massachusetts?

Obtaining state licensure is a fundamental requirement for occupational therapists in Massachusetts to establish professional credibility and ensure compliance with legal practice standards. This credential safeguards public safety by confirming that practitioners have met essential educational, examination, and ethical standards.

Navigating the Massachusetts occupational therapist licensing process involves several critical steps that aspiring occupational therapists must carefully complete.

Here are the key steps involved in how to get your OT license in Massachusetts:

• Complete an ACOTE-Accredited Educational Program: Successfully graduating from an occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education is a mandatory first step. For occupational therapists, this generally means earning at least a master’s degree, while occupational therapy assistants need an associate’s degree from an accredited program.
• Pass the NBCOT Certification Examination: After finishing your education, passing the National Board for Certification in Occupational Therapy exam is essential. This standardized exam evaluates your competency and is a prerequisite for licensure, demonstrating you meet the profession’s national standards.
• Submit Official Academic Transcripts: You must provide official transcripts from all educational institutions attended, showing degree completion and required academic and fieldwork components. These should be sent directly to Professional Credential Services, the licensing processor for Massachusetts.
• Complete the State License Application: The application to Professional Credential Services must be thoroughly completed and submitted with the appropriate fee. The fees depend on the license type and process, including options for temporary licenses or reciprocity.
• Request NBCOT Verification: You need to have NBCOT send verification of your certification directly to the Massachusetts Board of Allied Health Professions, confirming your passed exam status.
• Complete Required Background Checks: Massachusetts may require state and federal criminal background checks to ensure public safety. These must be successfully completed before the license is granted.

Prospective occupational therapists should also consider how the licensing process intersects with the professional responsibilities of a medical biller and coder, as comprehensive knowledge in related healthcare roles can enhance understanding of the healthcare system while pursuing licensure.

How often do you need to renew an OT license in Massachusetts?

License renewal plays a crucial role in upholding the standards of occupational therapy by ensuring practitioners remain accountable and competent throughout their careers. In Massachusetts, this process helps maintain alignment with current clinical practices and state regulations, which are essential for patient safety and professional integrity.

Without systematic renewal, the risk of outdated knowledge and noncompliance with evolving laws could compromise the quality of care delivered by occupational therapists.

Occupational therapists in Massachusetts must renew their licenses every two years, with the deadline set on the licensee’s birthday. This fixed biennial schedule is strictly enforced, and the license expires if not renewed by that date. While the state does not prominently communicate formal grace periods or specific penalties for late renewal, delays can lead to loss of eligibility to practice, along with possible late fees or disciplinary actions.

This renewal cycle also requires OTs to complete continuing education, ensuring ongoing professional development consistent with regulatory expectations. Such structure reinforces readiness to meet the dynamic demands of healthcare and supports a competent, informed workforce.

An occupational therapist from Massachusetts, who graduated from a local university, shared reflections on this renewal process. He described the task as a well-integrated yet occasionally stressful part of professional life: “Knowing the license expires exactly on my birthday keeps me aware but also adds a personal reminder each year.” He mentioned the challenge of juggling continuing education credits with a busy schedule but emphasized that “completing the required ethics and state-specific courses made me feel more connected to my role here.” His experience underscores the balance between administrative responsibilities and the ongoing commitment to professional growth embedded in Massachusetts’ renewal system.

What continuing education is required for OT license renewal in Massachusetts?

Continuing education plays a crucial role for occupational therapists in Massachusetts, helping them sustain professional competence while meeting state requirements. It also supports practitioners in staying informed about evolving therapeutic techniques and legal regulations that affect their daily practice.

Such ongoing learning is essential to delivering care that is both effective and ethically responsible.

