ACOTE accreditation is the Accreditation Council for Occupational Therapy Education's review of occupational therapist (OT) and occupational therapy assistant (OTA) education programs against the 2023 ACOTE Standards and Interpretive Guide. This page is for colleges and universities sponsoring a new or existing OT or OTA program. Integral Healthcare Solutions (IHS) builds the ACOTE evidence structure and drafts program policies and fieldwork procedures; your OT faculty own the curriculum.

Last reviewed: October 2026.

What is ACOTE accreditation?

The governing text is the "2023 Accreditation Council for Occupational Therapy Education (ACOTE®) Standards and Interpretive Guide (effective July 31, 2025) April 2026 Version." In ACOTE's words, it "provides the required elements for educational programs and establishes critical competencies necessary to prepare students to become entry-level occupational therapists (OTs) or occupational therapy assistants (OTAs)" (ACOTE, 2023 Standards and Interpretive Guide).

The standards set requirements in parallel columns for "DOCTORAL-DEGREE-LEVEL" and "MASTER'S-DEGREE-LEVEL" OT programs and "BACCALAUREATE-DEGREE-LEVEL" and "ASSOCIATE-DEGREE-LEVEL" OTA programs (ACOTE). Compliance is judged standard by standard, with no partial credit: "FOR ALL STANDARDS, IF ONE COMPONENT OF THE STANDARD IS NONCOMPLIANT, THE ENTIRE STANDARD WILL BE CITED. THE PROGRAM MUST DEMONSTRATE COMPLIANCE WITH ALL COMPONENTS OF THE STANDARD" (ACOTE).

Process rules sit in the ACOTE Accreditation Manual (Policies and Procedures), including Policy III.A on initial accreditation and Policy V.A on fees (ACOTE, Policies). ACOTE also states: "The Standards review process is completed every 5 years to ensure that the entry-level educational standards reflect current occupational therapy practice" (ACOTE).

Who needs it and what triggers it

The buyers are OT and OTA program sponsors. The triggers ACOTE publishes:

• A new program. ACOTE's steps start with a slot: "Reference the New Program Slots page, select an available candidacy application due date and include in the Letter of Intent" (ACOTE, Get Accredited).
• Securing that slot. "Once the Letter of Intent and Eligibility Application is submitted, the program will receive an invoice for a nonrefundable deposit. Upon receipt of payment, the candidacy slot is secured, and the program will receive an email outlining the established timeline" (ACOTE).
• A planned admission date. "If documentation is not approved, the program will be moved to the next available review cycle and planned student admission must be delayed accordingly" (ACOTE).
• Institutional accreditation. Standard A.1.1 states that "The sponsoring institution(s) and affiliates, if any, must be accredited by an institutional accrediting agency recognized ..." (ACOTE, Standard A.1.1).
• The 2023 Standards, effective July 31, 2025, in the April 2026 version (ACOTE).

How IHS helps

Your program obtains the 2023 Standards for its degree level. IHS then works through candidacy, preaccreditation and the self-study with your program director:

1. A gap assessment of the program against the 2023 ACOTE Standards for its degree level, using questionnaires on fieldwork, faculty and assessment.
2. Document and evidence mapping: a crosswalk from each standard, and each component of it, to its evidence.
3. Drafting: academic and student policies, fieldwork agreement and oversight procedures, assessment governance records and the self-study plan, written for your faculty to review and approve.
4. A mock review of the Report of Self-Study before your program submits it.
5. Readiness support after review: drafted responses to findings, for your program to submit through its own eAccreditation account.

What you supply: the standards, curriculum, faculty files, fieldwork site data, outcome data and qualified OT educators.

The limit: educational content and professional assessment belong to your faculty, and IHS does not judge curriculum adequacy. IHS has not previously done education accreditation work; what we bring is a gap-assessment, crosswalk and mock-review process used across healthcare accreditation. IHS does not use your eAccreditation account, submit documents or correspond with ACOTE. Your program does.

What to have ready

This is the list we would ask for first, each item tied to what ACOTE publishes.

