If you’re in the pre-application process of becoming an Occupational Therapy practitioner and are trying to decide which path to choose, this post is for you.

General Difference Between OTR vs. COTA

Registered Occupational Therapist (OTR)

To start with the basics for those of you who are not yet fully aware of the difference, OT(R) stands for Registered Occupational Therapist. Registration occurs after you pass your boards and requires at least a two and a half to three year Master’s degree.

Some OTs you meet may have a Bachelor’s degree, but those programs have been phased out. The other option is a five year Bachelor’s to Master’s program. Whether or not this option is available depends on the school and does not take into account prerequisite courses.

Certified Occupational Therapy Assistant

COTA stands for Certified Occupational Therapy Assistant. The “Certified” part is added to your title after you pass the COTA boards. At this point, the educational requirement to be a COTA is a two year Associate’s degree. It does not require a Bachelor’s, whereas like the Occupational Therapist Master’s (OTR).

Differences in Responsibilities

As an OTR you will:
  • Perform patient evaluations
  • Create the patient’s plan of care with goals
  • Complete weekly or progress notes
  • Complete the discharges
  • Provide treatments for your patients
As a COTA you will:
  • Follow the OTR’s treatment plan
  • Carry out interventions (treatments) in line with the OTR’s goals
  • Will not complete the evaluation/discharge paperwork
  • Write daily notes which entail what you worked on with the patient and everything that went on in your treatment

Job Opportunities

COTA’s may have fewer job options in the hospital setting. If you are set on inpatient rehab or acute care, going for your Master’s would most likely be your best bet. However, COTAs are always in demand at skilled nursing facilities and in the school systems if you’re driven to pediatrics.

Educational Requirements

Since the OTR is a Master’s degree, you will spend more time in school (approximately 5-7 years total including Bachelor’s degree). To become a COTA, you will likely need 2 years of schooling if you do not have a Bachelor’s degree.

If you already have a Bachelor’s degree, it will take you the same amount of time to get your Master’s, so it may be a better choice for you to go for the Master’s.

OTR vs COTAIf you do decide that you want to pursue your OTA degree, you can always go back to school later on to get your Master’s and become an OTR. There are many bridge programs that hold classes every other weekend so you can work during the week as a COTA, and still get your Master’s.

If you go straight in to your Master’s full time, you will have little to no time to work while completing your coursework.

To be a COTA. you are learning a lot of the same information in a condensed amount of time. Just because “it’s an associate’s degree” doesn’t mean it won’t be a tough program. You will definitely still have to buckle down.

Both Master’s and OTA programs can have wait list of one to two years due to the high levels of competition.

Cost of Schooling

You will also spend quite a bit more on tuition getting your Master’s. Averages for the OT Master’s degree are anywhere between $60,000 (rare that the number is this low) to over $100,000 for the whole program (ouch).

The Associate’s degree will be considerably cheaper, ranging from $7,000 to $15,000 for private schools, according to OTCareerPath.com.

Note: Data from OT Career Path is a few years old. Unfortunately, I wasn’t able to find good comprehensive data for the cost of OTA school. Still, I can say with certainty the OTA is significantly less than a Master’s or doctorate. I will plan to do a more thorough analysis of the typical costs of different OT degrees for 2016.

Salary Potential for OTR vs. COTA

With the cheaper tuition of OTA school comes less income.

According to Payscale.com, the median salary for an entry-level COTA is $43,893 compared to $60,985 according to Payscale.com.

Both types of programs are competitive… not gonna lie.

You still need to bring your A-game in terms of GPA and grades on your pre-reqs when applying to OTA school. Once you get into the program of your choice, they will both be quite a challenge.

Summary of Differences



The best choice is the one that you feel will work best for you given your life circumstances. Whatever you decide, be sure to take a good look at tuition rates, accreditation, curriculum, and program length if this a deciding factor to make sure you get the best fit for you.

I hope some of this info helps you at least get a basic idea of some of the differences between the OTR vs. COTA.

If you have anything to add about your experience as a COTA or OTR, please add it in the comments. I’m really curious to hear feedback about how you decided on your path.

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  • Amanda May 14, 2018   Reply →

    COTAs do progress notes as well, and honestly my schooling was at least 20,000 though the associates and OTA program was incorporated together. It was a fast track program, still 2 years, but why it was longer. Though according to my OTA professor, she had to obtain an associates in the program she was at before entering in the OTA program. Plus, the salary is different than what is being stated, it is more, though this also depends on what state your in….

    • Sarah Stromsdorfer, OTR/L May 17, 2018   Reply →

      Thanks so much for your input, Amanda! I agree that each school and state will have different rates so it is best for those still in the deciding process to do some extra research before making a decision.

  • Traci Brossfield July 14, 2018   Reply →

    I would like to know how much harder the board test is for a COTA than a full OTR board test. My daughter is an OTA and can’t seem to pass the board! She also needs to get her Masters- but wondering how much harder that board test will be or if it’s not that much harder?

    • Sarah Stromsdorfer, OTR/L July 14, 2018   Reply →

      I can’t speak for the COTA exam as I haven’t taken it myself but I would imagine the OTR exam would likely be similar in difficulty, possibly more challenging. I wrote this article after interviewing NBCOT test takers that previously failed the exam that provides actionable tips for next time. I hope this helps! So You Failed the NBCOT? Get Advice To Succeed On Your Next Try

  • Mindy February 14, 2019   Reply →

    I am currently enrolled in the OTA program at Bryant and Stratton. My tuition will cost around 60k when I complete the program. Although this is extremely expensive for an Associate degree, there was no waiting list.

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