COTA vs. OTR: Which is Right for You?


If you are considering a career in the field of occupational therapy, you may be wondering about the differences between working as a COTA and working as an OTR.

While both of these career choices do certainly fall under the umbrella of occupational therapy, there are some key differences between the two.

Defining Terms: OTR vs. COTA

First things first, let’s clarify the definitions of the terms COTA and OTR.

OTR stands for Occupational Therapist Registered, which refers to an occupational therapist who has completed an accredited OT program and passed the licensing exam in order to become registered to practice occupational therapy.

COTA, on the other hand, stands for Certified Occupational Therapy Assistant, which refers to an occupational therapy assistant who has completed an accredited OTA program and passed the certification exam in order to practice as an occupational therapy assistant.

So now that you know the difference between the terms, let’s take a closer look at the differences between a career as a COTA vs. OTR.


One of the biggest differences between choosing to become an OTR or a COTA lies within the amount of schooling that is required for each path.

Occupational Therapist Registered (OTR)

To become an OTR, you will have to complete a 4-year bachelor’s degree in a relevant course of study. This could be pretty much anything from psychology, to exercise science, to even dance or music, so long as you complete the necessary prerequisite requirements to get into the OT graduate program of your choice.

After completing your bachelor’s, you will need to attend a 2-3 year graduate program in occupational therapy. There are a few different degree options out there, so be sure to check out this article for more tips on choosing the right degree path for you.

Once you’ve finished your OT graduate program, you will have to take the NBCOT licensing exam in order to begin practicing as an OTR–so this process is about 6-7 years in total.

Certified Occupational Therapy Assistant (COTA)

In contrast, in order to become a COTA, you are only required to complete a 2-year occupational therapy assistant associate’s degree in order to be eligible to sit for the certification exam. This path does not require a bachelor’s degree, so the total process only takes about 2 years.

In considering the differences in the amount of education required to become a COTA vs. OTR, it is important to recognize that less education means a lower cost of tuition and a faster transition into the working world.

You should also know that there are many bridge programs offered in which you can work as a COTA during the week, then attend classes on the weekends in order to work towards becoming an OTR. This might be the right option for you if the cost of education is a major issue, or if you have other responsibilities that require you to be working.

Yet this difference in education will certainly be reflected in the difference in job roles.

Job Roles

Another important factor in deciding between pursuing a career as a COTA vs. OTR lies in the daily activities or job roles of each of these positions.

As a COTA, you will:

  • Treat patients according to the OTR’s treatment plan
  • Write patient progress notes which you will have to have signed by your supervising OTR
  • Carry out interventions according to the OTR’s treatment plan

As an OTR, you will:

  • Evaluate patients for clinical needs and services
  • Put together treatment plans with the patient’s goals in mind
  • Treat patients according to the care plan
  • Write patient progress notes
  • Complete discharges and all other necessary paperwork
  • Potentially supervise a COTA or a team of COTAs

To sum it up in one key difference: as a COTA, you will do less paperwork and may even have a heavier caseload than the OTR, however, you will have less power when it comes to making treatment plans and decisions.

You may have fewer job opportunities as a COTA since the education requirements are lower, meaning more people are more likely to complete the requirements in order to get a job as a COTA.

You may also have more job opportunities as an OTR to create resources, advocate for the field, and even open your own practice if you choose to do so.


If you do decide to become a COTA or an OTR, it is also important to understand the difference between potential salaries for each of these positions.

As a COTA, the median salary offered for a full-time position is around $56,000 per year.

As an OTR, on the other hand, the median salary is around $83,000 per year–about a $27,000 difference, which is a pretty big gap. But remember that less education to become a COTA will yield a lesser salary.

Choosing Between COTA vs. OTR

So, friend–I’m not sure of all the circumstances in your life, but making the decision between becoming a COTA and becoming an OTR is certainly situational.

Be sure to consider the length of each program, the cost of tuition, and the typical salary when making your decision.

There are tons of personal factors to consider as well–including physical and mental health, family responsibilities, work responsibilities, the demands of school, etc.

It is also important to note that not all OTA and OT programs are considered equal. In order to be eligible for the licensing exam for each of these positions, you must attend an accredited program–so be sure to check your potential program’s website for more information.

Whatever you choose, be confident in your decision and go forth knowing that you will impact real people’s lives through occupational therapy either way!

I hope this article has helped you understand a bit more of the differences between becoming a COTA and becoming an OTR–and if I can help you any further, please do not hesitate to contact me! I’d love to help you along your occupational therapy journey.

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