How Many CE Hours Do OTs and OTAs Need? Continuing Education Requirements in All 50 States and DC

Most states ask OTs and OTAs for about 24 hours of continuing education every two years, and most of those hours can be on any topic that relates to your practice. The differences are in the details: nine states count per year instead, New York counts over three years, Hawaii and New Jersey require none, and 24 jurisdictions add required topics such as ethics, suicide prevention, implicit bias or a state law exam.

I'm an occupational therapist, and this is the question I have to answer every renewal, so I went through the practice act and board rules for every state and DC. Below is each state's requirement for OTs and OTAs, the topics it requires, when you renew, and the rule it comes from, quoted and linked to the official source.

This isn't legal advice. I checked every rule on November 9, 2026, on the state's own legislature, code or board site. Your board's current rule is the one that counts.

The Short Answer

• 49 of 51 jurisdictions require continuing education. Hawaii and New Jersey require none to renew an OT or OTA license.
• 24 hours every two years is the most common rule, used for OTs in 22 jurisdictions (counting the states that call them PDUs, points or credits). In the 39 states that count in two-year blocks, the range is 10 hours (Virginia) to 40 (Kansas).
• Nine states count per year, at 10 to 15 hours a year for OTs: Arkansas, Idaho, Kentucky, Louisiana, Maine, Montana, New Mexico, North Carolina and South Dakota. New York counts 36 hours over a three-year registration.
• OTAs need the same hours as OTs in 41 of the 49. Eight set fewer for OTAs: Alabama, Arizona, Connecticut, DC, Iowa, Maine, Minnesota and Nebraska.
• 24 jurisdictions require specific topics. Ethics is the most common (10 states, alone or combined with state law). Others: suicide prevention (4), implicit bias (3), human trafficking (3), child or elder abuse (3), a state law course (3), a jurisprudence exam or questionnaire (3), cultural competency or health equity (3), pain management (2), plus a few one-offs. None of the OT rules I read names opioids.
• First renewal: 16 jurisdictions exempt at least the hours, 20 cut or prorate them, and 13 give no break.
• NBCOT is a separate credential. South Carolina requires current NBCOT certification to renew. Eight states accept it in place of their hours. The rest don't tie your license to it.

Every State at a Glance

The OT and OTA columns give the hours and the period, with the rule's own words in quotes. Same as OT means the same rule sets the same number for OTAs. None in the topics column means the rule requires hours but no particular subject. Each citation links to the official text I read, with the source type in parentheses.

Hours, PDUs, Points and CEUs Aren't the Same Unit

Read the unit in your state's rule before you add up certificates. Most states count contact hours or clock hours, but some use PDUs, points, credits or CEUs, and a CEU doesn't mean the same thing everywhere.

• A CEU is usually 10 hours. Alaska: "one continuing education unit awarded by a professional health care association equals 10 contact hours" (12 AAC 54.710(d) (opens in a new tab)). California: "One Continuing Education Unit (CEU) equals 10 PDUs" (16 CCR § 4161 (opens in a new tab)). Missouri: "One (1) CEU equals ten (10) Continuing Competency Credits" (20 CSR 2205-5.010 (opens in a new tab)).
• But not in Delaware or New Mexico. Delaware: "One continuing education unit equals 60 minutes in a learning activity, excluding meals and breaks" (24 Del. Admin. Code 2000-3.5 (opens in a new tab)). New Mexico: "One continuing education contact hour is equivalent to one continuing education unit" (16.15.4.7 NMAC (opens in a new tab)). A course certificate that says 1.0 CEU is 10 hours in most states and may be read as 1 hour in these two.
• Illinois counts in units of two hours. "24 contact hours of CE is equivalent to 12 units of Continued Competency Activities (CCA) (2 contact hours = 1 unit)" (68 Ill. Adm. Code 1315.145 (opens in a new tab)).
• An hour can be 50 or 60 minutes. Illinois: "A CE contact hour equals 50 minutes" (1315.145(a)(6) (opens in a new tab)). Wisconsin: a contact hour "means not less than 50 minutes of actual professional activity" (OT 3.06 (opens in a new tab)). Kentucky defines a contact hour as "sixty (60) minutes engaged in a learning activity" (201 KAR 28:200 (opens in a new tab)). Colorado: "one PDA is equal to one clock hour (sixty minutes)" (3 CCR 715-1 (opens in a new tab)).
• Points can be worth more than an hour. Massachusetts gives "one point per contact hour or equivalent as awarded by the provider" for courses but more for publishing and teaching (259 CMR 7.01 (opens in a new tab)), and North Carolina, Oregon, South Dakota and Wisconsin score other activities by their own tables.

