How to Get Your COTA License in Mississippi (2026 Guide)

How to Become a Licensed OTA/COTA in Mississippi

Mississippi's healthcare workforce continues to grow, creating steady demand for certified occupational therapy assistants across hospitals, skilled nursing facilities, schools, and home health agencies. The Mississippi Board of Licensure for Professional Counselors and Therapists — OT section — regulates occupational therapy practice in the state. Here is how to earn your Mississippi COTA license in 2026.

Step 1: Complete an ACOTE-Accredited OTA Program

You must first graduate from an associate-degree OTA program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Mississippi hosts programs at institutions including Hinds Community College and Pearl River Community College. Programs include classroom instruction, laboratory practice, and a minimum of 16 weeks of Level II fieldwork in clinical settings. ACOTE accreditation is non-negotiable — Mississippi will not accept degrees from non-accredited programs. Confirm current accreditation status through the AOTA directory before enrolling.

Step 2: Pass the NBCOT COTA Exam

After completing your program and fieldwork, you must pass the NBCOT COTA certification examination. The exam contains 200 scored questions and runs 4 hours, covering occupational therapy practice across the lifespan — including evaluation support, intervention implementation, and professional responsibilities. The examination fee is approximately $555. Passing earns you the COTA credential, a prerequisite for Mississippi licensure. Most candidates schedule the exam within 90 days of graduation while clinical knowledge is freshest.

Step 3: Apply for Your Mississippi OTA License

Submit your application to the Mississippi Board of Licensure for Professional Counselors and Therapists (OT section). Required materials include the completed application, official academic transcripts, proof of NBCOT COTA certification, and a licensing fee of approximately $50–$75. The Board may require a criminal background check as part of the process. Review current Board guidance for any additional documentation requirements, as these can change. Once approved, your license will authorize you to practice as a COTA under the supervision of a licensed occupational therapist in Mississippi.

OT Compact Membership

Mississippi's participation in the OT Compact should be verified on the OT Compact's official website, as compact membership status can change. If Mississippi is an active member, COTA licensees from other compact states may be able to work in Mississippi under a Compact privilege, streamlining multi-state practice for travel therapists and per-diem contractors. Check the compact site for the most current list of member states and any Mississippi-specific endorsement requirements before assuming compact privileges apply.

Continuing Education Requirements

Mississippi requires COTAs to complete 20 continuing education hours per two-year renewal cycle. Acceptable CE includes AOTA-approved courses, professional conferences, university coursework, and other Board-approved education. Topics such as ethics, cultural competency, and evidence-based practice are commonly required or strongly recommended. Keep copies of all CE certificates for at least five years to support any Board audit. License renewal fees apply, and late renewal may incur additional penalties.

Mississippi COTA Salary Ranges

COTAs in Mississippi generally earn between $42,000 and $58,000 annually, with entry-level positions near the lower end and experienced practitioners in metro areas such as Jackson and the Gulf Coast earning more. Skilled nursing facilities are the largest employer segment and typically offer full-time schedules with benefits. School districts provide stable employment tied to the academic calendar with summers off. Home health COTAs earn approximately $28–$40 per hour depending on caseload and geography, while travel contracts in rural Mississippi can reach $30–$48 per hour given the state's persistent therapy access gap.

Top Employers

The University of Mississippi Medical Center (UMMC) in Jackson is the state's flagship academic health system and a consistent COTA employer. Baptist Health Systems and Merit Health facilities employ COTAs across inpatient rehab, SNF, and outpatient settings. Mississippi's 152 public school districts together represent one of the largest COTA employment sectors in the state, driven by IEP mandates for occupational therapy services. Regional SNF chains operating across the state — including Diversicare and Signature Healthcare — maintain active COTA hiring year-round.