Pursuant to T.C.A. § 63-13-204, the Board is authorized to establish requirements for assessing continued competence of licenses. On January 1, 2006, the Board shall begin to notify applicants for licensure renewal of the continued competence requirements as provided in T.C.A. § 63-13-204(d). Effective January 1, 2022, the Board shall require each licensed occupational therapist and occupational therapy assistant to participate in a minimum number of activities to promote continued competence during the twenty-four (24) months that precede the licensure renewal month. The renewal cycle will begin the first day of the licensee’s birthday month and continue to the last day of the month preceding the licensee’s birthday month.

1. (1) The requirements for continued competence activities are defined as planned learning experiences that occur for occupational therapists and occupational therapist assistants. Content of the experiences must relate to a licensee’s current or anticipated roles and responsibilities in occupational therapy. Qualified learning experiences may include theoretical or practical content related to the practice of occupational therapy; research; management; or the development, administration, supervision, and teaching of clinical practice or service delivery programs in occupational therapy. The purpose of this OCCUPATIONAL THERAPY requirement is to assist in assuring safe and effective practices in the provision of occupational therapy services to the citizens of Tennessee.
2. (2) For applicants approved for initial licensure by examination, successfully completing the requirements of Rules 1150-02-.04, .05, and .08, as applicable, shall be considered proof of sufficient competence to constitute compliance with this rule for the initial period of licensure. The use of physical agent modalities by any licensee requires additional certification pursuant to Rule 1150-02-.04.

3. (3) Occupational Therapists and Occupational Therapy Assistants are required to complete twenty-four (24) continued competence credits during the twenty-four (24) months that precede the licensure renewal month.

   1. (a) A maximum of four (4) continued competence credits during the twenty-four (24) months that precede the licensure renewal month that are in excess of the twenty-four

4. (24) credit requirement may be used to partially complete the requirement for the subsequent renewal period.

   1. (b) The subjects of any continued competence credits used to partially complete the requirement for the subsequent twenty-four (24) month period shall not pertain to:

      1. 1. The AOTA Code of Ethics; or
      2. 2. The occupational therapy portions of T.C.A. §§ 63-13-101, et seq., the Tennessee Occupational and Physical Therapy Practice Act; or
      3. 3. Chapter 1150-02, General Rules Governing the Practice of Occupational Therapy.
5. (4) Twelve (12) of the required twenty-four (24) continued competence credits must be directly related to the delivery of occupational therapy services.
6. (5) One (1) hour of the required twenty-four (24) continued competence credits shall pertain to the AOTA Code of Ethics or other ethics related continued competence activities which have implications for the practice of occupational therapy.
7. (6) One (1) hour of the required twenty-four (24) continued competence credits shall pertain to the occupational therapy portions of T.C.A. §§ 63-13-101, et seq., the Tennessee Occupational and Physical Therapy Practice Act, and shall pertain to Chapter 1150-02, General Rules Governing the Practice of Occupational Therapy.

8. (7) Suicide Prevention Training required under the “Kenneth and Madge Tullis, MD Suicide Prevention Training Act”:

   1. (a) Current Tennessee Licensees - Beginning January 1, 2020, all persons who hold an active license as an occupational therapist must complete a minimum two (2) hour training program by a Board-approved provider relative to suicide prevention at least once every four (4) years.
   2. (b) New Tennessee Licensees - An occupational therapist applying for initial licensure in the State of Tennessee on or after January 1, 2020 is not required to complete a training program on suicide prevention for two (2) years after the date of initial licensure if the applicant can demonstrate successful completion of a two (2) hour training program by a Board-approved provider that was completed no more than two (2) years prior to the application for initial licensure. OCCUPATIONAL THERAPY
   3. (c) Hours Earned - The continuing education hours earned through the training program in Part (a) or Part (b) of this subparagraph count toward meeting the continuing education requirements listed in this rule.
9. (8) Ten (10) hours of the required twenty-four (24) continued competence credits may pertain to the licensee’s current or anticipated professional role or may be directly related to the delivery of occupational therapy services.
10. (9) Continued competence credits are awarded pursuant to the Activity Table in paragraph (12).

