2026 How to Become an Occupational Therapist in Texas

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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Texas offers a promising future for occupational therapists, with employment expected to grow 21% until 2032, much faster than the average for all jobs. This demand stems from the state’s expanding healthcare needs and aging population. Choosing a career as an occupational therapist in Texas means job security, competitive salaries, and the chance to make a real difference in people’s lives every day.

This article breaks down the steps to become an occupational therapist in Texas. It’s crafted by career planning experts to help you navigate licensing, education requirements, and practical tips to kickstart your journey confidently and informed. You’ll find all the key info needed to launch your OT career in the Lone Star State.

Key Things to Know About Becoming an Occupational Therapist in Texas

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

Getting the right education is key for anyone serious about a career in occupational therapy. This field demands a solid grasp of anatomy, psychology, and rehab skills to truly help patients with their physical and emotional challenges.

If you’re focused on occupational therapy education Texas offers a clear and structured path that builds the knowledge and hands-on experience needed to succeed. Here’s a quick look at the main educational steps involved:

• Bachelor’s Degree: Your journey starts with completing a bachelor’s degree from an accredited school. While any major works, it’s smart to take courses in biology, anatomy, psychology, and social sciences to prepare for graduate programs.
• Graduate OT Program: Next, you’ll need to enroll in an accredited Master or Doctor of Occupational Therapy program. Texas schools like the University of Texas Health Science Center at San Antonio offer these, focusing on building advanced clinical and critical thinking skills. Most don’t require the GRE anymore.
• Prerequisite Coursework: Make sure you complete required courses such as anatomy with lab, psychology, and statistics before applying to grad school. Most programs want these classes done recently and with good grades.
• Supervised Fieldwork: Hands-on experience matters a lot. Texas programs usually require at least six months of supervised clinical practice, where you gain real-world skills in diverse settings.
• Certification and Licensure Preparation: After finishing your degree and fieldwork, the next step is to pass the NBCOT exam to become a Registered Occupational Therapist, then get your Texas state license. Continuing education keeps you current in the profession.

If you’re curious about related healthcare career options and earning potential, here’s a useful guide to nurse medical coder salary.

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

Getting your Texas occupational therapy license is a crucial step if you want to practice legally and build a solid professional reputation in the state. This license shows you’ve met all the standards in education, ethics, and skills required to help people effectively. Here’s a straightforward look at the main steps to secure your occupational therapy license in Texas.

• Complete an Accredited Occupational Therapy Program: You need to graduate from a program recognized by the Accreditation Council for Occupational Therapy Education (ACOTE). Texas offers many such programs, preparing you with the foundation necessary to move forward in your career.
• Fulfill Clinical Experience Requirements: Hands-on experience matters. Occupational therapists complete at least six months of supervised clinical work, while assistants do two months. This practical time helps you build real-world skills under expert guidance.
• Pass the NBCOT Exam: Achieving certification through the National Board for Certification in Occupational Therapy (NBCOT) is mandatory. You must score at or above the 70th percentile on this national exam to prove your knowledge and competency.
• Submit Your Texas Licensure Application: After passing the exam, you’ll send your application to the Texas Board of Occupational Therapy Examiners along with supporting documents like transcripts, proof of NBCOT certification, and a photo. The application fee varies depending on your role.
• Pass the Texas Jurisprudence Exam: This 20-question open-book test covers Texas laws and ethics related to occupational therapy practice, ensuring you understand local regulations.
• Complete a Criminal Background Check and Fingerprinting: To finalize your application, you must pass a background check via fingerprinting. The Texas Board offers a pre-application evaluation if you have any past convictions, which can make this step smoother.
• Additional Board Requirements (If Applicable): If you’re transferring from another state or serving in the military, you might qualify for licensure by endorsement or experience expedited processing. It’s worth checking if you fit these categories for a faster route.

And if you’re curious about career options beyond occupational therapy, exploring the job functions of a medical biller and coder can give you insight into another key healthcare role.

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

Renewing your occupational therapy license in Texas is more than just a bureaucratic step—it’s a key part of making sure therapists stay sharp, ethical, and on top of changes in the field. This ongoing license renewal helps keep the profession trustworthy and guarantees that therapists keep learning about new rules and best practices to provide the best care possible. It’s an accountability check that benefits both the therapist and the patients they serve.

In Texas, occupational therapists must renew their licenses every two years, with the deadline typically falling on the last day of their birth month. The renewal process is straightforward but firm: there’s no official grace period if you miss the deadline, meaning you can’t practice legally until you get your license reinstated, and late fees might kick in.

