OT Act and Rules 

Occupational Therapy Act and Rules

OT Rules
As mandated by the Texas Occupational Therapy Practice Act, the OT Board adopts rules to govern the practice of occupational therapy in the state. The rules establish a minimum standard, ensuring that the public is adequately protected from poor practice and unethical practitioners.

The rulemaking process requires the Board to propose and vote on any rules changes and to send them to the Executive Council of Physical Therapy and Occupational Therapy Examiners for review. If approved by the Executive Council, they are published in the Texas Register. Comments on the proposed amendments may be submitted no later than 30 days from the date that the proposals are published in the Texas Register. 

At the next board meeting, the board members will again review the proposed changes as well as any comments from the public. A final vote is taken on adoption of the proposed rule changes, in full or in part, based on consideration of the comments from the public. Notice of the adopted rules is published in the Texas Register, along with a response to any comments received. The rules automatically go into effect 20 days after notice of the amendments is filed, unless otherwise stated. In general, the whole rulemaking process takes approximately four to six months, depending on public comment or meeting schedules.

OT Practice Act
In 1983, the 68th Texas Legislature passed Senate Bill 1213 enacting the Texas Occupational Therapy Title Act (Vernon’s Texas Civil Statutes, Article 8851). The legislation established the Texas Advisory Board of Occupational Therapy (TABOT) and attached it as an advisory board to the Texas Rehabilitation Commission. Effective September 1, 1983, the board was charged with grandfathering by March 1, 1984, all qualified occupational therapists and occupational therapy assistants who were working in the state of Texas.

Senate Bill 690 was passed by the 73rd Texas Legislature in 1993, creating the Executive Council of Physical Therapy and Occupational Therapy Examiners. The OT Board was renamed the Texas Board of Occupational Therapy Examiners (TBOTE), and the OT Title Act was changed to the Texas Occupational Therapy Practice Act. Personnel for the OT Board and the PT Board are located in the same offices, while additional staff address administrative responsibilities for the Executive Council and both boards.

The 1999 Texas Legislature codified the OT Practice Act and incorporated it into the Occupations Code, Chapter 454. The Occupations Code contains the enabling statutes for other licensed professions, as well. The codification was intended to make the Act conform to current legal citations, terminology, and definitions and to eliminate obsolete provisions and a number of grammatical errors.

In 2001 the Texas Legislature adopted a change to the OT Practice Act through SB 692 and HB 1919. The Act was amended again in 2009 by the 81st legislature to make changes to several sections, primarily to allow the board to determine late and restoration fees and to allow the restoration of an expired Texas license by various methods. In 2011, the Act was amended by the 82nd legislature to revise the date in the section Application of Sunset Act from 2013 to 2017. 

In 2017, the 85th Legislature passed a Sunset Bill during the regular session. This bill, SB 317, continued ECPTOTE and the OT and PT Boards until their next scheduled Sunset Review in 2029.  Further changes were made to the OT Practice Act including to remove language specifying the level of degree an individual must hold in order to be eligible for licensure to instead refer to entry-level degree requirements, update references to NBCOT and the initial certification examination, and add requirements regarding policies and procedures. Additional changes from SB 317 became effective in 2019, including the discontinuation of the Board’s occupational therapy facility registration program. 

TBOTE Adopted Rule Changes – Effective June 1, 2026

The amendment will not take effect until June 1, 2026. See the current rules.

The Texas Board of Occupational Therapy Examiners has adopted an amendment to §374.1, Disciplinary Actions. The amendment will correct a typographical error.

As of June 1, 2026, the “December, 2025” compiled PDF version of the OT Rules will no longer be up to date as it will not contain the adopted changes. An up-to-date version of the compiled rules will be available from the Act and Rules page soon after the amendment takes effect and will have “June, 2026” on the cover. 

Notice of the adoption was published in the May 15, 2026, issue of the Texas Register, and a PDF version of such is available from the link below.
TBOTE Adopted Rules – Effective June 1, 2026

Notice of the proposal was published in the March 27, 2026, issue of the Texas Register, and a PDF of such is also available from the link below.
TBOTE Proposed Rules – March 2026