States With No Continuing Education Requirement

Hawaii. The statute sets the renewal date and nothing else: "The biennial renewal fee shall be paid to the department on or before December 31 of each even-numbered year" (HRS § 457G-6 (opens in a new tab)). The program's FAQ asks whether there are CE requirements for licensure renewal and answers: "No, there are no CE requirements for renewal." (Hawaii OT/OTA FAQ (opens in a new tab))

New Jersey. The Occupational Therapist Licensing Act mentions continuing education only for coming back from inactive status, where the licensee "completes any continuing education requirements which may be established by the director, in consultation with the council" (N.J.S.A. 45:9-37.68 (opens in a new tab)). The council's rules, N.J.A.C. 13:44K, have no continuing education requirement for renewal. I couldn't open the council's current rules page because the state's site blocks automated reading, so I checked the council's last published PDF of the rules (revised January 18, 2022) and the statute, and found no CE requirement in either.

Neither state's lack of a rule changes what NBCOT asks of you if you keep your certification, and both may change. Check with the board before your renewal.

Required Topics, State by State

These are the rules behind the topics column, in the boards' own words.

Ethics and state law

• Georgia: "Each licensee must complete a minimum of two (2) hours of the required twenty-four (24) continuing education hours in the ethics of occupational therapy practice. These hours may be obtained online." (671-3-.08(6)(b) (opens in a new tab))
• Illinois: "In each renewal period, one contact hour shall include a course in ethics." (68 Ill. Adm. Code 1315.145(a)(2) (opens in a new tab))
• Louisiana: every year, "1 hours of Ethics (approved by AOTA, LOTA, or NBCOT) and a 1 hour course provided by LSBME on the rules and regulations for OTs and COTAs." (§ 1965(A) (opens in a new tab))
• Maine: "During each reporting period, one (1) hour of the total required ten (10) hours for occupational therapists and one (1) hour of the total required six (6) hours for occupational therapy assistants shall be on ethics in the practice of occupational therapy." (ch. 4, § 3(1)(B) (opens in a new tab))
• Massachusetts: points "must include two points in ethics, laws and regulations governing practice in the Commonwealth of Massachusetts, or some combination thereof." (259 CMR 7.01(1) (opens in a new tab))
• Mississippi: "Two (2) contact hours of an ethic courses(s) related to the practice of occupational therapy shall be required during each licensure period." (R. 8.7.2 (opens in a new tab))
• North Carolina: "the licensee shall document completion of at least one contact hour of a qualified activity for maintaining continuing competence related to ethics in the practice of occupational therapy" (21 NCAC 38 .0802(b) (opens in a new tab))
• Ohio: "License holders shall complete at least one contact hour of ethics, jurisprudence, or cultural competence education per renewal cycle." (OAC 4755:1-3-01(A)(5) (opens in a new tab))
• Tennessee: one hour on "the AOTA Code of Ethics or other ethics related continued competence activities," and one hour that "shall pertain to the occupational therapy portions of T.C.A. §§ 63-13-101, et seq., the Tennessee Occupational and Physical Therapy Practice Act" (1150-02-.12(5)-(6) (opens in a new tab))
• Utah: "complete at least two hours of qualified continuing professional education in legal and ethical principles," even if you use NBCOT for the rest (R156-42a-304(2) (opens in a new tab))
• Florida's law course: "each licensee shall attend a two (2) hour Board approved course on laws and rules covering Chapters 456 and 468, Part III, F.S., and Division 64B11, F.A.C." (64B11-5.001(7) (opens in a new tab))