Along with the renewal application, you need to show that you completed the necessary continuing education hours during those two years, including a mandatory course on human trafficking prevention. This routine keeps therapists eligible to work while making sure they stay aligned with evolving state regulations and professional standards.

I spoke with an occupational therapist from Texas who graduated from a local university about his renewal experience. He told me it was a bit nerve-wracking the first time—juggling paperwork, tracking continuing education credits, and meeting the exact deadline felt like a juggling act. “I remember double-checking every requirement because missing something meant delay and added stress,” he said. But over time, he found a rhythm and now appreciates how this process keeps him engaged with updates in the profession. It’s a steady reminder that staying current isn’t just required, it really benefits your work and your patients.

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

Continuing education is key for occupational therapists in Texas to keep their skills sharp, meet state standards, and stay updated on the latest techniques and rules. This is especially important as healthcare keeps evolving, and OTs need to adapt to new challenges and patient needs. If you're curious about the OT continuing education requirements Texas law sets, here’s a quick rundown.

• 24 Hours Every Two Years: OTs and occupational therapy assistants (OTAs) licensed in Texas have to complete at least 24 contact hours of continuing education every two years to renew their licenses. The renewal is timed with your birth month, so you’ve got a clear deadline to hit.
• Approved Course Content: Courses should focus on practical and important topics like clinical techniques, ethics, patient safety, or professional growth. The Texas Board of Occupational Therapy Examiners trusts courses approved by the American Occupational Therapy Association (AOTA) or the Texas Occupational Therapy Association (TOTA) to meet these standards.
• Human Trafficking Training: Within those 24 hours, completing a human trafficking course approved by the Texas Health and Human Services Commission is mandatory. This helps OTs recognize and respond to human trafficking cases, which is something Texas takes seriously.
• Keep Your Records: Make sure to hang on to certificates or verification letters for at least two years after renewal. The Board might audit your continuing education records anytime, so having proof ready is important.
• Verification and Audits: You won’t usually have to show your continuing education info when you renew, but if the Texas Board requests it or if your renewal is late by over 90 days, you’ll need to provide evidence. Missing documents could mean trouble with your license.
• OTAs Follow the Same Rules: If you’re an OTA, you have the exact same continuing education requirements as OTs, including the human trafficking training. There aren’t any extra hoops for assistants.
• Know What Doesn’t Count: Routine work duties, professional organization membership, and volunteering outside clinical duties don’t count toward your hours. Stick to approved activities to be safe.
• Don’t Wait Till the Last Minute: Technical glitches or paperwork issues can delay your renewal, possibly causing late fees or gaps in your license. Starting early keeps things smooth.

If you want to boost your credentials or explore related fields, check out these Kaiser free medical billing and coding classes that can complement your occupational therapy career nicely.

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

The cost of becoming an occupational therapist in Texas can vary quite a bit depending on the school you pick, the degree you pursue, and the extra steps like exams and licensing. Knowing what expenses to expect can help you map out your budget and avoid surprises down the line.

• Tuition and Fees: This tends to be the biggest cost. For example, a master’s program might run from around $36,700 at some schools to over $90,000 at others. If you’re going for a doctoral program, it could be $110,000 or more, covering tuition, fees, books, and supplies.
• NBCOT Exam Fee: After finishing your program, you’ll need to pass the NBCOT exam to get certified. The exam fee is about $555 as of 2024.
• State Licensure Fees: To legally work in Texas, you must apply for licensure with the state board, which costs around $140 for the initial application plus possible small additional fees.
• Background Check and Fingerprinting: Texas requires a criminal background check and fingerprints, generally costing between $40 and $80 depending on where you go.
• Professional Memberships: Joining groups like the American Occupational Therapy Association isn’t mandatory but is helpful. Student memberships usually cost about $78 a year.