11. (10) Approved Continued Competence Activity Providers

    1. (a) American Medical Association (AMA)
    2. (b) American Nurses Association (ANA)
    3. (c) American Occupational Therapy Association (AOTA) and AOTA approved providers
    4. (d) American Physical Therapy Association (APTA)
    5. (e) American Speech-Language-Hearing Association (ASHA)
    6. (f) International Association of Continuing Education (IACET)
    7. (g) National Board for Certification in Occupational Therapy (NCBOT)
    8. (h) Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)
    9. (i) State occupational therapy associations
    10. (j) State occupational therapy regulatory agencies
    11. (k) Substance Abuse and Mental Health Services Administration (SAMHSA)
    12. (l) Tennessee Occupational Therapy Association (TNOTA) and TNOTA approved providers
    13. (m) Tennessee Suicide Prevention Network (TSPN) and TSPN approved providers
12. (11) The Board does not pre-approve continued competence activities. It is the responsibility of the licensed occupational therapist and occupational therapist assistant to use his/her professional judgment in determining whether or not the activities offered by entities other than those specifically approved by the Board are applicable and appropriate to his/her professional development and meet the standards specified in these rules. OCCUPATIONAL THERAPY

13. (12) Activity Table (Per Twenty-Four (24) Month Cycle) Approved Activities Equivalency Max.Credits Documentation

    1. (a) Volunteer Services to 5 Hours 12 Credits Verification letter organizations, populations, Equals 1 from organizations. individuals, that advance the Credit Describe outcomes reliance on the use of one’s of volunteer service OT skills and experiences. provided. (See This excludes holding any guidelines on the elected or appointed offices. Board’s web page at Tennessee.gov/heal th)
    2. (b) Attending workshops, 1 Hour 24 Credits Certificates of seminars, lectures, Equals 1 attendance or letter professional conferences Credit from sponsor of offered by approved providers, course. as listed in 1150-02-.12(10).
    3. (c) Attending workshops, 1 Hour 12 Credits Certificates of seminars, lectures, Equals 1 attendance or letter professional conferences by Credit from sponsor. other providers.
    4. (d) Attending employer-provided 1 Hour 12 Credits Attendance records continuing education. Equals 1 or certificates with Credit name, date of course. (Attending OSHA, CPR & Safety Courses required for maintaining employment are not acceptable.)
    5. (e) Attaining an OT specialty or 10 Credits 20 Credits Award of board certification (i.e., certification within Certified Hand Therapist.) the renewal cycle.
    6. (f) Making professional 1 Hour 20 Credits Copy of presentations at state, national Equals 2 presentation, or or international workshops, Credits program listing. seminars, and conferences.
    7. (g) Panel and/or poster 1 Presentation 12 Credits Copy of presentations for state, Equals 1 presentation, or national, or international Credit program listing. workshops, seminars, and conferences. OCCUPATIONAL THERAPY Approved Activities Equivalency Max.Credits Documentation