• Required Hours – License renewal for OTs and OTAs mandates completing 24 points (equivalent to 24 hours) of approved continuing competence activities every two years, aligning with the licensee’s birthdate renewal cycle.
• Ethics and Regulations – At least two of these hours must specifically address ethics, laws, and regulations governing occupational therapy practice in Massachusetts, underscoring the importance of legal and professional standards.
• Course Topics and Formats – Approved activities include formal courses, workshops, and seminars relevant to occupational therapy, but must contribute directly to professional growth. Some providers offer courses that fulfill these criteria, such as those who include mandated ethics content; one example is the online medical billing and coding class which can supplement broader professional knowledge.
• Reporting and Documentation – Practitioners must maintain proof of completed education for at least four years and verify compliance during the online license renewal process, recognizing that audits may occur randomly.
• OTA Requirements – Occupational therapy assistants are subject to the same continuing education expectations as therapists, without additional distinct mandates, ensuring consistent standards within the profession.

How much does it cost to become an occupational therapist in Massachusetts?

The total cost of becoming an occupational therapist (OT) in Massachusetts depends on various factors, including the choice of program, exam fees, and licensing requirements. Recognizing these expenses upfront helps prospective students manage their finances and avoid unexpected burdens during training and certification.

• Tuition and Fees: Accredited OT programs in Massachusetts show considerable variation in costs. For example, MCPHS charges around $103,845 total for its two-year master’s program, while Boston University’s one-year Doctor of Occupational Therapy (OTD) program estimates direct fees near $69,870. More affordable routes, like community colleges offering Occupational Therapy Assistant programs, may cost significantly less per credit but still require financial planning.
• NBCOT Exam Fee: Passing the National Board for Certification in Occupational Therapy exam is mandatory with a $555 application fee (2025 rates). Additional costs for study materials or preparatory courses, which can range from $100 to $300, should also be factored in, alongside potential retake fees.
• State Licensure Application: To legally practice in Massachusetts, applicants pay a $226 licensing fee through the state board. Renewal and verification fees may also apply over time, adding to ongoing professional expenses.
• Background Checks and Health Screenings: Many programs require these for field placements or employment, typically costing between $50 and $100 for background checks and $100 to $400 for health-related screenings or immunizations.
• Professional Memberships: While optional, memberships in associations like the American Occupational Therapy Association offer networking and resources. Student memberships usually cost about $75 annually, with state association fees often lower, around $30 to $50 per year.
• Books, Supplies, and Technology: Required materials and equipment for coursework and clinical practice often total between $1,000 and $3,000, a cost that may vary depending on specific program requirements.
• Living Expenses: Urban campuses involve higher housing and food costs, with estimates like $65,742 total over two years at MCPHS or roughly $15,450 annually at Boston University. These expenses merit careful budgeting, given their sizable share of overall costs.

What financial aid options are available for OT students in Massachusetts?

Affording occupational therapy education in Massachusetts presents a significant challenge, as total costs often exceed $100,000 in tuition alone, excluding living and material expenses. Financial aid plays a critical role in reducing this burden, enabling a wider and more diverse group of students to pursue licensure and professional practice.

Below are the key financial aid options available to occupational therapy students in the state:

• Federal Grants provide need-based support primarily for undergraduate students, including those in combined or bridge OT programs, helping to offset early educational expenses.
• Federal Student Loans such as Direct Unsubsidized and Graduate PLUS loans are accessible through FAFSA, offering graduate OT students funds with manageable repayment options that often begin post-graduation.
• Massachusetts State Grants and Scholarships target residents enrolled in approved programs, with emphasis on financial need and fields related to behavioral health, providing additional resources specifically within the state.
• Massachusetts Loan Repayment Program (MLRP) encourages service in underserved areas by offering up to $50,000 in loan repayment over two years to licensed occupational therapists committed to high-need communities.
• University-Based Scholarships and Assistantships are merit- or achievement-based awards offered by institutions such as Western New England University and MCPHS, sometimes including tuition remission and stipends for teaching or research roles.
• Professional and Association-Sponsored Awards from groups like the Massachusetts Association for Occupational Therapy support students demonstrating leadership and academic excellence within the profession.
• Private and External Scholarships come from various foundations and organizations, often targeting financial need, community service, or specific backgrounds, with awards typically ranging from $1,000 to $5,000.
• Work-Study and Part-Time Employment provide income through federal or institutional programs to help cover living costs while gaining relevant experience, often via campus-based roles.