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

Paying for occupational therapy school in Texas can be a bit overwhelming since programs can be pretty expensive, especially at the graduate level. Luckily, there are several financial aid options geared toward easing that burden—whether you’re still working on undergrad prerequisites or in a doctoral program. Here’s a quick rundown of the main types of support you can tap into:

• Federal Grants: These are mostly for undergrads who show significant financial need and haven’t yet earned a bachelor’s or higher degree. The Pell Grant is a well-known example that you don’t have to pay back, perfect if you’re finishing up prerequisite courses before grad school.
• Federal Student Loans: OT graduate students can access loans like the Direct Unsubsidized and Grad PLUS loans. They don’t require demonstrating financial need, but there are borrowing limits. After graduation, many can qualify for repayment programs that ease the payment load or even forgiveness if you work in public or nonprofit sectors.
• Texas State Grants and Aid: The state offers need-based grants mainly for undergrads, like the TEXAS Grant, but some programs support graduate students entering high-demand fields, including OT, especially in underserved areas.
• University-Based Scholarships and Grants: Many Texas schools with OT programs offer merit scholarships based on academics, leadership, or need. Some are automatic with your admission, while others require applications; amounts vary widely.
• Professional and Association Scholarships: These awards come from groups like the American Occupational Therapy Foundation and Texas-specific associations. They’re for full-time OT students, often Texas residents, with amounts ranging from a few hundred to several thousand dollars.
• External and Employer-Sponsored Scholarships: Some employers and healthcare organizations provide scholarships or tuition help if you commit to working with them post-graduation. The VA and other institutions have programs like these, too.
• Loan Repayment and Forgiveness Programs: Working in public service roles or underserved communities may qualify you for loan forgiveness after meeting certain employment and payment requirements, which can make paying off your federal loans much easier.

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

If you’re an occupational therapist licensed out of state and looking to work in Texas, you’ll need to get licensed by the Texas Board of Occupational Therapy Examiners before practicing here. Texas doesn’t allow you to just jump in without a valid state license, so you have to apply either by examination or endorsement.

The endorsement path is for those already licensed elsewhere in the U.S. and who’ve passed the NBCOT exam. You’ll need to submit an application, pay fees, prove your current licensure, and meet Texas’s education and fieldwork standards. Don’t forget the Texas Jurisprudence Exam and fingerprint-based background check, too.

Texas also makes things easier if you’re from another state that belongs to the Occupational Therapy Licensure Compact. This lets you apply for a "compact privilege" to practice here without going through the full licensing process again, but you do have to get that privilege first. For many therapists outside the Compact, endorsement is the key route. Temporary licenses may be available in some cases, like if you’re waiting on exam results or are a military service member.

I talked with an occupational therapist from Texas who graduated from a local program, and she shared how the process felt both straightforward and intense. “When I moved here from another state, I thought my license would transfer easily, but Texas really makes sure you meet their standards,” she said. She appreciated the endorsement route but stressed that the background check and jurisprudence exam took extra time. “It was a bit nerve-wracking waiting, but having to prove my knowledge of Texas laws made me feel more confident practicing here.” This perspective shows how the system balances experience with state-specific requirements, helping therapists adapt and succeed.

Could caregiver certification broaden your occupational therapy career opportunities in Texas?

Expanding your credentials with a caregiver certification can open additional avenues within home and community-based care, offering occupational therapists a competitive edge in Texas. This certification emphasizes skills in personalized care, holistic patient support, and practical day-to-day assistance, which complements traditional occupational therapy techniques. Integrating these competencies can help professionals meet evolving patient needs and tap into interdisciplinary roles in both clinical and residential settings. For detailed information on the process and requirements, consider reviewing how to become a caregiver in Texas.

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

Being a successful occupational therapist in Texas means having a mix of skills that help clients regain independence, boost their quality of life, and fit smoothly into healthcare teams. These skills let therapists customize treatment plans for each person’s unique challenges, whether at home, work, or school. Mastering these abilities makes a real difference in client outcomes and supports the wider healthcare system.

Here are some key skills you’ll need to thrive as an occupational therapist in Texas:

• Communication Skills: Being able to listen carefully and explain treatment plans clearly is a must. Plus, working well with diverse clients and healthcare teams across Texas makes this skill even more important.
• Clinical Reasoning: You’ll need sharp problem-solving skills to gather info, assess needs, and adjust interventions to fit each client’s situation.
• Emotional Intelligence: Staying emotionally stable helps you build trust with clients and handle the fast-paced healthcare environment effectively.
• Motor and Sensory Skills: Physical ability and keen senses are essential for delivering safe assessments and therapies.
• Adaptability: Healthcare settings in Texas can vary a lot, so being flexible to changing client needs is key for success.

What specializations are available for occupational therapists in Texas?

