Occupational therapy assistant screening questions: COTA, OT Compact status, supervision and setting fit
On this page
- Which OTA job is it?
- Which credentials and compact checks apply?
- How does OTA supervision work for this client?
- Knockout questions
- Treatment and scope questions
- Supervision, productivity and documentation questions
- How OTA experience gets overstated
- A 12-minute phone-screen flow
- Scoring
- Lawful phrasing for OTA screens
- Questions people ask
Occupational therapy assistant screening questions should confirm that the candidate passed NBCOT's COTA exam, that they are licensed in the job state or can be by the start date, that they have recent experience in the client's setting, and that they work inside an OTR's evaluation and plan. As of October 2026, the OT Compact is opening state by state, so do not assume a compact privilege exists until you check it.
The occupational therapist screening questions explain the OTR and COTA credentials, licensure and productivity for therapists. This page adds what changes when the order is for an assistant: supervision rules, the compact's status, what OTAs may and may not do, and the treatment questions that show real ADL and setting skills. The physical therapist assistant screening questions cover the PT side of the same rehab team.
Which OTA job is it?
| Setting | What the OTA mostly does | Ask the candidate |
|---|---|---|
| Skilled nursing facility | ADL retraining, transfers for toileting and bathing, adaptive equipment, often a productivity target | "Which ADLs did most of your residents work on, and what equipment did you issue most?" |
| Home health | Bathroom safety, home modifications, caregiver training, visits alone | "How many visits a week, and what did you recommend for a bathroom last month?" |
| Inpatient rehab or acute care | Early mobility for self-care, cognition and safety, discharge planning input | "What was your patient mix: stroke, orthopedic, brain injury, cardiac?" |
| Outpatient or hand therapy | Fine motor, home programs, splints under OTR direction where the state allows | "Who fabricated splints in your clinic, and what was your part?" |
| Schools and pediatrics | Handwriting, sensory and motor goals inside an IEP, classroom strategies | "What ages, how many students, and who wrote the IEP goals?" |
| Behavioral health | Groups on daily living and coping skills, structured activity | "What groups did you run, and how did you document participation?" |
Which credentials and compact checks apply?
As of October 2026. We checked these on NBCOT's, the OT Compact Commission's, CMS's and the California board's own pages. Rules change by state; check the job state's board before you submit.
- COTA certification. NBCOT's eligibility page says COTA candidates must graduate with an entry-level degree from an ACOTE-accredited occupational therapy assistant program. Check the credential with NBCOT's Verify Credentials search.
- The state license. Verify it on the job state's occupational therapy board, separately from NBCOT. They are different records kept by different bodies, and the client needs both answers.
- The OT Compact. The OT Compact covers both OTs and OTAs licensed in good standing in a member state. Its status page, updated October 2026, says each state opens applications at its own pace. The Before You Apply page lists dates for 11 states (Arkansas, Indiana, Maryland, Minnesota, Mississippi, Missouri, Ohio, Tennessee, Virginia, West Virginia and Wisconsin); the other listed states show "Not Yet". For any other state, plan on a full license.
How does OTA supervision work for this client?
OTAs work under an OTR's supervision, but the rules on how often, how close and how many differ by state and by payer. Ask the client for its model, then ask the candidate about theirs.
- A state example. The California Board of Occupational Therapy's supervision FAQ cites Business and Professions Code 2570.3(j)(2), under which an OT may supervise three OTAs concurrently; requires weekly review of all aspects of OT services and periodic on-site supervision (defined as every 30 days); says an OTA may not treat a client without a documented OT treatment plan; and says the OTA may contribute to the evaluation by carrying out delegated assessments and reporting to the OT.
- Medicare plan of care. Under 42 CFR 410.61, the outpatient plan of care is established and changed by a physician, the treating therapist, or a nurse practitioner, clinical nurse specialist or physician assistant. OTAs are not on either list.
- Private practice. CMS's CY 2025 final rule allows general supervision of OTAs by OTs in private practice, matching institutional settings. State law can still require more.
- Payment. Outpatient OT furnished in whole or in part by an OTA is marked with the CO modifier and paid at 85 percent of the otherwise applicable Part B amount from January 1, 2022, when the OTA furnishes more than 10 percent of the service (CMS).
Knockout questions
| Question | Strong answer | Red flag |
|---|---|---|
| 1. Do you hold NBCOT's COTA, and which state licenses do you hold? | COTA with a number, each license state and its renewal month. | "I'm certified" with no state license for the job state and no plan. |
| 2. How will you be licensed in [state] by the start date? | An existing license, a filed application with a date, or a compact privilege in a state that is accepting applications. | Assumes the OT Compact covers the job state without checking. |
| 3. Has any board taken action on your license or certification? | A clear no, or a direct explanation with dates. | Vague answers. |
| 4. How recent is your experience in [setting]? | Months, employer and caseload in the same setting. | Only fieldwork in the client's setting. |
| 5. This role is [schedule, buildings, territory]. Does that work? | Yes, or a specific limit stated now. | Asks for a different setting or schedule straight away. |
Treatment and scope questions
-
"Walk me through a lower-body dressing session with a resident after a hip replacement."