Can out-of-state occupational therapists work in Massachusetts?

Massachusetts does not permit out-of-state occupational therapists to practice using their existing licenses, nor does it participate in the Occupational Therapy Licensure Compact. Instead, anyone trained outside Massachusetts must apply for a state license through the Board of Allied Health Professionals.

This process involves submitting official educational transcripts, proof of NBCOT certification, and passing a criminal background check, along with demonstrating “good moral character.”

For those already licensed elsewhere, the state offers licensure by reciprocity or endorsement, which requires verification of active license status in all states where the therapist has been licensed. However, reciprocity still entails a comprehensive review and fees, emphasizing Massachusetts’s commitment to maintaining high professional standards.

Temporary licenses are only available to new graduates awaiting NBCOT exam results, not to experienced out-of-state therapists, which may restrict immediate practice opportunities. An occupational therapist from Massachusetts, who graduated locally, reflected that although the licensing process seemed lengthy and detailed, it reinforced the profession’s integrity in the state.

She noted, “While it was initially frustrating navigating the paperwork and waiting for approval, the thorough checks ultimately gave me confidence in the quality and safety standards that protect both therapists and patients here.” Her experience offers insight into the rigorous but thoughtful approach Massachusetts uses to integrate out-of-state professionals into its healthcare system.

How can occupational therapists leverage their skills for caregiver roles in Massachusetts?

Occupational therapists possess a broad clinical skill set and patient-centered approach that are highly transferable to caregiving roles. Professionals interested in expanding their practice into caregiving should consider obtaining targeted certifications and training to meet the nuanced requirements of in-home and community care settings. By complementing their existing expertise with specialized education, these practitioners can offer integrated care services, bridge gaps in transitional care, and address the growing demand for personalized support. For more detailed guidance on the certification process and state-specific criteria, review how to become a caregiver in Massachusetts.

What skills do you need to be a successful occupational therapist in Massachusetts?

Occupational therapists in Massachusetts serve a critical function in assisting clients to regain independence and enhance their overall quality of life. Their role extends beyond individual patient care to active collaboration within multidisciplinary healthcare teams, ensuring holistic support.

Given the state's strong demand for occupational therapy professionals, mastering a range of specialized skills is essential for effective practice and regulatory compliance. Below are key skills necessary for success in this field:

• Clinical Reasoning and Problem-Solving: This involves analyzing client evaluations to design tailored intervention plans, adapting approaches based on patient progress, which directly influences rehabilitation outcomes and satisfaction.
• Communication and Interpersonal Skills: Clear and empathetic communication facilitates collaboration with clients, families, and healthcare teams, fostering trust and adherence to therapy protocols essential for sustained improvement.
• Evidence-Based Practice and Technical Competence: Occupational therapists must apply current research and standardized assessments rigorously, ensuring interventions are safe, effective, and meet Massachusetts regulatory standards.
• Ethical and Professional Judgment: Maintaining client confidentiality, securing informed consent, and recognizing when referrals are necessary safeguard client well-being and uphold professional integrity.
• Adaptability and Lifelong Learning: Continuous education and responsiveness to emerging healthcare technologies are mandated by the state, helping therapists remain competent amid evolving practice landscapes.

What specializations are available for occupational therapists in Massachusetts?

Specializing enables occupational therapists to develop targeted expertise in particular populations or clinical areas, which can significantly broaden career opportunities and deepen their professional impact in Massachusetts. Choosing a specialization also aligns with regional healthcare needs and supports the evolving demands of the workforce.

Below are several occupational therapy specialties in Massachusetts that practitioners may pursue to enhance their skills and credentials.