Specializing allows occupational therapists to sharpen their skills in specific populations, conditions, or practice areas, making them more effective and opening up better career opportunities in Texas. These targeted expertise areas mean therapists can provide exactly the right support where it's needed most. Here are some of the common occupational therapy specializations in Texas that many professionals pursue:

• Pediatrics: Focused on helping kids build the skills they need for daily life, learning, and social activities. Therapists often work in schools, outpatient clinics, or early intervention programs, tackling challenges like autism and sensory processing issues.
• Geriatrics: This specialty supports older adults in staying safe and independent. Therapists usually find positions in long-term care facilities, rehab hospitals, or home health agencies, working with seniors on mobility and cognitive health.
• Mental Health: Occupational therapists in mental health assist people dealing with psychiatric conditions and emotional struggles. They practice in places like community health centers, schools, and psychiatric hospitals, helping clients engage in meaningful daily activities.
• Hand Therapy: Targeting injuries and conditions of the hand and upper limbs, these therapists help with recovery from fractures, arthritis, or surgery. They typically work in orthopedic clinics, hospitals, and outpatient settings.
• Physical Rehabilitation: Therapists in this field assist patients recovering from strokes, injuries, or surgeries, helping them regain movement and independence. Common workplaces include inpatient rehab centers and acute care hospitals.

If you’re considering advancing your career or exploring types of occupational therapy certifications, gaining specialized knowledge in one of these areas can make a significant difference. And for those exploring healthcare training options, taking medical coding and billing online classes might complement your skills, especially in managing therapy documentation and billing processes.

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

When figuring out the average occupational therapist salary in Texas, it's important to know that several factors come into play. Experience level, work setting, and where you work in the state all shape how much you can earn as an OT. Here’s a quick rundown of the key influences on OT pay in Texas.

• Years of Experience: Starting out, occupational therapists tend to earn less, with entry-level salaries around $89,000 per year. As you build experience, your salary can climb well over $100,000, especially if you take on specialized responsibilities or supervisory roles.
• Type of Employer: Hospitals and home health agencies generally pay more compared to outpatient clinics or school systems. Home health OT jobs in Texas sometimes offer salaries from $97,000 up to $120,000 annually, reflecting the complexity and setting of care.
• Geographic Location: Where you work matters a lot. For example, OTs in cities like Waco earn about $52.84 an hour, slightly above the state average range of $48 to $57 per hour. Urban areas usually boost wages more than rural spots, which might offer perks instead of higher pay.
• Work Setting: Settings like acute care hospitals or skilled nursing facilities offer different pay scales. Generally, home health agencies top the pay scale, while school-based or outpatient roles have steadier but lower salaries.
• Specialization and Credentials: Holding advanced certifications or degrees can give you a salary edge. Employers look favorably on OTs with specialized training, often rewarding them with higher pay.
• Local Demand and Workforce Trends: In some Texas regions, a high demand for rehab services pushes salaries up to attract talent. In contrast, areas with more OTs might see more modest pay increases over time.

If you’re curious about related career paths, you might want to check out this guide on how to become a certified medical coder and biller without a degree, which could be an interesting option alongside occupational therapy.

What Do Occupational Therapists in Texas Say About Their Career?

References:

• 7 Occupational Therapy Skills You Need - St. Kate https://otaonline.stkate.edu/blog/occupational-therapy-skills/
• 40 Tex. Admin. Code § 370.1 - License Renewal | State Regulations | US Law | LII / Legal Information Institute https://www.law.cornell.edu/regulations/texas/40-Tex-Admin-Code-SS-370-1
• Tuition & Financial Aid | Entry-level OTD | Baylor University https://otd.robbins.baylor.edu/entry-level-otd/entry-level-otd-tuition-financial-aid
• OT - License Renewal - ECPTOTE Website https://ptot.texas.gov/ot-license-renewal/
• OTD Tuition and Financial Assistance | Doctor of Occupational Therapy Program | University of the Incarnate Word https://physical-therapy.uiw.edu/academics/doctor-of-occupational-therapy-program/tuition-and-fees.html
• Pre-Occupational Therapy Specialization | WTAMU https://www.wtamu.edu/academics/advising/pre-professional-specializations/pre-occupational-therapy.html
• How Much Is Occupational Therapy School? | USAHS https://www.usa.edu/blog/how-much-is-occupational-therapy-school/
• Obtain Your Occupational Therapy (OT) License in Texas https://www.growwithcoral.com/blog/obtain-ot-license-texas
• Licensing https://www.tota.org/licensing
• Texas OT CEU Requirements & Discounts! • OT Potential https://otpotential.com/ot-continuing-education-requirements/texas

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