Continuing Education 

About CE

Required CE Hours and Required Training

Texas OT and OTA licensees are required to complete 24 contact hours of continuing education each renewal period in order to maintain licensure, and the CE must include a course on human trafficking that is approved by the Texas Health and Human Services Commission (HHSC) and meets requirements as per the OT Rules.

Licensees may earn more than the required minimum of CE hours.

Refer to Chapter 367 of the OT Rules for further CE information and requirements. The licensee is solely responsible for keeping accurate documentation of all continuing education activities and for selecting continuing education as per the requirements in Chapter 367.

Acceptable CE

To be counted for license renewal, an activity must be an acceptable activity. 

With the exception of the HHSC approved human trafficking course noted above, licensees are not required to take a course approved by a specific entity or take courses pre-approved by the Board. 

There are two types of acceptable activities: pre-approved activities and other acceptable activities.            

See the information below, adapted from §367.1(d). 

Acceptable Activities. In order to be eligible for continuing education, activities must either be pre-approved activities or meet the requirements for other acceptable activities.

 (1) Pre-Approved Activities.   

            (A) Course Approved by the Texas Health and Human Services Commission on Human Trafficking. Up to a maximum of two hours of CE credit are pre-approved for a training course on human trafficking as provided under subsection (b)(3)(A) of the section (relating to Pre-Approved Credit and Additional Credit). 

            (B) Activities Approved or Offered by the American Occupational Therapy Association (AOTA) or the Texas Occupational Therapy Association (TOTA).
                (i) Professional development activities approved or offered by AOTA or TOTA are preapproved for CE credit for license renewal. However, a human trafficking training course approved or offered by AOTA or TOTA may not be used to satisfy the requirements of subsection (b)(3) of the section (relating to Training on Human Trafficking) unless it is also approved by the Texas Health and Human Services Commission, as described under that subsection.        

    (2) Other Acceptable Activities. In order to be eligible for CE, activities that are not pre-approved must meet further requirements in §367.2 (relating to Other Acceptable Activities).

Determining if an Activity is Acceptable

The licensee is solely responsible for selecting continuing education as per the requirements in Chapter 367.

    For pre-approved activities: Refer to §367.1, Continuing Education. Pre-approved activities do not need to meet the requirements specified in §367.2, Other Acceptable Activities.

   For other acceptable activities: Refer to §367.1, Continuing Education, and §367.2, Other Acceptable Activities.

Remember that all CE must meet further requirements in §367.3, Continuing Education Audit, in addition to any further requirements pertaining to the license renewal, restoration, and/or change of license status. 

See Additional Resources, above, for a resource concerning determining if an activity is an acceptable activity and the additional tabs on this page for further information.

CE Documentation Retention

Please note the following, excerpted from §367.3, Continuing Education Audit.

(c) The licensee is solely responsible for keeping accurate documentation of all continuing education requirements. Continuing education documentation must be maintained for auditing purposes for four years from the end of the expiration month of the corresponding renewal period or for a late renewal or a restoration, for four years from the end of the month when the late renewal or restoration was completed.

When you renew, you attest to having met CE requirements. Part of such is having the documentation of your CE. You are required to keep your CE documentation. You will need to ensure that if you do ever need to print your certificate, you will be able to do so from the electronic form of the certificate you have kept. As noted, you are required to keep your CE documentation.

Birth Month CE and Renewing Early

As per §367.1(b)(4), licensees who submit their renewal with all required items prior to the month when their license expires may count CE completed during their license’s expiration month for their next renewal period. Please note that if you are you are counting CE activities as per §367.1(b)(4), you will need to renew with a paper renewal form.

      Example: The license expires July 31, 2022, and the licensee wishes to take CE in July, 2022, for the next renewal in 2024, as the licensee has already earned enough CE for the 2022 renewal. The licensee would need to renew during the month or two preceding the birth month, i.e., renew in May, 2022, or June, 2022 (and verify the renewal on the Look up a License page). If the licensee does so, then the licensee may begin earning CE in July, 2022, for the next renewal period, which would end July, 2024. However, the licensee will need to renew by paper in 2024.

Additional CE information

The following is not comprehensive; refer to Chapter 367 for further regulations CE must meet.

Please note the following regarding the CE hours remaining after completing the required HHSC approved human trafficking training course and determining the CE credit earned for such according to the OT Rules. 

