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Texas Occupational Therapy 

Welcome to our Texas Occupational Therapy FAQs.  We've combined the state laws, board rules, and statements to create a clear guide on the rules that must be followed by OTs and OTAs.


Continuing Education 

  • How many continuing education hours are required during a reporting period?
  • How long is the reporting period?
  • Can CE credits be carried over into the next reporting period?
  • Are there any specific requirements for continuing education?
  • What types of activities can be used for the continuing education requirements?
  • What type of approval is needed for the courses?
  • What type of courses or activities are not allowed?
  • What are the reporting requirements?
  • How long must continuing education records be retained?
  • Audit

Scope of Practice

  • How is the practice of Occupational Therapy defined in Texas?
  • What is included in the practice of occupational therapy?
  • What services are explicitly excluded?
  • Does Texas allow OTs to practice physical agent modalities?
  • Does Texas allow OTs to practice wound care?


  • How does the board define telehealth?
  • Can I use telehealth to treat patients outside of Texas?
  • What kind of technology is required?
  • Can telehealth be used to conduct an evaluation?
  • Devices that require on-site care

Referrals and Direct Access

  • Is a referral required to provide OT services?
  • Are there exceptions to the referral requirement?
  • Which providers can issue the referral?
  • Can a referral be issued verbally?

Therapist's Responsibilities and Delegation 

  • Which services can only be performed by a licensed occupational therapist?
  • What are the responsibilities of the OT when delegating?


  • Which services are OTAs allowed to practice?
  • Are there specific services that OTAs are prohibited from practicing?
  • What type of supervision is required?
  • Does the supervising occupational therapist need to co-sign documentation created by the OTA?
  • What is the ratio between supervising OTs and OTAs?
  • What is the required designation for OT assistants?


  • What can an aide do?
  • What is an aide expressly prohibited from doing?
  • What are the responsibilities of the OT when delegating to an aide?
  • What type of supervision is required?
  • What is the ratio between supervising OTs and aides?

Documentation Requirements and Responsibilities

  • What must be included in the client record?
  • What are the OT’s responsibilities when performing the evaluation?
  • What are the OT’s responsibilities when creating the Plan of Care?
  • What are the OT’s responsibilities when performing an intervention?
  • Who is responsible for the discharge or discontinuation of OT services?
  • What are the assistant’s documentation responsibilities?

Temporary License - New Graduate Practice

  • Who is eligible for a temporary license?
  • Supervision of an occupational therapy assistant with a temporary license
  • Supervision of an occupational therapist with a temporary license
  • How long does the temporary permit last?
  • What happens if the applicant fails the exam?

Provisional License 

  • Who is eligible for a provisional license?
  • What is required to be issued a provisional license?
  • Duration of the provisional license

Identification and Notification

  • What is the required designation for occupational therapists?
  • Use of “Dr.”
  • Are there any specific requirements for posting notifications or licenses?
  • When do you need to notify the board when you change your information?

Licensure by Endorsement 

  • Who is eligible to receive reciprocity in Texas?
  • Am I eligible for license by endorsement if I already has a Texas license in the past?
  • What must I do to receive my license by endorsement?
  • What happens if I am having trouble getting the required information from NBCOT or my state’s board?

Unprofessional Conduct 

    • When am I obligated to report to the board?
    • Unprofessional conduct related to licensure
    • Incapacity
    • Unprofessional conduct in practice occupational therapy
    • Convictions and Arrests

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