Jurisprudence exams

• Alaska, every renewal: "a completed jurisprudence questionnaire prepared by the board covering the provisions of AS 08.84 and this chapter" (12 AAC 54.700(4) (opens in a new tab))
• Nevada, every five years: "A licensee must achieve a passing score on the Nevada Occupational Therapy Jurisprudence Examination at least once every 5 years." (NAC 640A.070(3) (opens in a new tab))
• Texas, every renewal: the renewal must include "a passing score on the jurisprudence examination" (40 TAC § 370.1(a)(1)(C) (opens in a new tab))

Suicide prevention

• Connecticut: "not less than two hours of training or education, offered or approved by the Connecticut Occupational Therapy Association, a hospital or other licensed health care institution or a regionally accredited institution of higher education, on (1) screening for post-traumatic stress disorder, risk of suicide, depression and grief, and (2) suicide prevention training during the first renewal period and not less than once every six years thereafter." (C.G.S. § 20-74h (opens in a new tab))
• Kentucky: "At least once every six (6) years from date of initial license issue or from date of last completed training program in suicide assessment, treatment, and management that is pre-approved by the board, each licensee shall complete a training program in suicide assessment, treatment, and management that is pre-approved by the board." The training is "six (6) or more hours." (201 KAR 28:200 (opens in a new tab))
• Tennessee: "all persons who hold an active license as an occupational therapist must complete a minimum two (2) hour training program by a Board-approved provider relative to suicide prevention at least once every four (4) years." The rule names occupational therapists, not assistants. (1150-02-.12(7) (opens in a new tab))
• Washington: "occupational therapists and occupational therapy assistants are required to obtain at least three hours of training every six years in suicide assessment" (WAC 246-847-065(1) (opens in a new tab))

Implicit bias, cultural competency and health equity

• Illinois: "In each renewal period, one contact hour shall include a course on implicit bias awareness training" (1315.145(a)(4) (opens in a new tab))
• Maryland, once: "an applicant for the renewal of a license or certificate issued by a health occupations board under this article shall attest in the application that the applicant has completed an implicit bias and structural racism training program," which "shall apply only to an applicant’s first license or certificate renewal after April 1, 2026." (Health Occ. § 1-225 (opens in a new tab))
• Michigan: "a minimum of 1 hour of implicit bias training for each year of the applicant’s license or registration cycle" (R 338.7004(2) (opens in a new tab)), so 2 hours over a two-year license.
• DC: "Beginning with the licensure term starting on October 1, 2017, the continuing education required in this section shall include two (2) hours of LGBTQ continuing education." Ten percent must also be "in the subjects determined by the Director as public health priorities of the District" (17 DCMR § 6306.3 (opens in a new tab))
• Oregon: "Effective July 1, 2020, all currently licensed occupational therapists and occupational therapy assistants must complete at least one hour on Cultural Competency during each license renewal cycle." (OAR 339-020-0025 (opens in a new tab))
• Washington: "As of January 1, 2024, occupational therapists and occupational therapy assistants are required to obtain at least two hours in health equity continuing education training every four years." (WAC 246-847-065(2) (opens in a new tab))

Human trafficking

• Florida: for OTs and OTAs under part III of chapter 468, "By January 1, 2021, each licensee or certificateholder shall complete a board-approved, or department-approved if there is no board, 1-hour continuing education course on human trafficking." (F.S. § 456.0341 (opens in a new tab))
• Michigan: "an individual seeking licensure or who is licensed shall have completed training in identifying victims of human trafficking," a one-time training (R 338.1215 (opens in a new tab))
• Texas, every renewal: "As part of the minimum hours of required continuing education for each renewal, licensees must complete a training course on human trafficking that is approved by the Texas Health and Human Services Commission." (40 TAC § 367.1(b)(3) (opens in a new tab))