      * There are many ways to earn CE for free. For example, refer to §367.2, Other Acceptable Activities, for categories of continuing education. Many of the categories included in that section, including those concerning the supervision of OT and OTA students, presentations by licensees, and mentorship, may be completed for free. Refer to the section for further regulations regarding these categories, including with regard to the maximum amount of CE that may be earned from each. See the links above for further resources. Remember that HHSC must also approve at least one human trafficking training course that is free of charge.

      * There is no maximum of contact hours that may be earned for the renewal period for the following: in-service educational programs, training programs, institutes, seminars, workshops, facility-based courses, internet-based courses, conference sessions, and home-study courses with specified learning objectives. Hour for hour credit on program content only, no maximum. Documentation shall include a certificate of completion, letter of verification, transcript, or sign-in/attendance sheet. Documentation must identify the licensee by name and include the date and title of the activity; the name of the authorized signer; either the signature of the authorized signer or the official seal, letterhead, or logo of the authorized signer if an area designated for a signature is not included; and the number of hours or contact hours awarded for the activity. When the documentation lists a unit of credit other than hours or contact hours, such as continuing education units (CEUs), professional development units (PDUs), or other units or credits, it must be accompanied by documentation from the continuing education provider noting the equivalence of the units or credits in terms of hours or contact hours. (Refer to §367.1, Continuing Education, for specific documentation requirements for pre-approved activities. The Pre-Approved CE tab includes related information.)     

      Remember that a contact hour is not the same as a learning credit, PDU, etc. When you renew, you must attest to your CE in contact hours.

* NBCOT Navigator® Activities. CE credit may be earned for the completion of NBCOT Navigator activities. For such activities, 1 NBCOT CAU is the equivalent of 1 contact hour. No maximum. Documentation is a certificate of completion or letter of verification. Documentation must identify the licensee by name and include the date and title of the activity; the name of the authorized signer; either the signature of the authorized signer or the official seal, letterhead, or logo of the authorized signer if an area designated for a signature is not included; and the number of hours, contact hours, or CAUs awarded for the activity. When the documentation lists a unit of credit other than hours, contact hours, or CAUs, such as continuing education units (CEUs), professional development units (PDUs), or other units or credits, it must be accompanied by documentation from NBCOT noting the equivalence of the units or credits in terms of hours or contact hours. Self-reflections and self-assessments, reading list and research portal activities, professional development plans, or similar activities are not eligible for CE credit.

Information regarding categories of CE activities for other acceptable activities, including additional categories and any limits concerning the number of contact hours that may be earned from and the required documentation for each, can be found in §367.2, Other Acceptable Activities. §367.3, Continuing Education Audit, provides further information regarding documentation.

Refer to the full Chapter 367 and the full OT Rules for further CE and renewal requirements. See the FAQ page for frequently asked questions.

Refer to §371.2, Retired Status, of the OT Rules for additional information regarding CE requirements for those initiating or renewing retired status.

Human Trafficking Prevention Training Requirement

HB 2059 of the 86^th Legislative Session added the completion of a training course approved by the Health and Human Services Commission (HHSC) on the prevention of human trafficking as a condition for license renewal for certain health care practitioners. HB 2059 requires that HHSC approve at least one course that is available without charge.

As part of the minimum hours of required continuing education for each renewal, OTs and OTAs must complete a training course on human trafficking that is approved by HHSC. Documentation of completion of a training course is a certificate of completion or letter of verification indicating credit awarded.

Only human trafficking training courses that are approved by HHSC pursuant to HB 2059 may be used to meet this requirement; no other courses may be used to satisfy this requirement. Refer to HHSC’s related web page for information regarding approved courses; the link to that page appears under “Accessing an HHSC Approved Course,” below. 

Licensees may complete this training any time during the current renewal period prior to renewal. Licensees are encouraged to not wait until the last minute to complete this required training. 

Note that completing this training is a CE requirement for each renewal period, not a one-time requirement.

Remember that approval by AOTA or TOTA does not in any way suggest and/or ensure that a course is approved by HHSC or indicate that completion of the course will satisfy the training requirement. If the course is not approved by HHSC, as previously noted, it will not meet the human trafficking training requirement, regardless of whether it has been approved or offered by AOTA or TOTA.

When selecting a human trafficking training course to meet the requirement, ensure that the course is approved by HHSC pursuant to HB 2059. Refer to HHSC’s list of approved courses to confirm this.

What follows is a brief overview of the requirement. Refer to Chapter 367 of the OT Rules for further CE regulations and the FAQ page for frequently asked questions.

