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United States · Certification exam

NBCOT passing score: what 450 means

You need a scaled score of at least 450 to pass either exam from the National Board for Certification in Occupational Therapy (NBCOT), the Occupational Therapist Registered (OTR) or the Certified Occupational Therapy Assistant (COTA). Scores are reported on a scale from 300 to 600. The NBCOT passing score stands for the same level of knowledge on every version of the exam, because NBCOT converts the number of items you get right into a scaled score.

  • 450Scaled score to pass either exam
  • NoneSeparate pass marks for each domain
  • 300 to 600Range of NBCOT scaled scores
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Updated October 2026 · Written from official sources, listed at the bottom of this page

How is the NBCOT exam scored?

Both exams are criterion-referenced: you pass by reaching a fixed standard, not by beating other candidates. The decision rests only on how many scored items you answer correctly across the whole exam, so there’s no pass mark for any one domain.

You get credit for each correct option you choose, including each of the three right options in a multi-select item, and nothing is taken off for a wrong one. Field-test items are mixed in and don’t count, and you can’t tell which they are.

How many questions do you need to get right?

NBCOT doesn’t publish a number or a percentage. Each exam form uses different items, and one form can be slightly harder than another, so the same number right wouldn’t mean the same thing on both. NBCOT uses scaled scores and a statistical process called equating to even that out: a 450 means the same on every form.

The standard itself comes from standard-setting studies using the Modified Angoff method, where panels of experts decide the minimum level of competence needed to pass.

Is the NBCOT passing score the same for the OTR and COTA exams?

Yes. A total scaled score of at least 450 is required on both, and both are reported on the same 300 to 600 scale. If you pass, your congratulatory letter shows your score. If you don’t, your feedback report shows your score, how you did in each domain, and the average score of new graduates who recently passed. NBCOT says the domain information is for diagnosis only.

NBCOT pass rates →When scores come out →

If you score under 450

  • Reapply through your existing MyNBCOT account for a new Authorization to Test (ATT) letter. Don’t create a new account; NBCOT charges a fee for duplicates.
  • Wait 30 days after your last exam before attempts 2, 3 and 4, 60 days before attempts 5, 6 and 7, and 90 days before attempt 8 or later. You can apply 30 days before your next eligible date.
  • You don’t need to send another transcript unless NBCOT asks.
  • If you hold a temporary or limited state permit, contact that state’s regulator straight away to check whether it’s still valid.
  • To appeal a result, send a letter by traceable mail with signature confirmation so it arrives within 14 days of the result being posted. Failing alone isn’t grounds for an appeal.
Retake application fee →
Sources: NBCOT and 2 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.

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