Child and elder abuse

• Delaware: "During every biennial renewal period during which a license is required to complete CE, the licensee must complete a minimum of 2 hours in elder or child abuse." (3.4.4.1 (opens in a new tab))
• Iowa: "A licensee who is required by Iowa Code section 232.69 to report child abuse shall indicate on the renewal application completion of training in child abuse identification and reporting ... in the previous three years," with a matching rule for dependent adult abuse (481 IAC 804.8(4) (opens in a new tab))
• Pennsylvania: "licensees seeking renewal of a license issued by the Board shall complete, as a condition of biennial renewal of the license, at least 2 hours of approved continuing education in child abuse recognition and reporting" (49 Pa. Code § 42.48(b) (opens in a new tab))

Pain management and the rest

• Michigan: "at least 1 hour of continuing education must be earned in the area of pain and symptom management." (R 338.1252(1) (opens in a new tab))
• Oregon: "Beginning in 2024, as part of the renewal process, all applicants for renewal must demonstrate completion of the Oregon Pain Management Commission’s pain management course in a format prescribed by the Board during every license renewal." (OAR 339-020-0015 (opens in a new tab))
• Florida adds medical errors and HIV/AIDS: "Each licensee shall attend and certify attending a Board-approved 2-hour continuing education course relating to the prevention of medical errors," and "The licensee shall complete one (1) hour of HIV/AIDS education as set forth in Section 456.033, F.S., no later than upon first renewal." (64B11-5.001 (opens in a new tab))
• Illinois adds sexual harassment prevention and dementia: "one contact hour shall include a course in sexual harassment prevention training," and one hour on "dementia recognition training, which shall only apply to licensees who provide health care services to, and have direct patient interactions with, adult populations age 26 or older" (1315.145(a)(3), (5) (opens in a new tab)). For most of us in home health, that means the dementia hour applies.

Your First Renewal

Many states don't ask a new licensee for hours at the first renewal, but the exemptions are written differently, and several keep a required topic.

• Exempt from the hours (16): Arkansas, California, Colorado, Connecticut, DC, Illinois, Iowa, Louisiana, Massachusetts, Montana, New York, Ohio, Pennsylvania, Tennessee, Virginia and Wisconsin. Examples: California, "This section shall not apply to the first license renewal following issuance of the initial license" (16 CCR § 4161(e) (opens in a new tab)); Ohio, "License holders are not required to obtain any continuing education units for the first renewal" (OAC 4755:1-3-01 (opens in a new tab)); New York exempts you "for the triennial registration period during which they are first licensed" (Educ. Law § 7908 (opens in a new tab)). Colorado's exemption is in the board's guidance, not the rule: "CPC requirements do not begin until after the first renewal of an Occupational Therapist’s or an Occupational Therapy Assistant's initial license" (board statement (opens in a new tab)).
• The exemptions with strings attached: Pennsylvania exempts the first renewal "With the limited exception of the 2 hours of mandated training in child abuse recognition and reporting" (§ 42.53(b) (opens in a new tab)). Louisiana exempts a new licensee only if they "completed the Laws & Rules course prior to first annual renewal" (§ 1979 (opens in a new tab)). Connecticut exempts "licensees applying for the first renewal of their license in Connecticut" from the hours (§ 20-74i-7 (opens in a new tab)), but its statute puts the suicide prevention training "during the first renewal period" (C.G.S. § 20-74h (opens in a new tab)).
• Prorated or reduced (20): Alaska, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Maine, Maryland, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Mexico, North Dakota, Rhode Island, Vermont, West Virginia and Wyoming. Some of these turn on when in the cycle you were licensed: Florida exempts those licensed "in the second half of the biennium," except for medical errors and HIV/AIDS (64B11-5.001(8) (opens in a new tab)). Maine asks first-time renewers for "one (1) hour of ethics and one half of the required continuing education credit hours" (ch. 4, § 6(B) (opens in a new tab)).
• No break on the hours (13): Alabama, Arizona, Idaho, Michigan, Nebraska, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Texas, Utah and Washington. Plan on the full requirement, or ask the board. South Carolina does push back the first renewal itself if you are first licensed after December 14 (S.C. Code § 40-36-260(A) (opens in a new tab)).