Accessing an HHSC Approved Course

See the link below to access HHSC’s health care practitioner human trafficking page. From there, the list of HHSC approved training courses may be accessed. Information regarding approved course(s) that are available at no charge is included on the list. The list also contains a “Continuing Education Credit/Special Note” column. Licensees are not required to select courses that specifically reference OTs and/or OTAs under that column.
https://www.hhs.texas.gov/services/safety/texas-human-trafficking-resource-center/health-care-practitioner-human-trafficking-training 

CE Documentation

Documentation of completion of a training course is a certificate of completion or letter of verification indicating credit awarded. Documentation must identify the licensee by name and include the date and title of the activity; the name of the authorized signer; either the signature of the authorized signer or the official seal, letterhead, or logo of the authorized signer if an area designated for a signature is not included; and the number of hours or contact hours awarded for the activity. When the documentation lists a unit of credit other than hours or contact hours, such as continuing education units (CEUs), professional development units (PDUs), or other units or credits, it must be accompanied by documentation from the continuing education provider or a copy of the Texas Health and Human Services Commission’s list of approved human trafficking courses noting the equivalence of the units or credits in terms of hours or contact hours.

To renew, licensees must meet CE requirements, which includes having met this training requirement. Part of such is having the required documentation for the completed activity. Licensees are required to keep the CE documentation.

The documentation for this activity should be retained as any required CE documentation. Chapter 367 addresses the retention of CE documentation.  

CE Hours and Pre-Approved CE Credit

The OT Rules do not require that licensees complete a specific number of hours of training as HB 2059 does not set a specific number. To meet the requirement, licensees must complete an HHSC approved training course and retain the documentation of such as described in the OT Rules.

The OT Rules include that the completion of one training course per renewal period to meet the training requirement is pre-approved for CE credit up to a maximum of 2 contact hours. Additional CE credit may be earned for a training course exceeding 2 hours if the additional hours meet the requirements of Chapter 367 of the OT Rules.

Remember that unless otherwise specified in Chapter 367, 1 hour of continuing education is equal to 1 contact hour. For example, the completion of a 1-hour HHSC approved human trafficking course may be counted for a maximum of 1 contact hour of CE, which is pre-approved for CE credit.

Where can I find more information regarding this requirement?

Refer to Chapter 367 and the full OT Rules for further CE and renewal requirements. See the FAQ page for frequently asked questions, including FAQs concerning this requirement.

Pre-Approved Activities

See the following regarding activities that are pre-approved. 

In order to be eligible for continuing education, activities that are pre-approved as per §367.1(d)(1) must meet the following requirements. Refer to the full Chapter 367 for further requirements CE must meet.

Remember that with the exception of the HHSC approved human trafficking course noted below, licensees are not required to take a course approved by a specific entity or take courses pre-approved by the Board. For the CE hours remaining after the HHSC approved human trafficking course, activities approved or offered by the American Occupational Therapy Association (AOTA) or the Texas Occupational Therapy Association (TOTA) are pre-approved for CE credit for license renewal. For courses from other providers, licensees are responsible for ensuring, for example, that such meet the requirements for other acceptable activities in §367.2, Other Acceptable Activities, of the OT Rules. Refer to the full Chapter 367, Continuing Education, for further CE regulations.

Pre-Approved CE

1. Course Approved by the Texas Health and Human Services Commission on Human Trafficking.

Up to a maximum of two hours of CE credit are pre-approved for a training course on human trafficking as provided under §367.1(b)(3)(A) (relating to Pre-Approved Credit and Additional Credit), excerpted below. Remember that licensees must complete an HHSC approved training course on human trafficking. See the Human Trafficking Training tab for further information.

Excerpt from §367.1:
(b) Training on Human Trafficking. As part of the minimum hours of required continuing education for each renewal, licensees must complete a training course on human trafficking that is approved by the Texas Health and Human Services Commission. Documentation of completion of a training course is a certificate of completion or letter of verification indicating credit awarded. Documentation must identify the licensee by name and include the date and title of the activity; the name of the authorized signer; either the signature of the authorized signer or the official seal, letterhead, or logo of the authorized signer if an area designated for a signature is not included; and the number of hours or contact hours awarded for the activity. When the documentation lists a unit of credit other than hours or contact hours, such as continuing education units (CEUs), professional development units (PDUs), or other units or credits, it must be accompanied by documentation from the continuing education provider or a copy of the Texas Health and Human Services Commission’s list of approved human trafficking courses noting the equivalence of the units or credits in terms of hours or contact hours.
    (A) Pre-Approved Credit and Additional Credit. The completion of one training course per renewal period to meet the training requirement is pre-approved for CE credit up to a maximum of 2 contact hours. Additional CE credit may be earned for a training course exceeding 2 hours if the additional hours meet the requirements of this chapter.