    8. (h) Publication of an OT article in 1 Article 20 Credits Copy of publication. non-peer-reviewed publication Equals 5 (e.g., OT Practice, SIS Credits Quarterly, Advance, Community Newsletters, etc.)
    9. (i) Publication of article in peer- 1 Article 20 Credits Copy of publication. reviewed professional Equals 10 publication (e.g., journals, book Credits chapter, research paper)
    10. (j) Publication of chapter(s) in 1 Chapter 20 Credits Copy of text and occupational therapy or related Equals 10 original letter from professional textbook. Credits editor.
    11. (k) Mentoring a licensed OT 10 Hours 12 Credits Goals and colleague to improve the skills Equals 2 objectives, analysis of the protégé. (Mentor must Credits of protégé be currently licensed). performance. (See guidelines)
    12. (l) Mentoring other professionals 10 Hours 12 Credits Goals and in good standing to improve Equals 2 objectives, analysis the skills of the protégé. Credits of protégé (Mentor must be currently performance. (See licensed.) guidelines)
    13. (m) Mentoring with other 10 Hours 12 Credits Goals and professionals in good standing Equals 2 objectives to improve the skills of the Credits established in protégé. (Protégé must be collaboration with currently licensed.) the mentor and self- analysis of performance. (See guidelines)
    14. (n) Reflective occupational 10 Hours 12 Credits Verification of skills therapy practice in Equals 2 obtained. collaboration with an advanced Credits Evaluation licensed OT colleague to experience. improve one’s skill level. Analysis of learning. (See guidelines)
    15. (o) Guest lecturer, teaching OT 1 College 20 Credits Date, lecture or related academic course per Credit Hour academic course semester (must not be one’s Equals 6 title, name of primary role). For one time Credits institution, original lecture use presentation value, letter from instructor see subparagraph (f). regarding time spent in classroom, and course/lecture goals and objectives. OCCUPATIONAL THERAPY Approved Activities Equivalency Max.Credits Documentation
    16. (p) Independent reading peer- 5 Articles 12 Credits Annotated reviewed, role-related and/or bibliography and professional articles/chapters Chapters analysis of how in textbook, and writing a Equal 1 Credit articles impacted report describing the improving skills in implications for improving skills one’s role. (See in one’s specific role. Current guidelines) copyright on textbook edition, which should not exceed 5 years at time of licensure renewal. Textbooks required to be read for academic courses or audit courses are not allowed.
    17. (q) Providing professional in- 1 Hour 12 Credits In-Service training service training and/or Equals 1 attendance records, instruction for occupational Credit goals, and therapists, occupational objectives with therapy assistants, and related verification letter professionals. from supervisor.
    18. (r) Making presentations for local 1 Hour 12 Credits Date and location of organizations/associations/ Equals 1 presentation, copy groups on OT related topic. Credit of presentation or (e.g., energy conservation, program listing; back care and prevention of organization’s injury.) contact person. OCCUPATIONAL THERAPY Approved Activities Equivalency Max.Credits Documentation