NBCOT Certification Renewal Is a Separate Thing

NBCOT certification (the OTR and COTA credentials) and your state license are two different things, renewed to two different bodies on two different schedules. NBCOT says "50 states, Guam, Puerto Rico, and the District of Columbia require NBCOT initial certification for occupational therapy state regulation (e.g., licensing)" (NBCOT handbook (opens in a new tab)). That is the first license. Most states don't require you to keep the certification current afterward.

NBCOT's own rule, from its 2026 Certification Renewal Handbook: "Certificants must accrue at least 36 units during their renewal cycle. Units can be obtained through a combination of competency assessment units (CAUs) and/or professional development units (PDUs)." Renewing on time gets you "Active in Good Standing certification status for a three year period." NBCOT counts "1 contact hour (not to include meals or breaks) = 1 PDU" and "0.1 Continuing Education Unit (CEU) = 1 PDU." (NBCOT Certification Renewal Handbook (opens in a new tab))

How the states treat it:

• Required to renew your license (1): South Carolina. "As a condition of license renewal, a licensee must complete satisfactorily sixteen hours of continuing education per biennium as defined in regulation and must submit proof of completion on a form approved by the board and must be certified and in good standing with NBCOT or other board-approved certification program." (S.C. Code § 40-36-260(C) (opens in a new tab))
• Accepted in place of the state's hours (8): Alaska, Maryland, Mississippi, Montana, New Hampshire, Oregon, South Dakota and Utah. Maryland's wording is typical: "The Board recognizes the maintenance of current NBCOT certification as fulfilling the requirements of §B(1) and (2) of this regulation" (COMAR 10.46.04.04(C) (opens in a new tab)). Three of them still want their own topics on top: Mississippi accepts NBCOT "with the exception of the 2 hours of ethic requirement" (R. 8.7.2 (opens in a new tab)), Oregon's NBCOT credit "may not be used to satisfy the cultural competency CE requirements of OAR 339-020-0025 or the pain management CE requirements of OAR 339-020-0015" (OAR 339-020-0010 (opens in a new tab)), and Utah keeps its 2 hours of legal and ethical principles.
• Everywhere else: the rules I read don't require current NBCOT certification to renew, and don't accept it in place of state hours. Courses from NBCOT or NBCOT-approved providers often count, and Maine says outright that you can count activities "even if such activities are or have been submitted towards maintaining a current NBCOT certification" (02-477 C.M.R. ch. 4, § 3(1)(C) (opens in a new tab)). Colorado accepts a "Deemed Status" program that is equivalent to its own (3 CCR 715-1, Rule 1.11 (opens in a new tab)), but I didn't find which programs the state has approved.

If you keep your NBCOT certification, you're working toward two requirements at once. Pick courses your state accepts, track them against both cycles, and remember that dropping NBCOT doesn't cancel your state hours.

If You Hold Licenses in More Than One State

A lot of home health clinicians do PRN work across a state line. Each board counts hours under its own rule, on its own cycle, so a course can count twice only if both boards accept it. Watch the topics most: Florida wants its own laws and rules course, Tennessee its own law hour, and Texas its own jurisprudence exam. A general ethics course won't stand in for those. Our OT Compact page shows where the compact stands in each state, and if you hold more than one kind of license, COTA and PTA dual licensing covers what each board expects.