2. Activities Approved or Offered by the American Occupational Therapy Association (AOTA) or the Texas Occupational Therapy Association (TOTA).

Professional development activities approved or offered by AOTA or TOTA are preapproved for CE credit for license renewal. However, a human trafficking training course approved or offered by AOTA or TOTA may not be used to satisfy the human trafficking training requirement unless it is also approved by the Texas Health and Human Services Commission.

Documentation for activities approved or offered by AOTA or TOTA shall include a certificate of completion, letter of verification, or transcript. Documentation must identify the licensee by name and include the date and title of the activity; the name of the authorized signer; either the signature of the authorized signer or the official seal, letterhead, or logo of the authorized signer if an area designated for a signature is not included; and the number of hours or contact hours awarded for the activity.

Documentation for activities approved or offered by AOTA may include AOTA CEUs on the documentation instead of hours or contact hours; for such documentation, a licensee shall multiply the AOTA CEUs by ten in order to determine the equivalence in terms of contact hours.
        Examples:
               .1 AOTA CEU equals 1 contact hour
               .25 AOTA CEUs equals 2.5 contact hours.

When the documentation lists a unit of credit other than hours, contact hours, or AOTA CEUs, such as other continuing education units (CEUs), professional development units (PDUs), or other units or credits, it must be accompanied by documentation from the continuing education provider noting the equivalence of the units or credits in terms of hours or contact hours.

Other Acceptable Activities

See the following regarding activities that are not pre-approved. 

In order to be eligible for continuing education, activities that are not pre-approved must meet all of the following requirements as per §367.2. Refer to the full Chapter 367 for further requirements CE must meet.  

(1) Acceptable Content. Activities must be professional development activities that ensure the health, safety, and welfare of the public and directly concern the maintenance or enhancement of knowledge and proficiencies relevant to occupational therapy practice or the pedagogy, education, ethics, or theory development of occupational therapy.

    Examples of Activities with Acceptable Content

    Note: These are representative course topics. The licensee must determine if a specific activity meets requirements according to the OT Rules. Licensees are not limited to completing CE on the sample topics listed below. Please note that though topic titles may be general, the content, etc. for such courses would need to demonstrate that they meet the requirements for acceptable content and further requirements in Chapter 367.

         Alzheimer’s

         Intervention Techniques for Alzheimer’s Disease

         Anatomy and Physiology of the Hand

         Training in Physical Agent Modalities for Hand Patients

         Evaluation of and Treatment Strategies for Carpal Tunnel Syndrome

         OT Intervention for Adolescents Exhibiting Violent Behavior

         OT Strategies for Students with Attention Deficit Disorder 

         Stroke and Vascular Disorders

         OT Intervention for Individuals Recovering from a Stroke

         Managing Adult Hemiplegia

         Ethics in Occupational Therapy

         Regulatory Issues in Occupational Therapy

         Billing for Occupational Therapy Services

AND

(2) Categories of Activities. Activities must fall under one or more of the categories described under §367.2(b)(relating to Categories of Other Acceptable Activities).

    Examples of Acceptable Categories

    Note: This is a small sample of the activities included under Categories of Other Acceptable Activities in §367.2(b). The licensee must determine if a specific activity meets requirements according to the OT Rules. Licensees are not limited to completing CE from the categories listed below. 

    Remember that there are limitations on the number of hours that may be earned from certain categories, including some of those listed below, and regardless of the number of hours earned from different activity types, the HHSC approved human trafficking training must still be completed. Refer to Chapter 367 for further information.

          In-Service Educational Programs, Training Programs, Institutes, Seminars, Workshops, Facility-Based Courses, Internet-Based Courses, Conference Sessions, and Home-Study Courses with specified learning objectives

        Supervision of Students completing an Accredited Educational Program or Re-Entry Course (Ex: Supervision of Level 1 or Level 2 Fieldwork Students)

        NBCOT Navigator® Activities

        Professional or Community/Service Organization Presentations by Licensee

        Mentorship

        Independent Studies

AND

(3) Unacceptable Activities. Activities may not be unacceptable activities. Unacceptable professional development activities not eligible for continuing education include but are not limited to:

    (A) Any non-instructional time frames such as breaks, meals, introductions, and pre/post testing.