• Pediatrics: This area focuses on supporting children with developmental challenges or disabilities, including autism, to achieve daily living and educational skills. Pediatric therapists often work in schools, hospitals, or community clinics where early intervention is emphasized within Massachusetts’ healthcare framework.
• Geriatrics: Specializing in geriatric care involves aiding older adults in maintaining independence and managing age-related physical or cognitive changes. Therapists in this field typically serve in nursing homes, rehabilitation facilities, and home health environments, reflecting the state’s aging population trend.
• Mental Health: Occupational therapists with this specialization assist individuals facing mental health conditions to develop coping mechanisms and improve functional abilities. Their work usually takes place in psychiatric hospitals, community mental health organizations, and private practices, addressing the increasing recognition of mental health needs in Massachusetts.
• Hand Therapy: This technically demanding specialization helps patients recover hand and upper limb function after injury or illness. Hand therapists often practice in specialized rehabilitation clinics where they apply advanced techniques to restore mobility and dexterity.
• Rehabilitation: Therapists focusing on rehabilitation help patients regain independence following physical injuries such as strokes or spinal cord trauma. They work in hospitals and rehabilitation centers, employing evidence-based practices that are crucial given the anticipated growth in occupational therapy jobs from 2021 to 2031 in Massachusetts.

For those seeking to advance in their careers, understanding Massachusetts occupational therapist certification specialties is essential. Additionally, comparing a bachelors degree vs medical billing and coding certificate key differences can help clarify educational pathways related to healthcare professions.

What is the average salary of an occupational therapist in Massachusetts?

The average occupational therapist salary in Massachusetts is influenced by multiple factors including experience level, work setting, and geographic location within the state. These elements create a range of potential earnings that reflect the diverse environments in which occupational therapists practice.

Below are key factors that contribute to the occupational therapist pay range in Massachusetts.

• Years of Experience: Experience plays a significant role in salary differences. Entry-level occupational therapists in Massachusetts often start around $90,000 annually, but those with extensive experience can earn over $120,000. This progression reflects the increased skills and responsibilities gained over time.
• Type of Employer: The workplace setting impacts compensation, with hospitals and large healthcare systems typically offering higher pay compared to schools or private practices. Private practice positions might offer more flexible hours but often come with lower salaries, which can affect long-term earnings.
• Geographic Location: Salaries vary across Massachusetts depending on the cost of living and demand within specific areas. Urban centers like Boston and Cambridge usually provide higher pay rates, whereas smaller towns such as Salem have lower averages, with figures around $75,707 per year.
• Education and Certification: Additional qualifications, advanced degrees, and certifications can enhance job prospects and salary potential. Occupational therapists who invest in specialization may become more competitive in the market, impacting their overall compensation.

For those exploring career opportunities or valuing flexible education routes, considering programs like accredited medical billing and coding schools online with financial aid near me might be useful for broadening healthcare knowledge and related skills.

What Do Occupational Therapists in Massachusetts Say About Their Career?

References:

• Occupational Therapy Cost at Massachusetts College I MCPHS https://www.mcphs.edu/academics/programs/occupational-therapy-msot/tuition
• Continuing Education https://www.maot.org/Continuing-Education
• Continuing Education Information | Mass.gov https://www.mass.gov/info-details/continuing-education-information
• Leading Occupational Therapy Programs in Massachusetts https://www.growwithcoral.com/blog/occupational-therapy-top-programs-in-ma
• Office of Student Financial Assistance / Massachusetts Department of Higher Education https://www.mass.edu/osfa/programs/behavhealthscholarship.asp
• Tuition and Application - Occupational Therapy (MS) | Regis College https://www.regiscollege.edu/academics/majors-and-programs/occupational-therapy-ms/tuition-and-application-requirements
• Department of Occupational Therapy | MGH Institute of Health Professions https://www.mghihp.edu/health-rehabilitation-sciences/departments-programs/occupational-therapy
• Massachusetts CEU Requirements for PT, OT, SLP & RN – Medbridge Help Center https://support.medbridge.com/hc/en-us/articles/17790278729235-Massachusetts-CEU-Requirements-for-PT-OT-SLP-RN
• Learn the steps to occupational therapy state licensure. | AOTA https://www.aota.org/career/state-licensure/learn-the-steps-to-licensure
• Skills Every Occupational Therapist Should Have https://www.husson.edu/online/blog/2025/02/skills-occupational-therapists-should-have

Other Things You Should Know About Becoming an Occupational Therapist in Massachusetts