- Strong answer: checks the precautions in the OTR's plan, sets up the environment, uses a reacher, sock aid or long-handled sponge as the plan calls for, grades the help given, documents the level of assistance.
- Red flags: no mention of precautions or of the plan.
-
"A patient's cognition seems worse today than in the OTR's evaluation. What do you do?"
- Strong answer: keeps the session safe, tells the nurse and the OTR, documents what changed, and lets the OTR decide on reassessment.
- Red flags: re-scores a standardized test on their own and changes the goals.
-
"What adaptive equipment have you recommended, and who signed off?"
- Strong answer: specific items (tub transfer bench, raised toilet seat, grab bar placement, built-up utensils) and the OTR's role in the recommendation.
- Red flags: orders equipment without the OTR.
-
Schools: "How do you show a teacher a strategy without taking over the classroom?"
- Strong answer: a short demonstration, a simple written strategy, follow-up, and data toward the IEP goal.
- Red flags: works only on pull-out sessions and never talks to teachers.
-
"When your patient is ready for new goals, what happens?"
- Strong answer: reports progress; the OTR reassesses and updates the plan. They may contribute data.
- Red flags: "I update the goals."
Supervision, productivity and documentation questions
| Question | Strong answer | Red flag |
|---|---|---|
| How often did your supervising OTR see you and your patients? | A clear rhythm (daily contact, weekly review, co-treatment or on-site visits) that fits their state's rules. | Has not spoken to an OTR in weeks, in a state that requires regular review. |
| Have you worked where the OTR was in another building? | Describes phone contact, scheduled reviews and what they escalated. | Never worked without an OTR on site, for a role that requires it. |
| What was your productivity target and how close did you get? | The target in the employer's terms and an honest number. | No number at all. |
| Which documentation system did you use, and when did you finish notes? | Names it; same-day notes. | Days behind as a habit. |
| Did your clinic mark OTA-delivered visits for Medicare? | Knows about the CO modifier and why the clinic tracked who delivered what. | Never heard of it, in an outpatient Medicare clinic. |
How OTA experience gets overstated
- Rehab aide years counted as OTA years. Ask for the license issue date.
- "I did the evaluations." Usually means delegated measurements. Ask which parts.
- Hand therapy by title. Applied a prefabricated splint, described as splint fabrication.
- Pediatrics from one fieldwork rotation. Ask for months of paid work with children.
- Compact license. A home-state license described as working "in any compact state".
A 12-minute phone-screen flow
- Minutes 0 to 2: setting, schedule, buildings or territory.
- Minutes 2 to 5: knockouts; write down NBCOT number and each license, then verify both after the call.
- Minutes 5 to 9: two treatment and scope questions and the supervision question.
- Minutes 9 to 11: productivity and documentation.
- Minute 11 to 12: pay expectations (see salary expectation questions) and next steps.
Scoring
Pass or fail
- COTA or the license the job state requires, verified by you.
- Licensed in the job state, or a realistic route before the start date.
- Recent experience in the client's setting.
- Accepts the schedule and territory.
Scored 0 to 2 each (10 possible)
- ADL treatment: concrete, with precautions and equipment.
- Scope: escalates changes to the OTR and does not change the plan.
- Supervision fit for the client's model and state.
- Productivity and documentation.
- Communication with nurses, families or teachers.
Lawful phrasing for OTA screens
Ask about the job's functions, not conditions. "The role includes helping residents with transfers to the toilet and shower using the facility's equipment. Can you perform that, with or without accommodation?" is lawful before an offer under the EEOC's guidance on disability-related questions; "Any back problems?" is not. Ask about years in a setting, not graduation year or age. See illegal interview questions for the other common slips, and the interview guide for therapy roles for the later rounds.
Questions people ask
Is the OT Compact working yet for occupational therapy assistants?
Only in part. The OT Compact covers both OTs and OTAs, but as of October 2026 its status page says each member state opens applications at its own pace, and its Before You Apply page lists dates for 11 states while the rest show 'Not Yet'. Check that page and the job state's board before assuming an OTA can work on a privilege.
How do I verify a COTA?
Check two things separately. NBCOT's Verify Credentials search shows whether the person holds the COTA certification, and the job state's occupational therapy board shows whether they hold a current license there. They are separate records, so check both before you submit the candidate.
How many OTAs can an occupational therapist supervise?
It depends on the state. The California Board of Occupational Therapy's supervision FAQ, for example, cites Business and Professions Code 2570.3(j)(2), which lets an OT supervise three OTAs concurrently, and requires weekly review and periodic on-site supervision. Other states set different rules, so ask the client which apply.
Does Medicare pay less for OTA services?
Yes. Since January 1, 2022, Medicare pays 85 percent of the otherwise applicable Part B amount for outpatient occupational therapy furnished in whole or in part by an OTA, marked with the CO modifier. CMS applies it when the OTA furnishes more than 10 percent of a service.