    (B) Business meetings.

    (C) Exhibit hall attendance.

    (D) Activities that provide information about the work setting’s philosophy, policies, or procedures or educate employees about a specific work setting.

    (E) Activities that concern business development, general professional behaviors/standards, or customer service. 

    (F) Activities that concern the self-promotion of the provider’s or licensee’s programs, products, or services.

    (G) Activities that concern general topics such as social work; defensive driving; water safety; team building; Graduate Record Examinations (GRE)®, Graduate Management Admissions Test ™(GMAT), and Medical College Admission Test® (MCAT) preparation; general foreign languages; disposal of hazardous waste; patient privacy/rights or abuse of patients; cardiopulmonary resuscitation (CPR); First Aid; Health Insurance Portability and Accountability Act (HIPAA); and Family Educational Rights and Privacy Act (FERPA).

See the Unacceptable Activities tab for further information and resources.

Unacceptable Activities

See the following regarding activities that are not pre-approved. Remember that in order to be acceptable, activities that are not pre-approved must meet further requirements, including those concerning acceptable content and categories of education; see the Other Acceptable Activities tab for further information, in addition to the full Chapter 367.

Unacceptable Activities. Activities may not be unacceptable activities. Unacceptable professional development activities not eligible for continuing education include but are not limited to:

(A) Any non-instructional time frames such as breaks, meals, introductions, and pre/post testing.

(B) Business meetings.

(C) Exhibit hall attendance.

(D) Activities that provide information about the work setting’s philosophy, policies, or procedures or educate employees about a specific work setting.

(E) Activities that concern business development, general professional behaviors/standards, or customer service. 

(F) Activities that concern the self-promotion of the provider’s or licensee’s programs, products, or services.

(G) Activities that concern general topics such as social work; defensive driving; water safety; team building; Graduate Record Examinations (GRE)®, Graduate Management Admissions Test ™(GMAT), and Medical College Admission Test® (MCAT) preparation; general foreign languages; disposal of hazardous waste; patient privacy/rights or abuse of patients; cardiopulmonary resuscitation (CPR); First Aid; Health Insurance Portability and Accountability Act (HIPAA); and Family Educational Rights and Privacy Act (FERPA).

Is the Activity an Unacceptable Activity as per §367.2(a)(3)?
Questions to ask when Determining if an Activity is not eligible for CE Credit

 Note: This is just an overview. See Chapter 367 of the OT Rules for further information and regulations.    

1. Is it unacceptable because it may be an activity that many of the employees in a particular practice setting must complete and does not meet requirements in Chapter 367, for example, a course that provides information about the work setting’s philosophy, policies, or procedures or designed to educate employees about a specific work setting?
2. Is it unacceptable because it does not meet requirements in Chapter 367 and may even be a repetitive activity, such as courses related to patient privacy/rights, HIPAA and/or FERPA, preparing for natural disasters and other emergencies, infection control, disposal of hazardous waste, CPR, the prevention of fires, etc.? (For information regarding repeating acceptable CE activities, see §367.1.)
3. Is it unacceptable because it does not meet requirements in Chapter 367, such as a course on social work; defensive driving; water safety; team building; general foreign languages, etc.? 
4. Is it unacceptable because it is a course in topics concerning business development, general professional behaviors/standards, or customer service?
5. Is it unacceptable because it is an activity that concerns the self-promotion of the provider’s or licensee’s programs, products, or services?
6. Is it unacceptable because it falls under any of the provisions in §367.2(a)(3) and/or fails to meet any of the other requirements regarding CE in the OT Rules?

Sample Unacceptable Activities:

The list that follows contains examples of topics that are NOT acceptable for CE credit. While many of these topics may enrich your relationship with your clients or enhance the success of your practice, they are not required in order for licensees to provide occupational therapy services.

Please note that this list is not exclusive. Courses in other topics may be unacceptable activities. Check to make sure each activity you intend to claim for CE is eligible for credit according to the OT Rules. 

          General Foreign Language Course

          Social Work Courses

          Defensive Driving

          Water Safety Courses

          Team Building Workshops

          GRE, GMAT, MCAT Preparation

          Courses such as CPR, First Aid, Disposal of Hazardous Waste, Patient Privacy/Rights or Abuse of Patients, HIPAA & FERPA, or similar courses 

          Customer Service or General Professional Behaviors/Standards Courses

          Business Development

          Courses concerning Self-Promotion of One’s Services

          New Employee Orientation Courses