    19. (s) 1. Level I fieldwork direct 1 Credit per 12 Credits Documentation supervision OT or OTA (Not Student (A licensee required, name of one’s primary employment Supervised may not student(s), letter of role.) receive verification from more than school, dates of 12 Credits fieldwork. Co- for supervision is fieldwork acceptable; maintain supervision dates & times when total.) acting as primary student supervisor. Apply appropriate credits based on time spent supervising.

        1. 2. Level II fieldwork direct 1 Credit per 12 Credits Documentation supervision OT or OTA (Not each week of (A licensee required, name of one’s primary employment supervision, may not student(s), letter of role.) per student receive verification from supervised more than school, dates of 12 Credits fieldwork. Co- for supervision is fieldwork acceptable; maintain supervision dates & times when total.) acting as primary student supervisor. Apply appropriate credits based on time spent supervising.
    20. (t) Professional manuscript review 5 Hours 12 Credits Letter from (editing) for journals or Equals 1 publishing textbooks. Credit organization, verifying time spent.
    21. (u) Formal academic coursework 1 Credit Hour 20 Credits Official transcript per from an accredited Semester educational Equals 10 institution. Credits OCCUPATIONAL THERAPY Approved Activities Equivalency Max.Credits Documentation
    22. (v) Auditing formal academic 15 Clock 12 Credits Original letter from coursework. Hours instructor regarding Equals 2 time in class or labs Credits at accredited schools. Report by OT/OTA on learning objectives accomplished.
    23. (w) Professional study 3 Hours 20 Credits Group attendance group/online study group Equals 1 records; study group designed to advance Credit goals; analysis of knowledge through active goal attainment and participation. learning. (See guidelines)
    24. (x) Outcomes of self-assessment 2 Credits for 2 Credits Acceptable and professional development Self- documents include a plan. Assessment completed formal and self-assessment and Professional professional Development development plan Plan describing how goals were met and how they impacted competence and skills.
    25. (y) Extensive scholarly research 10 Credits 20 Credits Grant funding activities, or extensive number, abstract- outcome studies (defined as executive summary research associated with, e.g., and/or copies of the grants, post graduate studies, completed peer reviewed journals) research/studies.
    26. (z) Collaborative or Clinical 5 Credits 10 Executive summary Research activities Credits and/or copies of the completed research studies or letter of verification from senior researcher or supervisor.
    27. (aa) Fellowship Training in specific 10 Credits 12 Credits Certificate awarded area. (Minimum 12 from sponsoring Weeks) organization to include dates and learning objectives. OCCUPATIONAL THERAPY Approved Activities Equivalency Max.Credits Documentation
    28. (bb) Independent learning/study 2 Hours 12 Credits CEUs, certificate of (e.g., CE articles, video, audio, Equals 1 completion and # of and/or asynchronous online Credit contact hours courses.) awarded.
    29. (cc) Synchronous online learning 1 Hour 16 Credits CEUs, certificate of offered by approved providers, Equals 1 completion and # of as listed in 1150-02-.12(10). Credit contact hours awarded.
    30. (dd) External self-study series. 1 Hour 20 Credits Certificate of Equals 1 completion. Credit
    31. (ee) Development of instructional 5 Credits 12 Credits Program description materials using alternative and media/software media such as: video, audio materials available if and/or software programs to requested during advance professional skills of validation process. others (not for proprietary use).

14. (13) Documentation of compliance.

    1. (a) Each licensee must timely submit proof of successful completion of all continued competence requirements through the Board’s approved continuing education tracking system.
    2. (b) Each licensee must retain documentation of completion of all continued competence requirements of this rule for a period of five (5) years from when the requirements were completed. This documentation must be produced for inspection and verification, if requested in writing by the Board during its verification process.
    3. (c) The licensee must, within forty-five (45) days of receipt of a request from the Board, provide evidence of continued competence activities.
    4. (d) Any licensee who fails to complete the continued competence activities or who falsely certifies completion of continued competence activities may be subject to disciplinary action pursuant to T.C.A. §§ 63-13-108, 63-13-209, and 63-13-210.

15. (14) Reinstatement/Reactivation of an Expired, Retired or Inactive License.

    1. (a) Expired, retired, or inactive for three (3) years or less - An individual whose license has expired, or has been retired or inactive for three (3) years or less shall submit the appropriate application and documentation of continued competence, as provided in paragraph (13), for the two (2) year period that precedes the reinstatement/reactivation year.

    2. (b) Expired or retired more than three (3) years.

       1. 1. An individual whose license has expired or has been retired for more than three

16. (3) years shall submit the appropriate application and documentation of OCCUPATIONAL THERAPY continued competence, as provided in paragraph (13), for the two (2) year period that precedes the reinstatement/reactivation year; and

    1. 2. The Board may, at its discretion, require additional education, supervised clinical practice, or successful passage of examinations.
17. (15) The Board, in cases of documented illness, disability, or other undue hardship, may waive the continued competence requirements and/or extend the deadline to complete continued competence requirements. To be considered for a waiver of continued competence requirements, or for an extension of the deadline to complete the continued competence requirements, a licensee must request such in writing with supporting documentation before the end of the two (2) year period in which the continued competence requirements were not met.

Authority: T.C.A. §§ 63-13-204, 63-13-209, 63-13-210, 63-13-215, and 63-13-216. Administrative History: Original rule filed March 24, 2005; effective June 7, 2005. Amendment filed April 17, 2007; effective July 1, 2007. Amendment filed August 28, 2012; effective November 26, 2012. Amendments filed October 12, 2021; effective January 10, 2022. Amendments filed March 23, 2026; effective June 21, 2026.