hand therapy certification

Everything you need to know about Hand Therapy Certification

What’s the process to become certified in hand therapy? Do I need a hand therapy certification to practice hand therapy? If not, is it worth it to still get certified?

Is Hand Therapy certification worth it?

First of all, the Hand Therapy exam pass rate is about 50%.  The pass rate for the second attempt is 65%. The test is extremely difficult and requires months of preparation.  Many OTs and PTs have reported the exam was more difficult than their national board exams.

Certified or not, any OT or PT is able to work as a hand therapist.  Certification only shows that you have passed the exam.  

Many people will tell you that it’s difficult to get a job without certification, but this is not true.  Hand Therapy jobs are in high demand, and clinics are constantly searching for a therapist to cover for vacation, holidays, or medical leave. 

One of the biggest problems hand therapists face is finding coverage when they need time off.  It’s usually difficult to find a hand therapist and why the need for hand therapy jobs remain strong.

It’s true that some clinics will only hire a certified hand therapist, but there are plenty of other places that will hire you without certification.  I’ve known Hand surgeons who have preferred hand therapists over certified hand therapists. 

While it’s a great achievement to pass the certification exam, it’s not necessary. Listed below are a list of pros and cons to help you see if becoming a CHT is important.

Hand Therapy Certification Pros and Cons

Hand Therapy Pros and Cons


  • Marketable
  • Increased knowledge base
  • Recognition


  • Low pass rate
  • Expensive ($500) 
  • Must recertify every 5 years
  • Must have 80 hours of CEUs every 5 years
  • Must have 2000 hours related to hand therapy every 5 years
  • Recertification fees

Who can be a hand therapist?  

Most hand therapists are Occupational Therapists (OT) or Occupational Therapy Assistants (OTA).  If you’re an OTA or COTA you are limited to only assisting the OT with treatments or assisting with the evaluation.  

This may include following the treatment plan of care, making splints, and working with physical agent modalities. Although OTAs are able to work as hand therapists, they are unable to be certified.

Physical Therapists can work as hand therapists too.  It makes sense that PTs work in hand therapy, because of the similar outpatient work environment.

How to get experience in Hand Therapy as a Student or Therapist?

The easiest way to get experience is during fieldwork or clinical rotations.  This is my top recommendation, because you will generally work in hand therapy as a student for 3 months and have a general idea of how to work as a Hand Therapist. Plus, you won’t need as much mentorship and can work at an outpatient clinic or directly under a physician.  This provides more flexibility to negotiate salary. 

Some outpatient practices offer mentor opportunities, but it’s not always easy to find these types of jobs.  The pay is sometimes lower, because they’re providing training.  

How to get experience in hand therapy

You can also take training courses online or through universities, but these courses can be expensive and often not necessary.  I’d recommend getting experience as a student. 

If you are a licensed therapist and don’t have hand therapy experience it’s best to start out by taking hand therapy CEU courses.  I recommend using medbridge. For this reason, I’ve actually partnered with them and you can save $150 with my discount code: OTFOCUS.

Next, shadow a hand therapist for 3-5 days, and work for a clinic that will provide mentoring.   

Certification Requirements

Currently the hand therapy certification commission requires 3 years of experience working as an OT or PT in direct practice in hand therapy with 4000 or more hours.  This does not include hours working as a student or from CEU courses.

Certification Process


  1. Begin the application online through htcc.org
  2. Submit verification for 3 years of licensure as a PT or OT.  This can come from state licensure or national boards such as NBCOT.
  3. Submit form 1 verifying 4000 hours working as a Hand Therapist.  This must be signed by a physician, therapist, or yourself if you work in an independent practice.
  4. Submit form 2 to document where you worked and how you obtained hours in Hand Therapy.
  5. Submit current state license to practice.

For additional resources visit htcc.org

You are not required to have direct observation for hours worked.  Any direct hours working in hand therapy are accepted. This may include hand therapy hours at a rehab facility or nursing home.  

You may have a therapist or physician sign form 1 to verify hours worked. If self employed, you may sign for yourself. 

Exam Preparation

  • Resources can be found here
  • Online quizzes
  • Practice exams
  • Flash cards

The Test

  • Composed of 200 multiple choice questions
  • Enrollment occurs twice per year at AMP assessment centers.
  • $500 application


The goal of this post is not to discourage you from certification.  I truly believe that preparing for and passing the exam will allow you to grow in this occupation. However, I don’t think certification is for everyone, and there are other ways to grow.  If you are up for a good challenge and are passionate about hand therapy, just take the exam.  

This site contains affiliate links. Commerce or our Publishers may be compensated when you click through links on our site.