• A decision on degree level (doctoral or master's for OT; baccalaureate or associate for OTA), matching the columns of the 2023 Standards (ACOTE).
• The 2023 ACOTE Standards and Interpretive Guide, April 2026 Version (ACOTE).
• Evidence of institutional accreditation for the sponsor and any affiliates, per Standard A.1.1 (ACOTE).
• A target candidacy application due date from ACOTE's New Program Slots page, to name in the Letter of Intent (ACOTE).
• Access to the eAccreditation portal for the Letter of Intent and Eligibility Application (ACOTE).
• Funds for the nonrefundable Letter of Intent fee, which "must be received by the Accreditation department before an initial timeline is established" (ACOTE, Policy V.A Fees).
• A fieldwork plan that meets ACOTE's minimums: Level II fieldwork of at least 16 weeks full-time for OTA students and at least 24 weeks full-time for OTM or OTD students (ACOTE, FAQs).
• Written fieldwork agreements. ACOTE's FAQ states that Standard C.1.5 requires "evidence of written agreements in effect and signed by both parties from the onset to conclusion of the Level I fieldwork and the Level II fieldwork if it involves an entity outside of the academic program" (ACOTE, FAQs).
• Faculty files, curriculum and outcome data, owned by your OT faculty.
• An admission date that allows for moving to the next review cycle if documentation is not approved (ACOTE).

If most of this is in place, the introductory call is the place to start.

How it compares

We did not identify another programmatic accreditor for OT programs in the sources we reviewed. The degree-level choice depends on the sponsor's mission and students. This page does not recommend one over another.

What it costs

ACOTE publishes its fees in Accreditation Manual Policy V.A, "Revised August 2026" (ACOTE, Policy V.A Fees). For initial accreditation reviews in 2026/27 (reviews conducted Aug 1 through Jul 31):

ACOTE states: "ACOTE uses a fixed-fee model that incorporates the cost of reaccreditation on-site evaluations at the primary location into the program's annual fee," and "For new programs, the annual fee becomes effective with the first full academic year for which the program has accreditation status" (ACOTE, Policy V.A Fees). Verify current fees with ACOTE.

IHS scopes each engagement after a free introductory call.

What this is not

• IHS is not an accrediting body and does not grant, influence or predict an ACOTE decision.
• IHS does not submit the Letter of Intent, applications or the Report of Self-Study, or correspond with ACOTE on your behalf. IHS drafts; your program submits.
• This page is not legal or education advice, and IHS does not judge curriculum adequacy. Educational content and professional assessment belong to your OT faculty.

Frequently asked questions

How do we start a new occupational therapy or OTA program and get ACOTE accreditation?

ACOTE's steps start with selecting an available candidacy application due date from its New Program Slots page and naming it in the Letter of Intent. The program completes the Letter of Intent and Eligibility Application in the eAccreditation portal, then submits a Candidacy Application, a Report of Self-Study, and hosts an initial on-site evaluation.

What is the ACOTE new-program slot and candidacy timeline?

After the Letter of Intent and Eligibility Application are submitted, ACOTE invoices a nonrefundable deposit. Once paid, the candidacy slot is secured and the program receives an email outlining its timeline. If documentation is not approved, the program moves to the next available review cycle and planned admission must be delayed.

Should our new program be a master's (OTM) or doctoral (OTD) program under the 2023 ACOTE Standards?

That choice belongs to your institution. The 2023 Standards set separate columns for doctoral-degree-level and master's-degree-level OT programs, and both require Level II fieldwork of at least 24 weeks full-time. Read both columns against your mission, faculty and resources.

How much does ACOTE initial accreditation cost?

ACOTE's Policy V.A, revised August 2026, lists for 2026/27 a $2,000 Letter of Intent Fee, a $3,840 Candidacy Application Fee, a $5,840 Preaccreditation Review Fee and a $5,840 Initial On-Site Fee for US programs. The annual fee is $5,400 for 2026/27 and starts with the first full academic year of accreditation status. Verify current fees with ACOTE.

What does the Report of Self-Study need to show for preaccreditation?

ACOTE's sequence is a Candidacy Application, then preaccreditation review, then a Report of Self-Study, after which the program may proceed to the initial on-site evaluation. The self-study shows compliance with the 2023 Standards for the program's degree level, and every component of each standard counts.

What fieldwork agreements and Level II fieldwork hours does ACOTE require?

ACOTE's FAQ states that OTA students complete Level II fieldwork for at least 16 weeks full-time, and OTM or OTD students for at least 24 weeks full-time. Standard C.1.5 requires written agreements signed by both parties from the onset to conclusion of Level I fieldwork, and of Level II fieldwork if it involves an entity outside the academic program.

How long does it take from Letter of Intent to accreditation?

The ACOTE pages we reviewed do not state a total elapsed time. ACOTE sends each program an email outlining its timeline once the candidacy slot is secured, and a program whose documentation is not approved moves to the next available review cycle.

What happens if one component of a standard is noncompliant?

ACOTE states that if one component of a standard is noncompliant, the entire standard will be cited. The program must demonstrate compliance with all components of the standard.

Does the sponsoring institution need its own accreditation?

Yes. ACOTE Standard A.1.1 states that the sponsoring institution and affiliates, if any, must be accredited by a recognized institutional accrediting agency. Read the full standard text for the recognition requirement.