Key Takeaways

• Hawaii and New Jersey require no continuing education to renew an OT or OTA license. Every other state and DC does.
• The most common rule is 24 hours every two years. Nine states count per year, and New York counts 36 hours over three years.
• Eight jurisdictions require fewer hours from OTAs than from OTs. Everywhere else the hours are the same.
• 24 jurisdictions require at least one topic. Ethics is the most common, followed by suicide prevention, implicit bias, human trafficking, abuse reporting and state law.
• Read the unit: hours, PDUs, points and CEUs aren't interchangeable, and a CEU is 10 hours in most states but 1 hour in Delaware and New Mexico.
• NBCOT renewal is separate from your license. South Carolina requires it; eight states accept it in place of their hours.
• This isn't legal advice. I checked these rules on November 9, 2026, and your board's current rule is the one that counts.

Frequently asked questions

How many CEUs does an OT need to renew a license?

It depends on the state. The most common rule is 24 hours (or 24 PDUs, points or credits) every two years, which 22 jurisdictions use for OTs. Across the 39 states that count in two-year blocks, the range runs from 10 hours in Virginia to 40 in Kansas. Nine states count per year, at 10 to 15 hours a year for OTs, and New York asks for 36 hours every three years. Hawaii and New Jersey require none. Check whether your state counts contact hours, PDUs, points or CEUs, because a CEU usually means 10 hours.

Do OTAs need the same continuing education as OTs?

In most states, yes. Of the 49 jurisdictions that require continuing education, 41 set the same number of hours for OTAs as for OTs. Eight set fewer for OTAs: Alabama, Arizona, Connecticut, DC, Iowa, Maine, Minnesota and Nebraska. The required topics, such as ethics or suicide prevention, usually apply to both, with one exception I found: Tennessee's suicide prevention rule names occupational therapists only.

Does NBCOT certification renewal count toward my state license?

Only in some states. NBCOT renewal is a separate credential from your state license. South Carolina is the one state I found that requires current NBCOT certification to renew. Eight more let current NBCOT certification stand in for their hours: Alaska, Maryland, Mississippi, Montana, New Hampshire, Oregon, South Dakota and Utah, though Mississippi, Oregon and Utah still require their own topic hours on top. In the rules I read, no other state ties renewal to current NBCOT certification, so the state's own hours are what count for your license.

Do I need continuing education for my first license renewal?

Often not, or not all of it. Sixteen jurisdictions exempt at least the hours at your first renewal, and 20 more cut or prorate them. Watch for the exceptions inside the exemptions: Florida still wants medical errors and HIV/AIDS, Pennsylvania still wants its 2 hours of child abuse training, and Connecticut's suicide prevention training falls in your first renewal period. Thirteen states give no first-renewal break on the hours.

Which states require ethics or jurisprudence for OT license renewal?

Ten states require ethics, alone or combined with state law: Georgia, Illinois, Louisiana, Maine, Massachusetts, Mississippi, North Carolina, Ohio, Tennessee and Utah. Florida, Louisiana and Tennessee require a course on their own OT laws and rules. Alaska requires a jurisprudence questionnaire at every renewal, Texas a passing score on its jurisprudence exam at every renewal, and Nevada its jurisprudence exam once every five years.

Sources

Every state's rule is linked in the table, to the state's legislature, its official administrative code publisher or its OT board. All were read on November 9, 2026.

• NBCOT, 2026 Certification Renewal Handbook (opens in a new tab): the 36-unit, three-year renewal requirement and the PDU conversions.
• Cross-profession laws that reach OTs: Florida Statutes § 456.0341 (opens in a new tab) (human trafficking); Maryland Health Occupations § 1-225 (opens in a new tab) (implicit bias); Michigan R 338.7004 (opens in a new tab) (implicit bias).
• Pending changes I left out because they aren't in force: Oklahoma's new OT rules (effective 2027) keep 20 hours every two years and say the cycle ends October 31 of even years; New Mexico has posted a draft revision of 16.15.4 NMAC.